In recent years, the importance of assessment of quality of life (QOL) of patients has come to be gradually recognized. Patients with atopic dermatitis (AD) may experience intense itching and suffer discrimination on the basis of appearance, resulting in decreased QOL. In this study, we assessed QOL of patients with AD who had received inpatient treatment at our department. In the Dermatology Quality of Life Index (DLQI)-based QOL assessment performed on admission, all question items received high scores; in contrast, at the time of discharge after inpatient therapy, all these items received significantly lower scores. Additionally, the results of severity classification of AD, based on the Japanese Dermatological Association guidelines and the scores on itching visual analogue scale, as well as levels of serum thymus and activation-regulated chemokine (TARC) and lactate dehydrogenase—which are disease progression markers in blood—had significantly improved after hospitalization. Furthermore, DLQI scores of all items were positively correlated with serum TARC levels on admission, which indicated that QOL was increasingly impaired in patients with severe AD. On the contrary, there was no correlation between the DLQI scores of most items and serum TARC levels at discharge, which may be explained as follows: reduction in DLQI scores and improvement in QOL because of remission of symptoms on the skin surface observed at discharge. However, inclusion of patients with relatively high serum TARC levels might have prevented the demonstration of a correlation. In AD treatment, we recommend that clinicians consider evaluating both skin manifestations as well as QOL, in addition to monitoring disease progression markers, such as serum TARC.

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Objective : Dovobet^® ointment, a topical medication combining calcipotriol hydrate and betamethasone dipropionate (i.e., both activated vitamin D₃ and a corticosteroid) became available in Japan in September 2014. We investigated the usefulness of Dovobet^® ointment during routine treatment of Japanese outpatients attending our dermatology department from March to September 2015. Results : There were a total of 111 psoriasis patients, and Dovobet^® ointment was prescribed to 67 patients (60.4%). Among these patients, the continuation rate of treatment with Dovobet^® ointment was 78.0% (46/59 patients), after excluding 3 patients who failed to attend scheduled visits and 5 patients who discontinued this study owing to clinical trial participation. Analysis of the 15 patients who were switched from prior topical therapy with clobetasol propionate (Clobetasol), one of the strongest steroids, to Dovobet^® ointment showed that complete switching to Dovobet^® ointment was possible in 11/15 patients (73.3%). Conclusion : Treatment with Dovobet^® ointment could be favorably continued in 68.7% of the patients, and 72.3% of these patients were stable on Dovobet^® monotherapy. This topical medication was shown to be a readily acceptable treatment for psoriasis. Treatment of psoriasis with Dovobet^® ointment was considered to be more desirable in terms of efficacy, safety, and cost compared with the use of corticosteroids from the strongest class.

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An 80-year-old man had a black-blue nodule on his left cheek and its size increased to 7 mm diameter over the course of 1 year. Based on the clinical symptoms and dermoscopic findings, nodular melanoma, basal cell carcinoma or blue nevus was suspected. The nodule suddenly ruptured during the follow-up visits, and the lesion was suspected as basal cell carcinoma with hemangioma. A total resection biopsy was performed. Histopathological findings showed a pyogenic granuloma including intravascular papillary endothelial cell hyperplasia (IPEH). Pyogenic granulomas usually show vivid red to dark red color by dermoscopy. It is rare that pyogenic granuloma exhibiting a black-blue color as in our case. A rare observation with a black-blue color was speculated due to repeated recanalization of the thrombus by IPEH. A solid nodular lesion showing a black-blue color was recommended to perform a biopsy to confirm the diagnosis.

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