The Japanese Journal of Dermatology
Online ISSN : 1346-8146
Print ISSN : 0021-499X
ISSN-L : 0021-499X
Volume 127 , Issue 10
Showing 1-9 articles out of 9 articles from the selected issue
Seminar for Medical Education
Case Reports
  • Masayuki Suzuki, Satomi Hosoda, Tomoko Yamada, Takeo Maekawa, Mayumi K ...
    2017 Volume 127 Issue 10 Pages 2313-2319
    Published: September 20, 2017
    Released: September 22, 2017

    We report a 77-year-old Japanese man diagnosed with bullous pemphigoid (BP) who did not respond to systemic corticosteroids, but succeeded in achieving remission by a repetitive treatment with IVIG infusions as an adjuvant combined therapy. Fifty mg daily of oral prednisolone (PSL) was initiated, but was ineffective. Double-filtration plasmapheresis, minocycline and nicotinamide were administrated as an adjuvant combined therapy, and the skin lesions improved. Thereafter the dose of PSL was tapered, but the skin lesions soon worsened. During the third exacerbation, a bladder carcinoma recurred, and lung tuberculosis was suspected because of an abnormal chest X ray shadow. To treat the exacerbation of BP skin lesions, IVIG therapy was restarted. After 5 cycles of IVIG therapy, he achieved clinical remission. Thereafter, IVIG therapy was continued to prevent an exacerbation of BP, enabling a decrease in the dose of PSL. After he received a total of 16 cycles of IVIG therapy, and remained in remission with 15 mg PSL daily for three months after the last cycle. IVIG therapy can be a useful adjuvant therapy for patients with BP under immunosuppressive treatments who also have internal malignancies as well as serious infection.

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  • Yuri Kinoshita, Aya Yamase, Takashi Morita, Hideyuki Mitsuwa, Marina T ...
    2017 Volume 127 Issue 10 Pages 2321-2324
    Published: September 20, 2017
    Released: September 22, 2017

    A 56-year-old man presented with a nodular lesion on the head. The lesion had gradually increased over recent years. He had a 15×15 mm reddish nodule with erosion, and an erythematous prominence in the center. The nodule was surgically excised in January of 2017. Pathologically, syringocystadenoma papilliferum, tubular papillary adenoma, and apocrine gland cyst coexisted, so it was diagnosed as a recently proposed "tubular papillary cystic adenoma with apocrine differentiation". We discussed this new concept in the paper.

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  • Mamitaro Ohtsuki, Hidehisa Saeki, Hitoe Itakura, Hidemi Nakagawa
    2017 Volume 127 Issue 10 Pages 2325-2338
    Published: September 20, 2017
    Released: September 22, 2017

    Ixekizumab targets IL-17A, which plays a vital role in the pathogenesis of psoriasis. Results from multinational, randomized, double-blinded, placebo-controlled, parallel-group studies showed that, after 12 weeks treatment with ixekizumab, psoriasis area and severity index (PASI) 75 response rate was 77.5% to 89.7%, PASI 90 response rate 59.7% to 70.9%, and PASI 100 response rate 30.8% to 40.5%, respectively in patients with plaque psoriasis. In an open-label single-arm study in Japan, PASI 75, 90 and 100 response rates were 98.7%, 83.3% and 32.1%. Ixekizumab also showed efficacy in patients with psoriatic arthritis, erythrodermic psoriasis, and pustular psoriasis. The safety profile of ixekizumab was similar to that of other biologic agents; thus, it is considered that ixekizumab treatment can be safely managed. In this article, we summarize the pharmacological properties, efficacy, and safety of ixekizumab.

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