A Q-switch laser was applied to an area affected by nevus spilus and changes in the lesion after treatment were compared to its pretreatment condition using in vivo reflectance confocal microscopy (RCM). Before laser therapy, the affected area was rich in high density white granules compared to that in intact skin, and these granules were accompanied by a large number of dermal papillae. After laser therapy, the white granules showed decreased density and partially became non-refractive black inorganic areas. There was also an accompanying decrease in dermal papillae. Similar findings were obtained on histopathological examination, thereby confirming the usefulness of RCM as a method of assessing nevus spilus. Skin Research, 9: 521-525, 2010

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A 78-year-old man had a history of fever, pneumonia with dyspnea and eruption with pruritus 5 years previously, for which the patient was started on oral corticosteroid administration. Thereafter, the patient developed recurrent erythema when the dose of oral corticosteroid was reduced. Therefore, the patient unwillingly continued oral corticosteroid for 5 years. There were no signs of malignancy. Although drug-induced eruption and pneumonia were suspected, the patient reported that he had been taking no medicine. Then he was referred to our hospital for further evaluation. Review of the medical history demonstrated that he had continued to take fluvastatin, which had been prescribed by his family practitioner for almost 7 years. The eruption diminished within two weeks after discontinuing fluvastatin. The patient has had no recurrences during a 9-month follow-up to date. However, interstitial pneumonia on chest CT has persisted. Accordingly, fluvastatin-induced eruption and pneumonia was diagnosed. His symptom developed two years after the initiation of fluvastatin and recurred several weeks after the dose of steroid was reduced, which is an atypical feature of allergic drug eruption. Skin Research, 9: 526-531, 2010

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A 33-year-old female had a nevus existing at the border of the left palm and wrist since birth. In September 2009, she delivered a child, and consulted our hospital complaining of enlargement of the nevus during pregnancy. At the initial examination, there was a dark brownish, elevated mass (1.8×1.2cm) with a border that was unclear in parts. Based on clinical and dermoscopic findings, the possibility of malignant melanoma could not be excluded. Histopathological examination of the resected tissue showed an increased number of basal melanocytes and circular-round nevus cells forming nests from the lower epidermal layer to the upper dermis and very low-grade nuclear atypia. Based on these findings, a diagnosis of nevocellular nevus was made. Sex steroid hormones such as estrogen may be involved in the enlargement of the nevus in this patient. Skin Research, 9: 532-535, 2010

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Malignant pleural mesothelioma is an uncommon tumor derived from the serosal membranes of the pleura. Skin metastasis occurs by distant metastasis and/or direct extension. Direct extension of malignant pleural mesothelioma is caused by seeding of tumor cells along the tracts of chest instrumentation. We report a 55-year-old male patient who had a subcutaneous tumor on the right flank. One year before thoracoscopy and drainage were performed for pleural fluid, a needle biopsy had demonstrated malignant pleural mesothelioma (epithelioid type). An excised specimen of subcutaneous tumor showed proliferation of atypical epithelial cells in the dermis, positive expression of wide keratin, cytokeratin 7, calretinin, and mesothelin. These clinical, histopathological, and immunohistochemical findings demonstrated that our case had developed cutaneous extension of malignant pleural mesothelioma due to the previous thoracoscopy. This case emphasizes the need for awareness of the risk of direct extension of malignant pleural mesothelioma after chest instrumentation. Skin Research, 9: 536-540, 2010

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A 29-year-old man developed an itchy eruption on his left forearm two months previously. Since the rash gradually expanded, he consulted our hospital. He had started to keep a chinchilla six months earlier, and the animal had developed an area of patchy alopecia, coincident with his rash. A thumb-tip-sized [Note: it is better to indicate size in cm or mm], scaly, erythematous papule was observed on his left forearm, and direct microscopic examination of skin scrapings showed the presence of fungi, leading to a diagnosis of body ringworm. Slide cultures demonstrated round conidia in grape-like clusters, as well as spiral organs. Isolates were identified by culture as Trichophyton mentagrophytes, and by PCR as Arthroderma vanbreuseghemii. The chinchilla was then examined at an animal hospital, and was also diagnosed with ringworm by microscopy. The skin rash was relieved by topical application of terbinafine hydrochloride. Since rodents including chinchillas are increasingly being kept as pets, we predict that the incidence of fungal infections transmitted from murine hosts will increase in the future. Skin Research, 9: 541-544, 2010

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[in Japanese]

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Acne sometimes results in depressed scars that are extremely difficult to treat. Focal application of a high concentration of trichloroacetic acid treats acne scars by inducing the wound healing process after partial dermal necrosis. Significant improvement was observed in icepick- and deep boxcar- type acne scars. This technique is a safe and effective therapeutic method for depressed acne scars. Skin Research, 9: 548-553, 2010

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Urticaria is a common skin disease caused by transient dermal edema caused by mast cell degranulation. However, its clinical findings are variable. Here I describe some important information concerning classification of urticaria, new aspects of allergic urticaria caused by food intake, usefulness of clinical blood examination to find the pathogenesis of idiopathic chronic urticaria, and the effective administration of H1-blockers, combined H1- and H2-blockers, leukotriene antagonists and steroids. Skin Research, 9: 554-558, 2010

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Exercise is a triggering factor for certain types of urticaria. This category of urticaria includes food-dependent exercise-induced anaphylaxis and cholinergic urticaria. Food-dependent exercise-induced anaphylaxis is a distinct form of food allergy which is induced by exercise and/or aspirin intake together with food ingestion. Enhancement of allergen absorption from the gastrointestinal tract underlies in the triggering mechanisms induced by exercise and/or aspirin intake. Cholinergic urticaria can be diagnosed in terms of triggering by exercise alone. This type of urticaria is characterized by multiple small wheals in association with sweating. Sweat allergy may underlie the pathogenesis of cholinergic urticaria. Skin Research, 9: 559-562, 2010

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[in Japanese]

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