A 56-year-old female had a 10-year history of erythema in the periumbilical region, but left it untreated. However, when she sustained a left metatarsal fracture and visited a local orthopedic clinic, she was found to have an umbilical mass and was referred to our department. At the first examination, a 12×14.5 cm erythema in the periumbilical region and a 2.4×3.2 cm red mass in the umbilical region were noted. Visual inspection of the external genital, perianal, and axillary areas revealed no abnormalities. Skin biopsies of the periumbilical erythema and umbilical mass led to a diagnosis of solitary extramammary Paget’s disease in the umbilical region. Whole-body CT demonstrated no lymph node or visceral metastases, and the patient underwent tumor resection under general anesthesia. At present, 2 years after surgery, the patient is free from local recurrence or metastases. Few studies have reported extramammary Paget’s disease developing in the umbilical region. In Japan, 12 cases have been described, 4 of which were solitary extramammary Paget’s disease in the umbilical region. Skin Research, 19 : 1-6, 2020

A 58-year-old womanwas treated using radiationtherapy, four courses of FEC (fluorouracil,epirubicin, and cyclophosphamide) therapy, and 4 courses of DOC (docetaxel) therapy after surgical treatment for bilateral breast cancer. She later developed alopecia on the parietal region of her scalp, which lasted for more than2 years after chemotherapy. Therefore, she was referred to our department. We diagnosed her with diffuse alopecia by chemotherapy and treated her using minoxidil because no cause of alopecia was found by medical history, blood tests, or histological examination. Although alopecia after chemotherapy is generally considered reversible, a few patients exhibit long-term refractory alopecia. We reviewed previous reports, treatments, and preventive methods for prolonged cases of alopecia after chemotherapy. Skin Research, 19 : 7-10, 2020

A 54-year-old woman presented with a slightly itchy nodule on her right dorsum that had developed 5 years ago. Physical examination revealed a brownish nodule of 12 mm in diameter on the dorsum of the right foot. The nodule was resected and histologically diagnosed as cutaneous epithelioid angiomatous nodule (CEAN). CEAN was first reported in 2004 and is a rare benign vascular lesion characterized by the proliferation of epithelioid endothelial cells. We discuss the similarities and differences between CEAN and other vascular disorders exhibiting epithelioid endothelial proliferation, in addition to the dermoscopy ndings in the present case. Skin Research, 19 : 11-14, 2020

A 76-year-old woman presented with a solitary, well-defined, erythematous lesion on the thenar aspect of the right hand that developed 5years ago. Physical examination revealed a slightly depressed erythema measuring 10 mm × 7 mm. Histopathological findings included stair-like thinning of the horny layer. Topical therapy including corticosteroids was ineffective, but a single application of cryotherapy led to complete remission. There was no recurrence after cryotherapy even after 1 year. Skin Research, 19 : 15-19, 2020

A 71-year-old Japanese male presented with a gradually enlarging solid tumor on the left cheek. Physical examination revealed a dark red-brown tumor. Histopathologically, tumor cell nests were floating in a mucinous lake separated by a fibrous septum from the dermis to subcutaneous tissue. The patient was treated by wide local excision of the tumor and full-thickness skin grafting. There was no evidence of recurrence or metastasis even at 39 months after surgery. It is necessary to determine an appropriate surgical margin for primary mucinous carcinoma of the skin due to its high recurrence rate. Skin Research, 19 : 20-25, 2020

Transverse nasal lesions have been referred to as nasal crease, transverse nasal stripe, and transverse nasal groove ; they all have similar clinical features. Specifically, a transverse streak or shallow groove is observed at the junction of the middle- and lower-third of the nose. We report four adult patients with a nasal crease. Three patients had allergic rhinitis, and their condition was suspected to be related to nose rubbing. The fourth patient did not have allergic rhinitis and the pathogenesis of their condition was unknown. To the best of our knowledge, there have been only 18 previously reported adult patients with this disease, and there have been no case reports from Japan. Skin Research, 19 : 26-30, 2020

A 75-year old man noticed black spots on the scrotal and inguinal regions two years before the first visit. They gradually enlarged and bled, and he came to our department. At the first visit, dark red and light black pigmented plaques with black spots and erosions were noted on the right scrotal and left inguinal regions, respectively. We diagnosed these pigmented plaques as basal cell carcinoma (BCC) by skin biopsy. We next performed a whole-body skin examination and found a brown plaque with black spots on the posterior region of the right auricle. It was suggested to be BCC by dermoscopy. We surgically resected these 3 lesions and confirmed them all to be BCC histologically. Four years and five months after the surgery, no recurrence or new BCC lesion has developed. We examined 375 specimens from 335 cases of BCC at our hospital between 1991 and 2019, and confirmed 19 cases of multiple BCC. In the present case, we first diagnosed two BCC lesions, and after checking the entire body, we found an additional BCC. Whole-body examination and long term follow-up are important to find new BCC lesions and recurrence when patients have multiple BCC. Skin Research, 19 : 31-37, 2020

Although epidermal growth factor receptor (EGFR) inhibitors are one of the most effective treatment options for lung cancer, they frequently cause cutaneous toxicity. In order to continue using EGFR inhibitors, it is necessary to reduce and ameliorate cutaneous toxicity. Dryness, one of the most common forms of cutaneous toxicity, is usually treated using medical moisturizing agents such as heparin analog-containing products and white petrolatum. However, to ensure continued use by patients, the moisturizer should spread easily and not have a viscous texture. This study included 12 lung cancer patients who were undergoing EGFR inhibitor treatment and using topical medical moisturizers. The participants were divided into two groups, one that continued the application of medical moisturizers and another that switched to NOV^○R skin cream D. We assessed and compared the skin condition (dryness, itching, and erythema) and stratum corneum condition (water content, IL-1ra/IL-1α content, thymic stromal lymphopoietin content, degree of multilayer exfoliation, and trypsin activity) between the sites where the product was (the inner forearm) and was not (the upper back) applied. Moreover, we assessed the patients’quality of life (QOL) and a questionnaire on the patients’opinions of the products was administered. After eight weeks, the patients who switched to NOV ^○R skin cream D presented with significantly lower degrees of multilayer exfoliation and lower symptom scores, but there was almost no difference in the other parameters investigated. NOV^○R skin cream D may not only improve cutaneous toxicity caused by EGFR inhibitors, similar to conventional medical moisturizers, but also improve the QOL. This may help prevent discontinuation of the use of EGFR inhibitors, thereby ensuring continuous therapeutic effects. Skin Research, 19 :38-46, 2020