Dermoid cyst is a congenital disease that involves an aberrant ectoderm in the embryonic stage. It occurs mainly along the embryonic fusion line, such as periorbit and oral floor in head and neck lesions. We report two cases of dermoid cysts that occurred in the post-auricular area. Although post-auricular dermoid cyst is rare, we should be familiar with this entity. Dermoid cyst should be considered in the differential diagnosis of congenital tumor-like lesions of post-auricular lesions in infants.

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Case 1 was a 65-year old female with right renal cell carcinoma. At about 2 years following nephrectomy, a node appeared in the index finger of the right hand. Case 2 was a 53-year-old man with right renal cell carcinoma. At about 3 years following nephrectomy, a tumor appeared on the palm of the left hand. In both patients, a pathological examination showed skin metastasis of renal cell carcinoma. In CT scans of both patients, no infiltration of the tumor in the bones or surrounding tissue was confirmed and only the tumors were resected. No localized recurrences have been found more than 2 years postoperatively.

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A 54-year-old man was referred to our department with reddish nodules on his trunk and left arm. Serum anti-HTLV-1 antibody was positive. Although no infiltration of atypical lymphocytes was present in either the peripheral blood or the bone marrow, southern blot analysis detected monoclonal integration of proviral DNA of HTLV-1 into the host genome in the biopsy specimen of the cutaneous nodule. A diagnosis of tumoral subtype of ATLL was established. With oral administration of VP-16 and localized radiotherapy, he achieved complete remission. Eighteen months after the discontinuance of medications, many papules appeared on the extremities and vesicles were seen on the feet. He received combination chemotherapy but died of respiratory failure due to pulmonary involvement. We should keep in mind that the development of vesicles in ATLL patients may be a cutaneous manifestation of the disease.

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We carried out a seven-week study in 66 women who had hand roughness symptoms from early autumn to winter in order to assess the safety and effectiveness of low-irritation dishwashing detergent. The safety of this item was judged by comparing the adverse effects with two commercial products. This item was equal to two commercial products for the incidence of adverse effects. These adverse effects were slight or moderate, and no severe reactions were reported. The item was especially effective in controlling fissures in comparison with two commercial products. These results indicate that this item is safe and useful for women who have hand roughness symptoms from early autumn to winter.

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Adapalene, the first topical retinoid in Japan, is one of the first choices for mild to moderate acne in global acne treatment algorithm, and strongly recommended for comedonal and mild to severe inflammatory acne in Japanese acne treatment guidelines. But Japanese dermatologists and acne patients are not familiar with the treatment of comedonal acne and the adverse events of topical retinoids, which include scaling, erythema, and stinging on applied area. Dermatologists should encourage patients to continue its application every 2 to 3 months to realize the effectiveness. The frequency of adverse events is high, but most of them are mild or slight, and in many cases, skin care with moisturizer and adjustment of applied amount of adapalene decreases the severity of the adverse events. It is recommended to use 1 finger tip unit, or approximately 0.5g, of adapalene once a day, and adjusting the amount according to the efficacy and adverse events.
Adapalene is the only effective topical drug for comedonal acne in Japan. We must prescribe this medicine skillfully, while balancing positive effects and side effects.

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Psoriasis is characterized by excessive growth and aberrant differentiation of keratinocytes and considered to be an immune-mediated complex multigenic disease. Experiments using skin grafts onto SCID or athymic nude mice revealed that the development of psoriasis requires the interaction of keratinocytes and immunocytes, such as T cells in particular. T-helper 17 (Th17) cells are a newly identified T cell subset because they produce IL-17, which is distinct from Th1 and Th2, and have been implicated in the pathogenesis of psoriasis. Th17 cells produce a variety of cytokines, including IL-17A, IL-17F, IL-22, IL-21, and TNF-a. IL-22 was proved to mediate acanthosis through the activation of keratinocytes Stat3 in vivo. Evidence has demonstrated that psoriatic lesions contain increased Th17 and mRNAs of aforementioned Th17 cytokines as well as IL-23, which plays a critical role in maturation and activation of Th17. Furthermore, recent studies revealed that polymorphisms in genes that encode IL-12/23p40 and IL-23R enhance susceptibility to psoriasis. These results indicated that IL-23/Th17 represents a key axis for the pathogenesis of psoriasis, as well as the therapeutic efficacy of anti-IL-12/23p40. Corneodesmosin gene (CDSN) is a psoriasis susceptibility gene 1(PSORS1), expressed exclusively in skin, and encodes a protein needed for inter-corneocytes adhesion. We established CDSN gene targeted mice, and their transplanted skin onto nude mice demonstrated psoriasiform changes including Stat3 activation. This result suggests that corneodesmosin might play a role in the epidermal differentiation program and control of Stat3. Recent findings of other psoriasis susceptibility genes, including epidermal differentiation complex (EDC), together with genes related to immunity, implicate a contribution of epitasis to the pathogenesis of psoriasis.

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