Skin Research, 17: 189-190, 2018

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Severe axillary hyperhidrosis can be treated by local botulinum toxin type A (BTX-A) injections. We compared the injection time, pain of injection, and satisfaction with treatment between use of a 30-G single-needle and a 34-G triple-needle for local BTX-A injection. Use of the 34-G triple-needle shortened the injection time by half, and also reduced the pain of injection. In terms of satisfaction with treatment, approximately 90% of patients reported that they were either “very satisfied” or “relatively satisfied”. When they were treated with local BTX-A injections again, approximately 80% responded that they were “strongly in favor of use the 34-G triple-needle”. These results suggest that the 34-G triple-needle can shorten the injection time, alleviate the pain of injection, and provide very high treatment satisfaction.Skin Research, 17: 191-195, 2018

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A 23-year-old female was referred to us with a 3-month history of pruritic scaly erythema on the right knee and the left foreleg. Arthroderma benhamiae was identified based on mycotic cultures, and the results of polymerase chain reaction (PCR) and direct sequencing for the internal transcribed spacer 1 of ribosomal DNA. Her 27-year-old older sister was then referred to us with a 6-month history of pruritic scaly erythema and papules on the right cheek. A. benhamiae was also identified. A. benhamiae was identified from their pet guinea pig. Recently, patients with dermatophytosis by A. benhamiae from pets have been reported. We should examine all family members and their pets when affected lesions are diagnosed as dermatophytosis by zoophilic dermatophytes.Skin Research, 17: 196-201, 2018

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An 80-year-old man presented with indurated reddish nodules and a subcutaneous tumor on his left axilla. Histology revealed atypical glands with decapitation secretion, which were positive for CK7 and GCDFP-15. Apocrine carcinoma was diagnosed, and treated by wide local excision and radiotherapy with 50Gy. No evidence of metastasis was observed, but 3 years later, a tumor on his right axilla, the contralateral side, developed. The tumor was resected with local lymph nodes, and the histology was consistent with apocrine carcinoma. Seven months later, metastases to right supraclavicular and mediastinum lymph nodes were noted. The cervical metastatic lesions were treated using radiotherapy with 50Gy to prevent airway obstruction. Bilateral axillary apocrine carcinoma is rare, but careful long-term observation of both axilla is needed for patients with apocrine carcinoma.Skin Research, 17: 202-205, 2018

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A 12-year-old male presented to our hospital due to an itchy keratinized erythematous plaque on his palm. He had been treated with topical steroids for one and a half years. Symptoms were slightly improved with topical steroids, but the plaque did not disappear. At the first presentation, we noted the keratinized erythematous plaque on his left palm and both soles. We diagnosed the lesions as juvenile pityriasis rubra pilaris clinically and histopathologically. The plaque was not improved by topical steroids, but was almost completely healed by the combination of calcipotriol hydrate and betamethasone dipropionate. The combination of calcipotriol hydrate and betamethasone can be effective for refractory cases of juvenile pityriasis rubra pilaris.Skin Research, 17: 206-209, 2018

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A 72-year-old male noticed erythema on his face, trunk and extremities one week prior to presentation, which gradually spread to the entire body. He had developed symptomatic epilepsy approximately two years prior, and had been followed up at the neurology department of our hospital since. Physical examination at our department revealed edematous erythema on his face, pallor around the eyes, papules, pustules, and desquamation around the mouth, and pale erythema on the trunk and extremities. Levetiracetam, nifedipine, and lamotrigine had been administered since 17 months, 7 months, and 5 months before presentation, respectively, before the skin rash appeared. Although 5 months is an unusually long exposure period, we suspected drug-induced hypersensitivity syndrome (DIHS) eruption due to lamotrigine, and discontinued the drug. However, the eruptions temporarily worsened and they completely resolved 3 weeks later. Laboratory testing demonstrated eosinophilia and elevated levels of serum TARC. In addition, reactivation of HHV-6 was observed approximately one month after the appearance of the rash. Although this case did not satisfy the diagnostic criteria for DIHS, this patient may have had a similar pathological condition to DIHS.Skin Research, 17: 210-215, 2018

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