A 24-year-old woman exhibited erythema around the mouth after use of a facial pack. Although she was treated with topical steroids and oral antihistamines at a local clinic, the symptoms did not improved. She consulted our department one month after the onset. Infiltrative erythema was observed around the mouth, and there was no capillary dilation or pore-consistent papules. As we suspected contact dermatitis, cosmetics and topical preparations that had been used were discontinued, and a patch test was conducted. However, there was no positive reaction to any substance. Skin biopsy was performed. In the dermis, multiple granulomas without necrosis were detected. Under a diagnosis of perioral dermatitis, clindamycin ointment was prescribed and minocycline was orally administered, leading to the relief of exanthema. Even when clinically typical findings, such as papules and capillary dilation, are absent, there is a possibility of rosacea-like dermatitis, as demonstrated in the present case. Therefore, it is important to positively consider skin biopsy for patients with refractory facial erythema.Skin Research, 15: 466-469, 2016

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A 56-year-old male was referred to our dermatology department with foot ulcers. Due to diabetic nephropathy, he had received hemodialysis for 10 years. From the first quarter of 2015, he noticed ulcerative digits of the foot. As the foot X-ray indicated calciphylaxis, we controlled his calcium and phosphate serum levels, and performed topical debridement of the ulcers. Although his ulcers were improved for a while, the ulcers on the 3rd and 4th toes of the right foot was worsened from the beginning of 2016. On admission, we observed itchy, keratotic nodules and papules on the shins. Histologically, Kossa stain-positive deposits of calcium were revealed around the vessels from the ulcer on the 3rd toe. Furthermore, transepithelial elimination of denatured elastic fibers was observed from the keratotic papule specimen on the shins, which led to the diagnosis of acquired perforating dermatosis. After we treated him with sodium thiosulfate for calciphylaxis, the keratotic plaques were also flattened and improved. Thiosulfate may improve acquired perforating dermatosis by solubilizing insoluble cutaneous deposits and ameliorating inflammation.Skin Research, 15: 470-475, 2016

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A 30-year-old female noticed darkening and thickening of her nipple and areola during late pregnancy. No improvement was observed even after the birth of her baby, which prompted the consult to our hospital. Topical steroids were prescribed and were noted to be effective for the pruritus and exudate, but did not improve the skin lesions. Histological findings of the skin biopsy from the areola revealed papillomatosis with keratin plugs, thus we diagnosed her with hyperkeratosis of the nipple and areola. We tried other topical treatments, but none were successful. However, the hyperkeratosis disappeared when menstruation resumed. Hyperkeratosis of the nipple and areola is a benign disorder, but many treatments, including surgery, have been tried because of cosmetic problems. The involvement of imbalanced sex hormones was recently reported as a pathophysiology of this disease, and in some cases, including our case, spontaneous remission was obtained. Therefore, we propose watchful waiting instead of invasive treatments.Skin Research, 15: 476-480, 2016

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A 67-year-old female came to our hospital exhibiting erythema on her face and trunk one week after the administration of loxoprofen, acetaminophen, and cefditoren pivoxil for the treatment of a sore throat and high fever. She presented with erosions on her labial and lingual mucosa. A histopathological examination revealed liquefaction with the presence of numerous civatte bodies. Based on these findings, the patient was diagnosed with Stevens-Johnson syndrome (SJS). Immediately after starting steroid pulse therapy, we noticed the decreased level of serum Hb, and gastrointestinal ulcers and hemorrhages were detected endoscopically. We considered that the gastrointestinal involvement in the present case was caused by the occurrence of SJS, not by steroid administration or infection. This complication is rare, but care should be taken regarding the appearance of gastrointestinal involvement when treating a SJS case.Skin Research, 15: 481-485, 2016

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We performed a 4-week randomized double-blind clinical trial of a newly formulated mild body cleanser (Nachu body soap: Duskin) and a conventional cleanser (Uruoi body soap: Duskin) with 30 post-adolescent Japanese women volunteers with dry skin. The effects of trial were evaluated by visual grading, subjective symptoms, stratum corneum water content (SCWC), and transepidermal water loss (TEWL) on day 0 and day 28 in winter. The SCWC levels of the both forearms were elevated after the trial, and significant improvement of SCWC was observed on the left forearm. After elimination of 3 subjects who did not use the supplied towels, SCWC on the right arm also significantly improved after 4 weeks. In addition, the increase in SCWC level of the arms in the new formula group was significantly higher than that of the conventional group after the 4-week trial. However, TEWL and other data showed no significant difference. No remarkable side-effects due to these cleansers were identified through this investigation. Based on these findings, the newly formulated cleanser is a safe and more effective body cleanser compared with the conventional cleanser for Japanese women with dry skin.Skin Research, 15: 486-492, 2016

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In the treatment of acne vulgaris, skincare and makeup under the instruction of dermatological doctors are extremely important, in addition to pharmacotherapy. However, there are few reports about the investigation of effectiveness of skincare and makeup on acne therapy. In this study, the patients' satisfaction and QOL after skincare and makeup, in addition to medical treatment, for female patients with acne vulgaris were investigated. The satisfaction level based on VAS significantly improved immediately after receiving instruction and after one month compared with that at the start of the study. QOL also improved. There were no adverse effects due to the skincare and makeup, and patient compliance also improved.Skin Research, 15: 493-501, 2016

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Effective treatment for female pattern hair loss (FPHL) has been eagerly desired for several decades. In this study, we assessed the safety and efficacy of ethinyl estradiol-containing topical solution for FPHL. Thirty patients with FPHL were enrolled in this study, and ethinyl estradiol-containing solution was topically applied on the scalp hair loss area twice a day for 24 weeks. Twenty patients finished this study, and were assessed by clinical and subjective symptoms, QOL, efficacy, and safety. After using the solution for 24 weeks, we observed marked improvement of the “degree of baldness” (clinical symptom) and “degree of hair loss” (subjective symptom). Significant reduction in the amount of hair loss has been observed in the subjective symptoms after 4 weeks and in Visual Analog Scale (VAS) after 8 weeks. “Degree of baldness” was significantly improved after 12 weeks. It was suggested that ethinyl estradiol-containing solution may exhibit efficacy within a short period. Although adverse skin reactions (itching and erythema) were observed in 2 out of 22 cases, they disappeared by the discontinuation of the solution application. The ethinyl estradiol-containing solution should be suggested for mild FPHL.Skin Research, 15: 502-512, 2016

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