We retrospectively surveyed the use of a two-compound ointment containing calcipotriol and betamethasone dipropionate at our hospital during the 18-month period from October- 2014 to April- 2016. The subjects were 125 patients with psoriasis (96 men, 29 women), ranging in age from 21 to 90 years (average age, 57.8 years). The psoriasis types were psoriasis vulgaris in 114 patients (91%), psoriasis arthropathica in 8 (6%), guttate psoriasis in 2 (2%), and psoriatic erythroderma in 1 patient (1%). The combination therapies were biological treatments in 7 patients (6%), narrow-band ultraviolet B (UVB) in 14 (11%), combination therapy with narrow-band UVB and etretinate in 7 (5%), cyclosporine in 10 (8%), and external preparations alone in 85 patients (68%). Overall, 100 patients (80%) with psoriasis continued the treatment with the two-compound ointment. Twenty-five patients (20%) discontinued the two-compound ointment and restarted their prior external preparations. The reason for the discontinuation of the two-compound ointment was that the prior external preparations, which were mostly ointments comprising mixtures of corticosteroids and vitamin D3 analogues, had been more effective. Patients who discontinued the two-compound ointment received treatment with topical therapy mostly and had erythematous plaque with thick scale and/or strong infiltration on the back or lower limbs.

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Background
Orally administerd antiviral therapy for herpes simplex shortens the time to lesion healing. Although the traditional therapy for recurrent episodes in Japanese adults is given three times a day for 5 days, a patient-initiated, single-day regimen has been widely used worldwide. This study was conducted to assess the efficacy and safety of high-dose, short-duration, early Famciclovir (FCV) therapy, compared with placebo, in Japanese adult patients with recurrent herpes simplex (recurrent herpes labialis and recurrent genital herpes).
Methods
This multicenter, randomized, double-blind, parallel-group, placebo-controlled study compared one-day oral FCV (1000 mg twice) with placebo for the treatment of recurrent herpes simplex. Patients were instructed to initiate therapy within 6 hours after onset of prodromal symptoms, and take the second dose 12 hours later.
Results
A total of 1134 patients were randomly assigned to receive self-initiated therapy with FCV or placebo. In all, 531 patients had prodromal symptoms of a recurrent herpes simplex, started study medication, and were included in the intent-to-treat (ITT) and safety populations. A total of 373 patients developed vesicles (modified ITT population). FCV shortened the median time to healing of non-aborted lesions (i.e., those that did not progress beyond the erythema/papule stage) from 4.7 to 5.7 days, compared with placebo (P=0.008). The secondary endpoints, time to virus shedding cessation and time to complete crusting, showed similar results (P=0.042 and 0.004, respectively). Adverse events in the FCV group were infrequent overall and of mild severity.
Conclusion
A single-day regimen of FCV shortened the time to healing of recurrent herpes simplex lesions by approximately 1 day compared with placebo, and was well tolerated and safe. Therefore, this one-day FCV treatment regimen can be regarded as a useful treatment option for herpes simplex.

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In recent years, options of drugs for the treatment of acne vulgaris, particularly those of topical drugs, have increased in Japan to levels similar to those in Europe and America. Treatment guidelines that describe their selection and use have also been established. In clinical practice, however, appropriate drugs for individual patients with different symptoms cannot be chosen automatically by following the guidelines’ recommendations; sometimes a continuing process of trial and error taking various characteristics of patients into account is necessary. In this consensus meeting, five dermatologists who are expert at acne treatment drafted plans on the selection of drugs to treat selected patients, representative of common patients with acne vulgaris that physicians often see in routine clinical practice, based on the patients’ photographs, age, lifestyle, economic status, etc. Then, 27 dermatologists actively involved in acne treatment discussed the plans, and consensus was achieved. Here we report the results of the discussion for a total of 13 cases, including facial acne vulgaris (6 cases) from 3 different age groups; truncal acne vulgaris (2 cases); and special cases of mandibular acne (1 case), acne with atopic dermatitis (2 cases), post-inflammatory erythema caused by acne (1 case), and post-inflammatory hyperpigmentation caused by acne (1 case), to aid in their treatment.

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The patient was a 53-year-old woman who was living in a Tokyo ward and had no history of contact with soil, including gardening. However, she did have several cats, including some stray cats. An insect bite on the back of her right hand 6 months prior to the initial examination caused a rash, which was protracted and became aggravated, spreading as far as the wrist and forearm from the proximal back of the hand. In July 201X, she underwent initial examination in our department. Small to large bean-sized red nodules were distributed on the back of her right hand in a linear pattern like stepping stones. Yellow crusting had formed at the base of her index finger, and superficial erosion was observed at the back of her hand, with fusion in some areas. Several short linear scars were visible on the forearm. Mycologically, Sporothrix schenckii species complex was isolated from both the scales and biopsy tissue of the skin lesion using Sabouraud dextrose agar at 25 °C and further identified as S. globosa via genetic analysis. The histopathological examination of the nodule on the right hand revealed an irregular acanthosis, showing pseudocarcinomatous hyperplasia. Neutrophilic microabscess and granulomatous inflammatory cell infiltration in the dermis were also observed. Therefore, the patient was diagnosed with lymphatic sporotrichosis. She was administered oral potassium iodide 300 mg/day for 14-days and itraconazole 100 mg/day for 3 months, which alleviated the cutaneous lesions. The mechanism of spontaneous remission was considered during the course The infection route may have been infection via soil adhered to a cat or zoonotic infection from an infected cat. Genetic analysis utilized in our case as well as recent domestic reports have shown S. globosa as the causative microorganism, as well as the predominant species of sporotrichosis nowadays.

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An 8-year-old boy presented with bilateral lower extremity purpura, pain in the bilateral wrists, left ankle, and bilateral knees, and fever. Redness of the pharynx and tonsils and palpable purpura involving the entire bilateral lower extremities were observed at initial consultation; skin biopsy was performed on the lower extremity purpura. Based on pathological findings of leukocytoclastic vasculitis, the child was diagnosed with Henoch-Schönlein purpura. Although treatment was initiated with oral vitamin C, tranexamic acid, and acetaminophen, with topical application of steroid, arthralgia persisted and new eruptions developed. Diaphenyl sulfone (DDS) was administered at 1 mg/kg per day, and the symptoms rapidly improved. DDS was gradually tapered and oral administration of DDS ended approximately 6 months after initial use. The patient has had no recurrence for one year following completion of treatment.

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