Introduction: The burden of the medical costs and hospitalization period of 1-stage immediate breast reconstruction with implants remains unclear. We investigated and examined them from the viewpoint of patient burden.
 Method: We investigated the medical costs of hospitalization for 13 cases of 1-stage immediate breast reconstruction with implants (P1) and 10 cases of 2-stage immediate breast reconstruction (P2).
 Results: P1 medical costs of hospitalization were 1,067,732 yen, and those of P2 were 1,681,579 yen. The respective hospitalization periods were 9.5 days and 18.0 days.
 Discussion: A difference of about 610,000 yen was found between P1 and P2 in inpatient medical costs, with P1 constituting a smaller burden for patients. On the other hand, the drawbacks of P1 in terms of plastic surgery and for medical institutions, such as the reduced price of reconstruction cost for immediate breast reconstruction, were also clarified.
 Conclusion: When P1 and P2 were compared, P1 was found to require lower inpatient and outpatient medical costs as well as a shorter hospitalization period. However, current restrictions on the use of acellular dermal matrices and the lower reconstruction cost in P1 remain obstacles.

 Eyelid cleft (coloboma) and ankyloblepharon are rare congenital malformations. There is no report of their diagnosis along with skin tumor or hyperplasia. Herein, we report a case of congenital skin tumor of the eyelid in a 1-month-old boy with ankyloblepharon. We excised the skin tumor, but pathological examination did not reveal tumor tissue. This case was suspected as a congenital malformation similar to eyelid cleft or hypoplasia complicated by skin hyperplasia. However, to the best of our knowledge, there are no reports of skin hyperplasia in patients with eyelid cleft or lateral ankyloblepharon; therefore, we suspect this case to be a rare type of congenital eyelid malformation.

 Phototherapy is an innovative treatment for acne vulgaris that is minimally invasive and simple. An 11-year-old boy consulted our hospital for right lower eyelid edema. Despite taking a thorough history of present illness, we were unable to make a preoperative diagnosis. After the surgery, the father informed us that his son had been diagnosed with acne vulgaris and had undergone xenon phototherapy at a dermatology clinic. A red bulge had appeared on his lower eyelid the next day that had gradually expanded. We diagnosed the patient as thermal skin lesion caused by phototherapy. Our findings suggest the importance of careful medical history taking for all medical examinations, as it may help physicians to provide patients with a definitive diagnosis and begin appropriate treatment. Moreover, paying close attention to adverse events post-administration is crucial.

 Most Mycobacterium tuberculosis infections are pulmonary tuberculosis, but occasionally extrapulmonary tuberculosis occurs in organs other than the lungs. Extrapulmonary tuberculosis most often occurs in the lymph nodes or chest wall, and tuberculous myositis is very rare.
 A 71-year-old man with a history of pulmonary tuberculosis developed swelling and pain in his thigh during oral steroid therapy. Muscle biopsy and culture tests were performed, and Mycobacterium tuberculosis was detected. Because there were no other active tuberculosis lesions, he was diagnosed with tuberculous myositis. It is thought that his tuberculosis had reactivated due to immunosuppression caused by steroid use, which resulted in myositis. He was initially treated with anti-tuberculosis drugs; however, as an inter-muscular abscess formed, we performed surgical resection. Postoperatively, there was no recurrence of myositis.

 Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare, low-grade, locally recurring neoplasm. No clear treatment plan has been established because there are few case reports, especially in Japan. The present report describes a PHAT which developed in the forearm of an 83-year-old male. According to previous reports, PHAT is most common in the subcutaneous tissue of the lower extremities of middle-aged adults. Since there are no characteristic clinical course or laboratory findings for this tumor, it is often diagnosed as hemangioma or lipoma. Histologically, it needs to be differentiated from schwannoma and sarcoma, but can be diagnosed by additional immunostaining. Even in cases where no metastases have been reported, wide resection and long-term follow-up should be considered due to the high local recurrence rate. After marginal resection, our patient was well with no evidence of disease for 6 months.

 Rectovaginal fistulas caused by obstetric trauma can result in the release of uncontrolled flatulence or stool from the anorectal tract. This could lead to severe impairment of the quality of life and social and sexual lives of the patient. We report the case of a 42-year-old female who presented with a rectovaginal fistula that occurred after vaginal delivery in fourth-degree perineal laceration. The fistula was repaired 7 months after delivery via the vaginal approach, and the submucosal tissue and rectal mucosa were sutured. The rectovaginal septum was repaired using a gluteal fold flap to transpose well-perfused tissue for wound healing. At 6 months postoperatively, there has been no recurrence and the patient does not feel any disability.

 There are various forms of polysyndactyly, and although several classification methods have been investigated, a standardized classification method has not been established to date. Herein, we report a case of polysyndactyly with skin and bone fused at different sites, which did not match any existing classification methods.
 According to the literature, in cases of multiple toes with bony abnormalities, an apoptotic disorder between the toes causes cutaneous syndactyly, followed by the formation of bony abnormalities in the fused area. However, this developmental mechanism cannot explain how the cutaneous component of the union of the toes differed from the bone fusion site that was observed in the present case. Thus, the present case is assumed to be a rare deformity in terms of embryology.