We conducted infection control against Trichophyton tonsurans infections based on the guidelines. The subjects were judo experts affiliated with the University Judo Federation of Tokyo during the period from 2008 to 2013. A hairbrush test was performed every April, and positive subjects received treatment. The following results were obtained: On average, 64.9% of subjects had a history of tinea, and the percentage of subjects positive for the hairbrush test was 11.3% in 2008 and then decreased by half. On average, 91.8% of subjects with positive cultures were asymptomatic carriers, and 0.53% of the entire population had symptoms. Regarding changes in the number of positive subjects by year in school, the percentage of subjects positive for Trichophyton tonsurans decreased as their year in school advanced. According to the results of reexaminations performed three months after treatment, 86.3% of subjects, on average, showed conversion to negativity. The guidelines are thus sufficiently effective.Skin Research, 14: 57-61, 2015

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A 79-year-old female developed a double rice-sized black papule between her eyebrows one month prior to the first visit. The diagnosis of basal cell carcinoma (BCC) was confirmed by skin biopsy and the papule with surrounding normal skin at 3mm width was removed. Five years after surgery, another pink nodulus appeared on the left side of her nasal dorsum, showing arborizing vessels in dermoscopy. It was diagnosed as non-pigmented BCC by biopsy, and thereafter widely excised. We histopathologically compared the features of the pigmented and non-pigmented BCC in the present case. We observed large melanocytes with well-developed dendrites, melanophages and a number of melanin granules in the pigmented BCC lesion. In the non-pigmented BCC lesion, however, no melanin granules or melanophages were observed. In some parts of non-pigmented BCC, the melanocytes disappeared and, in other parts, the existing melanocytes showed small circular shapes with a few very short dendrites. We consider that the reasons why the melanin pigment was not observed in non-pigmented BCC in our case were the disappearance of melanocytes in some parts of the lesion and the dysfunction of melanocytes even if they existed in its other parts.Skin Research, 14: 62-66, 2015

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A 72-year-old woman, resident in Nose-cho, Toyono-gun, Osaka Prefecture, cut the grass in an irrigation canal near her house in late April 2014. She found erythematous macules with itching on her limbs and trunk the next day and visited our department 2 days later. On the first visit to our department, solitary erythematous macules, papules and vesicles were disseminated on her limbs and trunk and a small tick was recognized at the center of each eruption. We removed more than 50 ticks from those lesions. The ticks were identified as larvae of Amblyomma testudinarium. Histopathologically, perivascular inflammatory infiltrations mainly of lymphocytes were seen in the dermis. After the administration of minocycline hydrochloride (100mg/day) for 2 weeks and topical application of 10% crotamiton cream, all skin symptoms disappeared. She had no systemic symptoms throughout the period of treatment. It seems that an increase of patients with tick bites is associated with an increase of wild animals in mountainous areas in recent years.Skin Research, 14: 67-72, 2015

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A 70-year-old female presented with skin ulcers with purpura on her left leg. She was diagnosed with vasculitis and treated with prednisolone at 10mg/day. However, her skin ulcers did not improve, so she was referred to our hospital. At the first visit, antiphospholipid antibodies were detected in a blood examination. A skin biopsy was performed near the skin ulcers, which showed pathological findings of the occlusion of dermal vessels by thrombosis. About one month later, thrombocytopenia, acute renal dysfunction and neurological abnormality occurred, so she was admitted for further examination. Although she was initially treated with antimicrobial drugs because of infection in the urinary tract, renal dysfunction and inflammation rapidly deteriorated within a few days and the skin ulcers expanded. In addition, nephritis with microthrombus and acute stroke were found. We diagnosed this patient with catastrophic antiphospholipid syndrome (CAPS). Anticoagulation therapy with warfarin and high-dose steroid administration was performed, after which the inflammation was reduced and the renal function soon improved. The skin ulcers improved without surgical treatment. We should note that the urgent initiation of treatment is critical if CAPS is clinically suspected.Skin Research, 14: 73-78, 2015

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We report here seven patients with diabetic scleredema, namely, four men and three women, in the age range of 55-87 years old, who showed resistance to treatment by insulin injections. In these patients, the injection sites were rotated appropriately and there were no obvious traumata or scars. However, histological examination showed thickening of the dermis, which led to the diagnosis of diabetic scleredema. Speculating that the thickened dermis might have caused the poor response to insulin, we provided the patients with instructions to change or adjust the angle or the site of injections, which proved to be successful. Although diabetic scleredema generally involves the posterior neck, we speculate that it can involve a more extensive region. Therefore, in diabetic patients with resistance to insulin therapy, diabetic scleredema is to be considered a potential cause of subcutaneous insulin absorption disorder.Skin Research, 14: 79-84, 2015

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A 37-year-old man had a dark red, pedunculated nodule measuring 20mm across the left side of the back. Histopathologically, the tumor was seen in the dermis and consisted of spindle-shaped cells. The tumor had multinucleated giant cells, extravasation of erythrocytes, hemosiderin, and cleft filled with erythrocytes. Immunohistochemically the tumor was positive for vimentin, partially positive for CD68, and negative for CD34, EMA, desmin, Melan-A, S-100 and HMB-45. On the basis of these findings, we diagnosed it as aneurysmal fibrous histiocytoma (AFH). Immunohistochemical examination should be helpful to distinguish AFH from malignant neoplastic diseases. SUVmax was slightly high, which was considered to be due to abundant fibroblasts in the tumor.Skin Research, 14: 85-88, 2015

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