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.

【はじめに】小児精索静脈瘤は様々な症状を呈する．精巣容積左右差，陰嚢部腫瘤は外科治療で改善が期待できる．しかし陰嚢部痛の外科治療効果に関する詳細な報告はない．今回，当科の小児精索静脈瘤を後方視的に検討し，陰嚢部痛に対する治療効果を明らかにすることを目的とした．【対象と方法】対象は 2016～2021 年に当科で手術を施行した 6 例の小児精索静脈瘤とした．手術は腹腔鏡下内精血管切離術を行った．術前後の症状の変化，精巣容積を評価した．【結果】症例 1（10 歳，精巣容積左右差あり，Dubin andAmelar’s 分類 G1），症例 2（12 歳，精巣容積左右差あり，陰嚢部痛あり，G3），症例 3（10 歳，陰嚢部痛あり，G1），症例 4（10 歳，G2），症例 5（14 歳，G2），症例 6（14 歳，G3）であった．術後に陰嚢部腫瘤と精巣容積左右差は改善した．陰嚢部痛はその他症状の重症度に関わらず改善した．術後合併症は認めなかった．【結論】小児本症の外科治療は陰嚢部痛にも治療効果がある可能性が示唆された．