In addition to therapeutic options such as steroid ointment, immunosuppressive drugs and ultraviolet phototherapy, recent reports have demonstrated the clinical efficacy of topical vitamin D₃ for vitiligo vulgaris. However, there seems to be little clinical effect of vitamin D₃ without combination of ultraviolet exposure. In the present study, we evaluated the clinical difference of sun illumination versus narrowband UVB in combination with topical tacalcitol by assessing the change of lesion size and that of color tone by a spectrophotometer. Thirty-three vitiligo patients were composed of 19 treated with sun illumination and 14 treated with narrowband UVB accompanied by topical tacalcitol. The mean percent size reduction was higher in the group treated with sun illumination than the narrowband UVB treated group (29% vs 23%). Delta L score, which represented the difference of whiteness between lesional and perilesional skin, was decreased shortly with the combination of tacalcitol and sunbathing but not with narrowband UVB (p＝0.0906). Taken together, we consider that sun illumination after topical tacalcitol administration may induce natural repigmentation and be an alternative therapeutic option for vitiligo vulgaris. Skin Research, 10: 485-493, 2011

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A 40-year-old man with gastrointestinal stromal tumor (GIST) in the rectum had been treated with imatinib mesylate (Glivec^®) at a dose of 400mg per day. Since the 15th day of the treatment course, he suffered from fever, erythema on his chest, and subsequent hyperemia of bulbar conjunctiva and oral erosion. Erythematous macules with target lesions spread to his trunk and extremities (＜10% body surface area), and severe liver dysfunction occurred. These findings led us to diagnoses imatinib mesylate–induced Stevens-Johnson syndrome. Further administration of imatinib mesylate was stopped. Treatment with intravenous methylprednisolone of 500mg per day for 3 days followed by oral prednisolone of 40mg per day for 4 days and gradual reduction of the dose of prednisolone over 2 months improved his eruptions and liver function. Although his tumor had partially decreased in size after using imatinib mesylate, further use of it was avoided because of severe side effects. Instead, sunitinib malate was given but was stopped due to recurrence of liver dysfunction.Skin Research, 10: 494-499, 2011

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We report here two cases of arteriovenous hemangioma. (i) A 59-year-old man who had suffered from chronic liver dysfunction for about 20 years and was diagnosed with liver cirrhosis associated with chronic hepatitis C 5 years ago; (ii) A 70-year-old woman who had suffered from chronic hepatitis C for about 20 years. The first patient showed asymptomatic reddish round nodules on the right side of the lower jaw. The second patient showed an asymptomatic reddish round nodule on the nose. Histopathological analysis of the tumors revealed aggregates of proliferating blood vessels, consisting of intermingling thick- and thin-walled vessels in the dermis lined with a single layer of endothelial cells. Elastic van Gieson staining showed no apparent internal elastic lamina but thin elastic fiber in the thick-walled artery-like vessels. These clinical and pathological findings were consistent with the diagnosis of AVH. Although the pathogenesis of AVH is unknown, several cases of AVH associated with chronic liver diseases have been described and it has been suggested that AVH may be a noteworthy dermadrome of chronic liver diseases.Skin Research, 10: 500-504, 2011

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Three cases of retronychia are reported. Case 1 was a 68-year-old male with retronychia affecting the left great toe, with a 3-year history. Avulsion was performed and revealed an underlying nail plate, which was removed. Case 2 was a 44-year-old female with retronychia affecting the right great toe. She had fallen on an escalator three months previously. Avulsion was performed. Case 3 was a 12-year-old female with retronychia affecting the right great toe, with a 3-week history. Ten days later, the top nail-plate fell off spontaneously, and the underlying nail plate was removed. In all three cases, the lesions (paronychia) did not respond to systemic antibiotics. All three cases were cured by removal of the nail plate. Persistent proximal nail fold inflammation can result from the proximal nail plate in case of stunted nail growth.Skin Research, 10: 505-507, 2011

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In order to assess the safety of soap and sunscreen in the “2e” skincare product series developed for sensitive skin by Shiseido Co., Ltd., we carried out a six-week study in infants with atopic dermatitis. A total of 38 subjects completed the study. We found adverse skin reaction in 2.6% of the subjects who used the soap, and in 0% of the subjects who used the sunscreen. On the basis of these findings, it is considered that these skincare products can be used safely by the great majority of infant patients with atopic dermatitis.Skin Research, 10: 508-516, 2011

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The occurrence of foot ulcers have increased recently and are a major cause of morbidity, mortality and disability in patients with diabetes. Patients at a high risk of developing foot problems, such as those with uncontrolled diabetes, or those with vascular disorder, neuropathy, and local lesions, should be followed closely by not only pre-surgical wound bed preparations but peri-operative and preventive care in terms of a periodical foot observations. In this article, our strategies for the diabetic foot in our unit are described, illustrating some representative cases.Skin Research, 10: 517-521, 2011

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Recently, foot care is more commonly carried out in many medical institutions. One reason that there are many new patients with foot lesions is that this is one of the complications of diabetes. Insoles can be created for shoes of the patient's choice, after taking into consideration a patient's impression and use situation. Then, the conditions that are important for producing an insole, including the manufacturing process, the conditions required for insole creation, and the creation process, are described.Skin Research, 10: 522-525, 2011

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