Generalized pustular psoriasis (GPP) is a rare and intractable form of psoriasis and is considered an intractableand rare disease (known as nanbyo in Japanese) under the Act on Medical Care and Social Supports for Patientswith Intractable and Rare Diseases. GPP often develops in patients with plaque psoriasis, the most common formof psoriasis. The number of patients with a GPP designation is approximately 2000. Every year, approximately80 patients with moderate to severe GPP are newly eligible for subsidizing the expense of medical costs based ondesignation. Treatment for psoriasis, including GPP, has undergone major advances in the last 15 years. Recentepidemiological studies have shown that the quality of life of GPP patients has improved in parallel with the advance of treatment. In addition, through a survey of a claim database, we recently elucidated the risk factors forthe development of GPP in patients with psoriasis vulgaris. In this article, I discuss the results of recent epidemiological studies on GPP. Further research should contribute to the understanding of this rare disease, improvementof disease management, and improvement of patient QoL.

A system for accrediting medical schools has been established to determine whether or not medical schoolsmeet international standards for medical education. Nihon University School of Medicine underwent an on-siteinspection by the Japan Accreditation Council for Medical Education (JACME) in December 2022. As part of theaccreditation process, medical schools are evaluated on whether they have the necessary personnel and facilities,an adequate educational environment, and fair administration and management in accordance with their established mission. Another important evaluation perspective is whether or not medical schools provide outcomebased education. In outcome-based education, it is not a matter of what kind of classes the medical school provides, but rather, it is essential that students have acquired a set of skills required for medical practice at the timeof graduation. The results of the evaluation were communicated in September 2023, and accreditation was grantedfor a period of three years. There are two reasons why the accreditation period was shortened from the standardseven years to three years. One is the scandal involving Nihon University headquarters in 2021. It was assessedto be “nonconforming” in terms of administration and management, and it was noted that reforms should be promoted to restore the trust of society. The other is that the evaluation stopped at a “partial conformance” rating inmany other evaluation items. It was mentioned that the educational content was not sufficiently outcome-basedand that student evaluation and the evaluation of educational programs were also insufficient. In this paper, wewould like to address each of these issues and explain in detail the challenges that must be addressed in time forthe reassessment in three years’ time.

Introduction: The therapeutic effects of pediatric varicocele surgery on symptoms other than testicular lateralityare unclear.Subjects and Methods: Six patients were included during the six-year period from 2016 to 2021 in this study.Laparoscopic varicocelectomy was performed. The symptoms and testicular volume resulting from surgery wereevaluated.Results: Patient 1 (10 years old, testicular laterality, scrotal mass G1), Patient 2 (12 years old, testicular laterality,scrotal pain, scrotal mass G3), Patient 3 (10 years old, scrotal pain, scrotal mass G1), Patient 4 (10 years old, scrotal mass G2), Patient 5 (14 years old, scrotal mass G2), and Patient 6 (14 years old, scrotal mass G3) were included. The pain improved, and the mass disappeared. There were no postoperative complications.Conclusion: The surgical indications for this disease in children include laterality of testicular volume and scrotalpain.