In recent years, attention has been focused on the importance of preventing ultraviolet damage to the human health. However, many schools forbid the use of sunscreens in swimming classes. The Ministry of Education, Culture, Sports, Science and Technology does not restrict their use. Some schools currently permit their use, but other schools forbid their use. Recently, the Osaka Dermatologist Association conducted a questionnaire survey of schools in Osaka Prefecture to clarify the current status of the use of sunscreens, and an opinion survey of dermatologists, and found a clear difference in the consciousness of the schools and dermatologists toward this issue.

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A 28-year-old woman presented at Dermatology Department on July 2, 2005, with a 10-day history of pruritic lesions on the trunk and both upper extremities. She had been treated with Anderm^® ointment for herpes zoster one month previously. She applied that ointment 1-2 days prior to the onset of signs and symptoms. Physical examination revealed dark reddish erythematous lesions on the trunk and both upper extremities. Patch testings were performed with dilutions of Anderm^® ointment. As a result, 2% is enough concentration for patch testing.

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A 76 year-old man presented with itchy erythema with thick scale and crust over the whole body for 3 months. His past history included gastrectomy for gastric cancer and alcoholism. Physical examination showed nail deformity, tongue atrophy, angular cheilitis, erosion in the genital area, renal insufficiency, loss of weight, edema of the lower extremeties and severe anemia. Histopathological finding of the erythema in the flank presented dyskeratosis, vacuolation, and subcorneal pustules in the upper layer of the epidermis and infiltration of neutrophils in the dermis. Further examination revealed that he had hypoproteinemia, zinc deficiency, and mild hyperglucagonemia. Amino acids administration quickly resolved the skin lesions.

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A 77-year-old man had been diagnosed as having psoriasis at the age of 73, and had been treated by topical steroids with good control. The patient consulted our hospital because of sudden appearance of erythema on almost entire body and blister formation on lumbus and the upper limbs. Histologically, there was subepidermal bulla containing neutrophils. Direct immunofluorescence study showed linear immunoglobulin G and C3 deposition at the basement membrane zone. The patient’s IgG bound to the dermal side of salt-split normal human skin in indirect immunofluorescence study. However, with immunoblot analysis, patient’s sera did not react with any of the 180kDa-BP antigen, 230kDa-BP antigen, and 200KDa-protein. ELISA did not show that patient sera reacted with either recombinant BP180 or BP230. We diagnosed this patient as pemphigoid reacting to an unknown antigen. Oral steroids with dialysis was effective to the patient. During the course of the treatment to Pemphigoid, the psoriasis-like skin lesions relapsed and these lesions was treated effectively by oral cyclosporin A.

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A 52-year-old man with abnormal findings on chest X-ray and computed tomography (CT) was referred to our hospital in January 2003. He presented with violaceous erythema on the eyelids, facial edema, Gottron’s sign over the interphalangeal joints of the hands, and scaly erythema over the elbow joints. Periungual telangiectases on the fingers were also observed. Analysis of the skin biopsy specimen from the dorsal aspect of the finger indicated findings compatible with dermatomyositis. Fine crackling sounds were audible in the lung fields. Chest CT showed reticular and ground glass opacities. Subjective or objective findings suggestive of skeletal muscle involvement, such as muscle weakness and apparently elevated creatine phosphokinase and aldolase levels, were not observed. The anti-SS-A antibody was positive. Clinical and laboratory findings including lip biopsy fulfilled the diagnostic criteria for Sjögren’s syndrome. Amyopathic dermatomyositis (ADM) with Sjögren’s syndrome and interstitial pneumonia (IP) was diagnosed. Oral and topical corticosteroids gave a favorable response.
Since Sontheimer and Miyagawa (2003) suggested a frequent association between a potentially fatal IP and ADM, we reviewed 20 Japanese cases of ADM with IP published thereafter. We found successful multidisciplinary treatment that included ciclosporine. However, 5 cases of intractable IP associated with ADM have been found.

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A 71-year-old woman presented with erythema on the face. It had persisted for 7 years prior to her first visit to our hospital. Biopsy of her right shoulder was performed with suspect of sarcoidosis or Hansen’s disease. Histopathological examination showed epithelioid granuloma without caseous necrosis. Chest CT revealed lymphnode swellings. Laboratory findings showed negative tuberculin reaction and high titer of serum angiotensin converting enzyme (24.8 IU/37ºC). The diagnosis of cutaneous sarcoidosis was established on the basis of these findings. The erythema on the face disappeared with topical injection of corticosteroids although it remained glossy plaque. Oral medication of tranilast and topical use of tape agents containing corticosteroids showed no improvement. A statistical study of sarcoidosis registered to the Department of Dermatology of the Ryukyu University Hospital during the 23-year-period from 1984 to 2005 is also reported.

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A rare lesion, a subcutaneous dermoid cyst, behind the ear, is discraibed. A 35-year-old Japanese female with an erythematous, raised lesion behind the left ear, that had been present since 20 years ago, developed a few days before presentation. Though epidermoid cyst was clinically considered, multiple hairs were found on sectioning. The cyst measured 10×20 mm, didn′t invade the periosteum. Histopathologically the subcutaneous tumor is lined by an epidermis, showed hyperplastic sebaceous glands and hair follicle in wall. No relapses occurred within 4 months.

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A 24-year-old woman had been complaining of slowly growing mass on the right buttock for approximately 3 months. On examination, there was an asymptomatic glaucous colored nodule of 1.5cm in diameter. The lesion was excised under local anesthesia and disrupted during surgical removal. With exclusion, clear to amber fluid discharged from the lesion. Histological findings revealed a dilated cyst lined by a single cuboidal to columnar ciliated epithelium. Cutaneous ciliated cyst is a rare lesion predominantly occurring in the lower limbs of young women. Although origin of the cyst is unknown, some investigators propose an origin from Müllerian heterotopia, but others from eccrine sweat glands.

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We report a case of solitary genital leiomyoma in a 66-year-old man with a lesion of the right side of scrotum. On microscopic examination, the tumor consisted of interlacing bundles of smooth muscle cells, which were positive for α-smooth muscle actin. As solitary genital leiomyoma is rare, we present this case and review 40 cases that occurred in Japan. Of these cases in Japan, about 70 per cent of the tumors were located in the lesions of the left side, thus our case arising from the right side of scrotum seems to be relatively rare

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We report a case of intravascular papillary endothelial hyperplasia(IPEH)associated with venous hemangioma and thrombosis. A 19-year-old woman had noticed two mass lesions on the sole of the left foot about 2 years earlier. At the first examination the lesions were slightly elevated, elastic-hard subcutaneous nodules. For diagnosis and treatment, we excised the lesions under local anesthesia. Histopathologically the specimen showed venous hemangioma with many dilated thin-walled vessels. Papillary structures were lined by a single layer of endothelial cells and thrombosis was observed within the dilated lumen of the hemangioma. Based on these features, a diagnosis of IPEH associated with venous hemangioma with thrombosis was made. It is suggested that thrombus formation may play an important role in the pathogenesis of IPEH.

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A 28-year-old woman and a 54-year-old her mother developed small papules and pustules on the body almost simultaneously. They took a daily bath at home using the same bath tub and synthetic sponge with soap to wash the body. The eruption did not occur in the son who had used a shower and towel outside the tub. Bacterial culture from the pustule of the daughter revealed the growth of Pseudomonas aeruginosa. We instructed the patients to stop using the bath sponge and to use dry cotton towels. Oral levofloxacin and topical gentamycin were given for one week with complete healing of the lesion. In the dermatological field, only a few patients with Pseudomonas aeruginosa folliculitis have been described.

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At the end of June in 2005, a 51 year old man scraped his hand on a wall. Two weeks later a reddish nodule appeared on the same area and he consulted a dermatologist on August 31, 2005. A surface area of 23×20mm on his right hand MP thumb joint, a scaly reddish nodule was observed. Since the patient often insert his bare hands into his tropical fish aquarium for maintenance, an atypical skin acid-fast bacterium, such as sporotrichosis, was suspected, so a skin biopsy was performed. An epithelioid granuloma infiltrating multinucleated giant cells was confirmed by staining. An Ogawa’s medium was cultivated at 25ºC. Three weeks later a colony was confirmed and Mycobacterium marinum was identified by DNA-DNA hybridization. 200mg of hydrochloric acid minocycline was orally administered daily for 7 weeks, and the infection abated.

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We analyzed the effects of PUVA-bath therapy in fifty-one inpatients with psoriasis. Of these, thirty patients were followed twelve month after discharge. All patients had steroid and / or topical vitamin D ointment. The mean number of exposure was 13.4 times and the mean dose of UVA was 11.1J/cm². Twenty-one patients had etretinate. PUVA-bath with etretinate was effective therapy to forty-seven patients(92%) as inpatients. Seven patients out of thirty outpatients(23%) had recurrence of psoriasis after discharge. The number of PUVA-bath therapy at 12 month after discharge is less than that at 6 month after discharge. Although some patients were resistant to the effects of cyclosporine or had side effects of cyclosporine, PUVA-bath therapy had effective on these patients. There were no side effects of PUVA-bath therapy. Taken together, PUVA-bath therapy with or without etretinate was useful to moderate to severe psoriasis patients.

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This study examined the enhanced properties of Laurier F^®, a new sanitary napkin that reduces overhydration and physical stimulus, using 16 female subjects with sanitary napkin dermatitis.
Initially, subjects used their regular sanitary napkins during their menstrual period. Subsequently, during their next menstrual period, they used Laurier F napkins. After using their regular napkins, the Laurier F napkins, and a non-menstruation period, dermatologists examined the condition of the skin in the area under the napkin and interviewed the subjects about their symptoms. In addition, the subjects completed a diary about using the napkins and answered questionnaires about their usage.
Of the 16 subjects, 15 had erythema, 8 had maceration and 7 had scaling, accompanied by itching and/or stinging after using their regular napkins. However, usage of Laurier F napkins caused erythema only in 5 of the subjects, 1 had maceration and 1 had scaling. Accompanying these reductions, the symptoms were relieved. These results suggest a marked reduction in the severity of dermatitis in subjects after use of Laurier F napkins. In addition, the questionnaires revealed improvement in the subjective sensation during and after the use of Laurier F napkins compared to other brand of napkins.

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We investigated whether topical application of tranexamic acid(TA) emulsion is effective for improving the pigmentation in melasma and freckles. The subjects, 25 with melasma and 8 with freckles, used the TA emulsion for five to eighteen weeks, and the outcome was evaluated based on a doctor’s visual assessment of skin pigmentation. At the last observation point, TA emulsion had improved the pigmentation in melasma and freckles in 20 subjects(80%) with melasma and 6 subjects(75%) with freckles. No side effect was recognized, so TA emulsion is considered to be safe. As regards the time course, marked improvement was observed within 8 weeks for melasma, but within 12 weeks for freckles ; therefore, improvement was considered to require at least two months of topical application. We conclude that TA emulsion is an effective cosmeceutical product having a whitening effect on melasma and freckles through inhibition of melanin synthesis, and preventing the appearance of new pigmented spots and freckles.

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