Focal infections are deeply involved in the pathogenesis of palmoplantar pustulosis (PPP); tonsils and dental foci are the major primary foci. Cooperation with otolaryngologists and dentists is required for the treatment of focal infections. We conducted a questionnaire survey of dentists in the northern and eastern Hokkaido areas in order to promote dental foci treatment for PPP. There were differences in the thoughts of dermatologists and dentists regarding the cause of PPP; most of the latter believing it to be a metal allergy. In addition, there were issues in sharing medical information from dermatology to dentistry and cooperation between the two departments. We need to promote inter-departmental collaboration by creating opportunities for dentistry and dermatology to interact and improving information sharing.

A 19-year-old woman presented with a two-month history of hair loss initially treated as alopecia areata. Medical interview revealed weight loss concurrently with hair loss. Additional examinations revealed pancytopenia, positive anti-nuclear antibody, anti-dsDNA-IgG antibody, anti-Sm antibody, and decreased complement levels. Skin biopsy showed no evidence of scarring alopecia. Alcian blue staining demonstrated mucin deposition in the deep dermis and subcutaneous tissue, and direct fluorescent antibody showed IgG and IgM deposits in the epidermal basement membrane and follicular epithelium. The patient was diagnosed with non-scarring alopecia associated with systemic lupus erythematosus (SLE). Her alopecia improved with oral hydroxychloroquine. Non-scarring alopecia is one of the major cutaneous manifestations of SLE included in recently proposed classification criteria. It is important to list SLE in the differential diagnosis of alopecia.

Doxorubicin is more commonly used in combination than alone for treating angiosarcoma. We report a case of taxane-resistant cutaneous angiosarcoma of the scalp that responded to doxorubicin monotherapy. An 82-year-old man diagnosed with angiosarcoma of the scalp had received electron radiotherapy and weekly paclitaxel therapy. Despite continued chemotherapy, he experienced local recurrence on the scalp eight months after initial treatment. Second-line eribulin therapy proved ineffective, but triweekly docetaxel suppressed disease progression for 11 months. He subsequently started oral pazopanib therapy, but discontinued it within two months owing to hepatic disorder. The tumor lesions spread to his face diffusely, forcing his eyes closed. We initiated doxorubicin monotherapy, which reduced tumor invasion to the extent that the patient could open his eyes. Seven courses of doxorubicin treatment were administered without severe adverse events. This treatment was able to slow the progression of local recurrence, although lung metastasis ultimately caused his death.

We analyzed the onset time after vaccination, type of cutaneous reactions, and clinical course of 22 patients (4 male and 8 female patients with Moderna vaccine, and 2 male and 8 female patients with Pfizer vaccine) from May to August, 2021. No patient exhibited systemic manifestations. Among the 12 patients who received Moderna vaccine, the onset time in 6 patients with pernio type and in 2 patients with delayed large local reaction type were 6-10 days after vaccination. Two Moderna patients had morbilliform type; one had contact dermatitis without vesicles, and the other urticaria type was after 2-4 days after vaccination. Among the 10 patients who received the Pfizer vaccine, the onset times in the 2 patients with the contact dermatitis type with vesicles, the one patient with pityriasis rosea type, and the one with large local reaction type were 2-8 days after vaccination. The four patients with morbilliform type had variable onset time of 7-22 days. Six patients with morbilliform type, 3 patients with pernio type, and one patient with contact dermatitis type were administered prednisolone, 20-30 mg/day for 10-14 days, and the other patients received anti-histamine drugs and topical corticosteroid treatment. Most of the cutaneous reactions disappeared within 2 weeks after treatments. Although the precise mechanism of cutaneous reactions after COVID-19 vaccination remains unclear, clinical knowledge of such reactions may help the daily practice of healthcare professionals and provide patients with correct information.