An 85-year-old woman was admitted with a sacral radiation ulcer that was closed using a gluteal perforator flap. Typically, a gluteal perforator flap is not a sensory flap; therefore, it may be associated with problems of loss of sensation and abnormality after surgery. We succeeded in preserving sensation without serious postoperative complications by including nerve-like tissues around perforators in the flap. The cutaneous nerves preserved were the branches of the superior or middle cluneal nerves. Gluteal perforator flap surgery should be performed keeping in mind the nerves present in that area and by preserving nerve-like tissues around the perforator so that sensation may be preserved.Skin Research, 10: 128-132, 2011

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We report six patients who developed photosensitivity caused by fixed-dose combination tablets of Angiotensin II Receptor Blocker (ARB) and hydrochlorothiazide. Photo-testing with UVA or UVB radiation revealed photosensitivity to UVA in all patients. Photopatch testing was performed in five patients after informed consent was obtained. Four of the five patients showed positive reactions to hydrochlorothiazide in a photopatch test. The eruptions totally cleared after discontinuation of hydrochlorothiazide together with avoidance of sun exposure in four cases, while two patients, who had been taking hydrochlorothiazide for a longer period even after the onset of photosensitivity, developed melanoleukoderma. We suggest that these six cases of photodermatitis might have been induced by photosensitivity due to hydrochlorothiazide.Skin Research, 10: 133-140, 2011

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A 56-year-old woman had suffered from bulla, erosion and cicatrix by external stimuli from birth. She had recently been diagnosed with recessive dystrophic epidermolysis bullosa by genetic study. During the course she complained of gradually increasing dysphagia, and esophagostenosis and gastric cancer were found by upper gastrointestinal endoscopy. Dilation of the esophagus by balloon catheter improved the symptoms, and the gastric cancer was surgically removed. We discuss esophagostenosis in an RDEB patient and the dilation by balloon catheter.Skin Research, 10: 141-143, 2011

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A 60-year-old woman was referred to our hospital with multiple pruritic moist erythemas mimicking eczema on the face that had worsened and persisted for a few months without responding to topical steroids or oral antibiotics. No pustules and no tendency of central clearing were clinically found. Skin biopsy showed subcorneal pustules in the infundibular epidermis, eosinophilic infiltration and spongiosis of hair follicules, perivascular and sebaceous gland lymphocytic and eosinophilic infiltration. The diagnosis of eosinophilic pustular folliculitis was made and the patient was successfully treated with 50mg/day oral indomethacin and topical tacrolimus ointment. The eruptions almost cleared within a week leaving slight pigmentation. Thereafter, she has occasionally experienced recurrences, which responded well to indomethacin or tacrolimus. Although our case lacked typical clinical features, its clinical course and histology seemed to be consistent with eosinophilic pustular folliculitis.Skin Research, 10: 144-148, 2011

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A 48-year-old woman presented with a tumor in the coccygeal region, which had gradually enlarged over thirty years. The finding of sacrococcygeal X-ray was that the space of the sacrococcygeal junction was open and the coccyx was slightly bending forward. The skin lesion was diagnosed as a coccygeal pad from the clinical and histological findings. Furthermore, MRI disclosed two cystic lesions which were considered tailgut cysts in the retrorectal space. This is a rare case in which a coccygeal pad was associated with tailgut cysts.Skin Research, 10: 149-153, 2011

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We report 2 cases of mammary Paget's disease with different clinical impact. Case 1: a 58-year-old woman had widely spreading erosion with white moss, approximately 5cm in diameter, overlying the right nipple and areola. Contrary to expectations, Paget's cells and their nests were histopathologically localized in the basal or suprabasal epidermis without tumor extension to the main mammary ducts. The tumor was resected with a 2cm peripheral margin. Case 2: a 62-year-old woman noticed a small erosion on right nipple. Histologically, Paget's cells had spread to the whole epidermis and deeply invaded the main mammary duct. Since the tumor cells remained in the deep main duct after clinical extirpation, we performed right breast resection for mammary carcinoma. In these cases, there were large dissociations between the clinical impact and histopathological findings. We need to take this difference into consideration when suspecting mammary Paget's disease.Skin Research, 10: 154-158, 2011

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A 66-year-old female patient with systemic lupus erythematosus and lupus nephritis presented with a subcutaneous nodule on the left lower limb. She had been treated with prednisolone and an immunosuppressant. The histological specimen showed numerous yeast-like bodies that were positive on PAS, Grocott and Fontana-Masson staining. Cryptococcus neoformans was found on a mycological culture of cerebrospinal fl uid. We diagnosed this case as cutaneous cryptococcosis. The patient was successfully treated with intravenous fl uconazole for 4 months.Skin Research, 10: 159-163, 2011

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The Make-Up Care Clinic attached to the Vitiligo Clinic in the Department of Dermatology at Kyoto University Hospital was established in October 2007. Initially, the clinic was only for patients with vitiligo; however, now it is available for patients with various skin diseases, such as pigmentary disorders, postoperative scars and cutaneous lesions associated with collagen diseases. Until August 2010, 105 patients (pts) had visited the Make-Up Care Clinic. The male-female ratio was 1:4.8. Their age range from one year old to 84 years old, and the average was 48.6 years old. Vitiligo occupied 74.3% (78 pts). The sites for camouflage were the face in 24 pts (74.3%), hands 24 pts (22.9%), neck 16 pts (22.9%), trunk 4 pts (3.8%) and lower extremities 3 pts (2.9%). Ten of 105 patients visited our camouflage clinic repeatedly. Through the clinic, we have reported a few tips for camouflage, including waterproof camouflage using a silicon spray. In this paper, we report a summary of our special clinic at Kyoto University over three years.Skin Research, 10: 164-169, 2011

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We carried out a four-week study of female patients with acne vulgaris in order to assess the safety of make-up cosmetics for sensitive skin, consisting of powder foundation, liquid foundation, and loose powder in the “d Program^®” series developed by Shiseido Co., Ltd. Eighty-five subjects completed the study. We found adverse skin reactions in 2.1% of the subjects who used the powder foundation. On the basis of these findings, it was concluded that these make-up cosmetics for sensitive skin can be used safely by the great majority of female patients with acne vulgaris.Skin Research, 10: 170-182, 2011

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