A 70-year-old man with a history of ulcerative colitis had been suffering from lacrimation and blistering of the skin for 3 years. At the referral to our department, physical examination revealed scattered hyperpigmentation and erosions on the extremities and trunk, a vegetating plaque in the umbilical fossa, erosions on the eyelid conjunctiva, and paving stone appearance on the palate and buccal mucosa. Histopathology showed epidermal hyperplasia, subepidermal edema, and a dense infiltrate of eosinophils and neutrophils. Direct immunofluorescence of the initial biopsy tissue showed IgG and C3 deposition in the epidermal basement membrane and intercellular IgA deposition in the epidermis; in contrast, our biopsy tissue was negative. The skin erosions improved after oral diaphenylsulfone. We performed a serological analysis and discussed differentiation from other diseases.

Patients with asymptomatic, hardly visible red spots rarely visit dermatological clinic. We inxestigated the chronological change in the number of cherry hemangiomas (CH) in the arms, chest and abdomen in 258 Japanese women. Tiny CH with diameters<0.5 mm were observed from the late teens and present in 77.9% (60/77) of women over the age of 60. CH with diameters≥0.5 mm were observed in women in their late 20s and present in 72.7% (56/77) of those over the age of 60; they often coexisted with tiny CH. The awareness that tiny CHs develop as early as the late teens may be helpful for differential diagnosis from other diseases with tiny vascular lesions.

An onychomatricoma (OM) is a rare, benign, epithelial fibrous tumor of unknown etiology that develops in the nail matrix of fingers and toes. It is classified into two types, OM-type 1 and OM-type 2, depending on the site of onset in the nail matrix. In OM-type 1, dermoscopy of the tip of the nail plate shows many lumina with clear borders side by side; in OM-type 2, a tubular structure with unclear borders and a honeycomb-like or spiral shape is observed. By preoperatively differentiating each case by dermoscopy, it is possible to predict the extent of nail matrix resection and the degree of postoperative nail plate regeneration, which is possible in OM-type 1. Careful treatment is recommended in all cases, even in OM-type 2, where the resection range is generally wider.