Nevus is called “母斑/bo-han (composed of two Chinese characters, meaning ‘mother’ and ‘macule’)” in Japan, but its origin is not known.
　Nevus is etymologically derived from a Latin naevus or gnaevus, meaning “born in”. The meaning of “mother” is not included here. Meanwhile, since the term “母斑” is not described in Japanese ancient medical books (医心方) and dictionaries (clause collections), it is not what existed as an ancient word.
　Judging from existing materials, the term “母斑” was first used in a book “対症方選” by Dr. Masazumi Takahashi published in 1876. In “Enchiridion Medicum” translated into Japanese by Dr. Koan Ogata, nevus is described as “痣/a-za (a Chinese character meaning ‘mole’), naevus in Latin, Moedervlek in Dutch”. Moedervlek is a Dutch word homologous to German word Muttermal. Moeder (Mutter) means “mother”, and vlek (Mal) means “freckle or mole”. It can be easily guessed that “Moedervlek or Muttermal” could be literally translated into Japanese as “母斑”. It was not Koan Ogata who did that translation. It is thought that the translation was done by Masazumi Takahashi or by another doctor at the short era between Takahashi and Ogata.
　Every Western language has a word (meaning nevus) with a nuance that “the emotions and experiences of pregnant mother develop in shape on the child’s body surface”. In addition to German Muttermal and Dutch Moedervlek, there is “mother’s mark” in English, “Envies” in French, “Dei Nei materni” in Italian, and so on. These terms were used in the medical books of each country in the past. Today, these terms are not used in the medical community. However, its literal translation, “母斑” is still under use in Japan.Skin Research, 17: 137-150, 2018

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　A 51-year-old Japanese man using oral lamotrigine for bipolar disorder developed widespread skin eruptions 25 days after starting the medication. He visited a primary-care doctor and was instructed to stop lamotrigine, and was instead prescribed topical steroids and oral betamethasone-d-chlorpheniramine. As the skin symptoms gradually improved, he stopped taking betamethasone-d-chlorpheniramine. However, the eruptions relapsed and he was referred to our hospital. On clinical examination, maculopapular eruptions and purpuras almost covered his entire body, and non-follicular pustules were observed on his lower jaw, neck and upper back. He had a high fever (38.3°C). Laboratory testing revealed an increased white blood cell count with atypical lymphocytes and hypereosinophilia, as well as increased levels of liver enzymes. The drug-induced lymphocyte stimulation test (DLST) was negative on the 7th hospital day but became positive on the 52nd hospital day. Skin biopsy revealed neutrophilic non-hair-follicle-consistency subcorneal pustulosis. We initially considered this to be a case of generalized exanthematous pustulosis (AGEP), as the patient's clinical features resembled those of AGEP. However, we ultimately diagnosed this patient with drug-induced hypersensitivity syndrome (DIHS) based on the clinical features, clinical course, laboratory findings, and late-onset positive DLST. The differential diagnosis of DIHS with pustules from AGEP is often difficult, and a diagnosis of DIHS should be made based on comprehensive judgment.Skin Research, 17: 151-156, 2018

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　A woman in her 30s visited a previous hospital for a subcutaneous tumor in the right lower abdomen that had grown over the past year. As malignancy was suspected, she was referred to our hospital for treatment. The tumor was surgically removed. Histopathologically, the tumor was well-circumscribed and exhibited proliferation of spindle-shaped tumor cells, which were arranged in fascicles. Proliferation of the tumor cells was seen in some areas of edematous stroma. There were numerous small to medium-sized vessels and collagen fibers. Immunohistochemically, the tumor cells were positive for CD34, progesterone receptor and estrogen receptor, and negative for SMA and desmin. We diagnosed this tumor as cellular angiofibroma based on the histological features and immunohistochemistry. Cellular angiofibroma is a rare mesenchymal tumor of the vulva or perineal region. We report a case of cellular angiofibroma of the lower abdomen and review the relevant literature.Skin Research, 17: 157-162, 2018

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　A man in his 20s had a ten-year history of swelling and hardening on the lateral sides of the PIP joint in the 2nd to 5th fingers on both hands. He had a habit of frequently folding his hands, and he used a personal computer for 8 hours a day for several years. No abnormal joint movement or abnormal findings on X-ray examination were observed. MRI revealed swelling and ligament thickening around the same area. Pathology demonstrated mild hyperkeratosis, -epidermal hyperplasia and increased collagen fibers throughout the dermis. Elastic fibers were segmented and decreased. Electron microscopy confirmed marginal irregularities and size disparities in collagen fibers, which were characteristic in our case. Therefore, we diagnosed this case as pachydermodactyly. Oral tranilast and steroid local injection were both ineffective. Our case was characterized by electron microscopic observation of thick collagenous fibers. We speculate that the persistence of extrinsic stimulus increased the collagen fiber diameter and density of the ligament. Similar changes were seen in collagen fibers of the dermis.Skin Research, 17: 163-167, 2018

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　An 82-year-old male presented with gradually expanding erythema and a nodule on the left side of the scrotum. His previous doctor performed skin biopsy and diagnosed squamous cell carcinoma in situ. He was introduced to our hospital for surgery, and we performed skin biopsy again. Immunohistochemically, the tumor cells were positive for CK7 and CAM 5.2, and we diagnosed the tumor as extramammary Paget's disease. We made an extended excision and performed lymph node biopsy. Histopathologically, the tumor was intraepidermal carcinoma, and there was no lymph node metastasis. Extramammary Paget's disease is known to exhibit marked morphological diversity even within the same lesion, and some cases are difficult to distinguish from Bowen's disease. When microscopic examination includes features of both diseases, it is necessary to perform skin biopsy at several sites in addition to immunohistochemical staining.Skin Research, 17: 168-172, 2018

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　Pericarditis is a well-known complication of autoimmune diseases. We report a case of overlap syndrome of systemic scleroderma, systemic lupus erythematosus and Sjögren's syndrome with digital gangrene and significant peripheral effusion. A female in her 60s was diagnosed with systemic lupus erythematosus by her doctor in 1990. Raynaud's symptom appeared from 2010. Swelling of the fingers and progressive digital gangrene developed in May 2016, and she visited our clinic in October. She was diagnosed with overlap syndrome of systemic scleroderma, systemic lupus erythematosus and Sjögren's syndrome. Systemic edema and significant pericardial effusion with hypocomplimentemia occurred in February 2017. Pulse intravenous steroid therapy with 500mg of methylprednisolone for three days and high-dose oral prednisolone were administered because these symptoms were considered to be due to acute exacerbation of systemic lupus erythematosus. Although pericarditis improved, the digital gangrene was aggravated. High-dose steroids markedly improved pericarditis, but they may have been one of the factors that exacerbated digital gangrene caused by systemic scleroderma. Appropriate treatments should be chosen after careful consideration of the pathology of overlap syndrome.Skin Research, 17: 173-180, 2018

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　A 71-year-old man presented with a 2-month history of multiple itchy eruptions mainly on the back. Each eruption consisted of a small, oval, slightly pigmented, thin, flat area that was less than 1 centimeter in diameter framed by narrow, elevated skin. Histological examination diagnosed this case as annular lichen planus (LP). One of skin lesions in this case was immunohistochemically investigated using monoclonal antibodies against HLA-DR, ICAM-1, CD1a, CD4, CD8 and Foxp3. HLA-DR and ICAM-1 signals protruded into normal-looking peripheral epidermis beyond the marginal area where liquefaction degeneration of the epidermis was prominent with mild lymphocytic infiltration, but rapidly diminished in the inner area of the lesion. The number of Langerhans cells was increased in the infiltrated and marginal areas, but rapidly normalized in the inner area. Helper, cytotoxic and regulatory T cells adhering to the basal cells in the infiltrated and marginal areas were distributed away from the epidermis in the inner area. The increase in epidermal Langerhans cells in the infiltrated and marginal areas, and their rapid normalization in the inner area may have resulted from the temporary expression of HLA-DR and ICAM-1 molecules. The annular formation, namely the regression of lymphocytic infiltration and recovery of the epidermis in the inner area of annular LP, may be closely related to the loss of epidermal HLA-DR and ICAM-1 expression, which enhances the infiltration of Langerhans cells and lymphocytes.Skin Research, 17: 181-185, 2018

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