In order to trace the roots of Japanese medical terms, it is essential to investigate medical archives. In the past, the work required a special environment where the old books could actually be referenced. However, now that the Internet has become widespread, the situation has changed, and digital preservation and publicly availability on the Internet of old books are progressing, not limited to medicine. However, these electronic materials are enormous, and it is difficult to select them without knowing the historical flow. There is no reference material yet in the field of dermatology. This article introduces electronic materials that can be viewed online, especially materials that may be related to dermatology, along the historical timeline of Japanese medicine. What has become clear is as follows. (1) The term“母斑, bo-han”was first published in the “Ganka Shinsho”by Ryukei Sugita (second son of Genpaku Sugita). (2) The original Latin book written by Plenck JJ states that“Imaginatio matris pro causa excitante censetur”, namely that“it is strongly thought to be caused by the mother’s imagination”. (3) In the era before the adoption of German medicine by the Meiji government,“Rangaku”doctors understood the latest European medicine and dermatology at that time. Skin Research, 18 : 256-278, 2019

A 71-year-old man presented with a linear scar from excisional biopsy of a nodule on the right jaw. A hematoxylin and eosin-stained specimen of the excisional biopsy demonstrated nests of tumor cells floating in the mucinous stroma compartmentalized by fibrotic septa from the dermis to the subcutis. Tumor cells possessed hyperchromatic nuclei and basophilic cytoplasm. Tiny lumens were partially detected. The neoplastic cells were positive for CK7 expression, and negative for CK20 and GCDFP15 expression. We performed an additional excision with a 10 mm-margin from the scar without remaining tumor cells on histology. FDG-PET/CT demonstrated no hot spots. Neither local recurrence nor distant metastasis has appeared during 12 months of follow-up after the last excision. We report a typical case of mucinous carcinoma of the right jaw. Mucinous carcinoma of the skin should be differentiated from metastatic mucinous carcinoma, and further study of a larger number of cases is needed. Skin Research, 18 : 279-282, 2019

A 3-year-old boy (case 1) and a 13-year-old girl (case 2) were referred to our hospital for woolly and sparse hair. We suspected autosomal recessive woolly hair/hypotrichosis, and performed direct sequencing analysis of the LIPH gene using peripheral blood-derived genomic DNA from both patients after receiving informed consent. As a result, compound heterozygous missense mutations, c.736T＞A (p.Cys246Ser) and c.742C＞A (p.His248Asn), in exon 6 of the LIPH gene were found in both patients. Although they had identical mutations, case 1 exhibited woolly and sparse hair on his entire scalp, whereas case 2 had sparse hair, especially on the occipital, frontal, and temporal regions of the scalp. Differences in genetic background, such as variants in modier genes or differences in single nucleotide polymorphisms in the hair follicles, may have affected the severity. Skin Research, 18 : 283-288, 2019

A 80-year-old woman had a black plaque measuring 12×8 mm on the right nipple, 5 pigmented macules on the left nipple-areola complex (NAC), and a pigmented plaque measuring 11×5mmon the left axilla. After histopathological conrmation of basal cell carcinoma (BCC), the tumors were excised with a normal skin margin of 5 mm. We needed to distinguish from nevoid basal cell carcinoma syndrome because she had calcification of the falx cerebri. As she had no other abnormalities, we finally diagnosed her with multiple BCCs without an apparent genetic or environmental background. Seventy-six cases of BCC on the NAC have been reported to date. Among them, only one was observed on both sides of the NAC. We report the second case of bilateral BCC of the NAC. Moreover, multiple lesions of BCC on the left NAC is rare. The usual site of origin of BCC is the epidermal surface or hair follicle. In our case, some tumor nests were attached to the breast ductal epithelium or sebaceous ductal epithelium. These findings are valuable to determine the origin of BCC. Patients with a history of BCC require life-long follow-up because of the risk of additional BCC. Skin Research, 18 : 289-294, 2019

A 72-year-oldman notedchanges in the surface of a burn scar on the lateral aspect of the left thigh andvisitedour hospital. He sustaineda burn injury from an explosion accident at a factory approximately 50 years ago. Physical examination revealeda palm-sizedlight pink plaque on the lateral aspect of the left greater trochanter part, andscales andcrusts were attachedto its surface. The lesion was surroundedby black nodules, andcontractures andscars were observedaroundthe lesion. Histopathology revealednests of tumor cells in the superficial dermis extending from the epidermis. The periphery of the tumor nests exhibited a palisade arrangement. Mucin deposits were observedaroundthe tumor nests andthere was markedscar tissue in the dermis. A diagnosis of basal cell carcinoma was made. The tumor was excised with a surgical margin of 5 mm and reconstructedusing a left free latissimus dorsi musculocutaneous flap. Squamous cell carcinoma commonly develops from burn scars, but basal cell carcinoma originating from a burn scar is thought to be relatively rare. Skin Research, 18 : 295-299, 2019

A 77-year-old female received cyclosporine and prednisolone for pure red cell aplasia and rheumatoid arthritis. She complained of general fatigue, fever, and multiple subcutaneous masses. We suspected actinomycetes infection based on Gram staining of pus from the subcutaneous abscess in the right cheek. Inflammatory signs and subcutaneous tumors were reduced by treatment with sulfamethoxazole-trimetoprim. In culture, Nocardia farcinica was detected and the patient was diagnosed with disseminated nocardiosis. Disseminated nocardiosis has a poor prognosis. Nocardiosis should be considered as a differential diagnosis of subcutaneous abscesses in immunocompromised patients to enable earlier treatment. Skin Research, 18 : 300-305, 2019

Atopic dermatitis (AD) is a common disease ; however, severe refractory cases have been reported. In April 2018, a biological drug, dupilumab, became available in Japan for the treatment of severe AD. This study evaluated the efcacy of dupilumab in 14 patientswith refractory AD, and treatment satisfaction regarding treatment costs and visit frequency. Dupilumab significantly alleviated itching, and improved the eczema area and severity index (EASI), body surface area (BSA),and Investigator’s Global Assessment (IGA) values after 4-week treatment, demonstrating high efficacy. In addition, treatment effects for refractory AD were observed at an early stage, and high treatment satisfaction was recorded for ＞80% patients. This effectively led to an increase in the willingness to continue dupilumab. However, patients were dissatised with the treatment cost and visit frequency (once every two weeks). Moreover, many patients were eligible for dupilumab use,but were unable to use it because of the treatment cost and visit frequency. Dupilumab was approved to for use as a self-injection in May 2019. Self-injection has reduced the frequency of hospital visits, and long-term prescriptions have enabled the use of social systems, thus reducing the financial and medical system burdens. In the future, doctors will have to provide treatment options,such as self-injection, to accommodate the patient’slifestyle and financial status. Skin Research, 18 : 306-312, 2019