We report a case of sporotrichosis caused by a lesion due to a rat bite. A 78-year-old woman had been bitten on her finger by a rat. Two months later, granulomatous skin lesions developed along her arm. Oral antibiotics and topical antimycotics were ineffective. Biopsy from a nodule on the wrist was performed, and histopathological analysis revealed granuloma formation with the presence of giant cells. Pus culture from the erosive nodule was performed by inoculation on Mycosel agar and incubation at room temperature. The culture showed round, white colonies resembling Candida species. However, giant culture and slide culture confirmed the presence of Sporothrix schenckii. The patient was successfully treated with oral potassium iodide for 7 months. Sporotrichosis due to a rat bite is rare. However, sporotrichosis is being recognized as a zoonotic disease, as some cases of sporotrichosis caused by animals (for e.g., cat, dog, horse, and cow) have been reported recently. We should consider sporotrichosis as a differential diagnosis while examining antibiotic-resistant lesions due to animal bites or scratches.

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Case1 : A 37-year-old woman who was pregnant noticed brown nodules and papules on both sides of the nipples and areolas. Case2 : A 30-year-old woman noticed the asymptomatic thickening and pigmentation of the nipples and areolas.We diagnosed as nevoid hyperkeratosis of nipple and areola（NHNA）by the clinical and histopathological findings in both cases. NHNA, which is more common in women of childbearing age, is a relatively rare disease characterized by hyperkeratosis and papillomatosis of the areola and nipple. It was first introduced by Tauber in 1923, and classified into three types as hyperkeratosis of nipple and areola（HNA）by Franckel in 1938. The pathogenesis is still unknown, and the typical treatment has not been established. We’d like to report two cases of NHNA, and discuss about its clinical and histopathological features and differential diagnosis.

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Hand-washing is the one of the most important nursing techniques for prevention of nosocomial infection as described in CDC Guidelines on Hand Hygiene in Health Care published by the Center for Disease Control and Prevention (CDC) in 2002. Therefore, nurses wash their hands frequently, and hand eczema (hand roughening) can become a problem as the frequency increases. Hand roughening changes the bacterial flora on the skin and facilitates infection by the pathogen, Staphylococcus aureus. Therefore, hand-care not only improves the QOL of health care workers, but is also important for nosocomial infection control. Shizuoka Cancer Center, Pharma Valley Center, and Sunstar Inc. co-developed ceramide2- and ceramide5-containing hand cream “Pro’s Choice Hand Cream,” and evaluated its effect on improving hand roughening, moisturizing effect, safety for volunteers with hand roughening at the same level as nurses, in comparison with a commercial product. Both products improved hand roughening for 90% of volunteers in 4 weeks, with comparable moisturizing effect and safety. With regard to usability, the “intention for continuous use” score was the same for both products, but the “texture” score was significantly higher for Pro’s Choice Hand Cream than the commercial product. This study suggested that improvement of hand roughening and skin moisturizing effect as well as safety of Pro’s Choice Hand Cream are equivalent to a commercial product, and its acceptability is greater than the commercial product. Pro’s Choice Hand Cream is helpful for the hand care of nurses and others at risk of hand roughening.

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