The Journal of dermatology最新文献

{"title":"Recurrent Cutaneous Mycobacterium chelonae Infection With an IgM-Predominant Antibody Response in DiGeorge Syndrome.","authors":"Makoto Kondo, Sho Mori, Koji Habe, Keiichi Yamanaka","doi":"10.1111/1346-8138.70302","DOIUrl":"https://doi.org/10.1111/1346-8138.70302","url":null,"abstract":"<p><p>A young girl with DiGeorge syndrome developed recurrent cutaneous infection caused by Mycobacterium chelonae infection while receiving immunosuppressive therapy. Immunological evaluation demonstrated reduced T-cell proportions and impaired humoral immunity. Western blot analysis using recurrence-phase serum showed IgM reactivity against the recurrent isolate but no detectable IgG reactivity. These findings suggest impaired T-cell-dependent class-switch recombination, resulting in an IgM-predominant humoral response in DiGeorge syndrome.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melanoma Dissemination Through Bullous Solar Elastosis: Previously Undescribed Pattern of Cancer Dissemination.","authors":"Ken Horisaki, Keisuke Goto, Arata Tsutsumida, Tsubasa Hiraki, Shusuke Yoshikawa","doi":"10.1111/1346-8138.70303","DOIUrl":"https://doi.org/10.1111/1346-8138.70303","url":null,"abstract":"<p><p>Metastasis can be classified into three forms based on the route of spread: lymphatic, hematogenous, and seeding within body cavities. We report a case of melanoma exhibiting seeding/dissemination around the primary site through bullous solar elastosis, a previously unreported pattern. A 75-year-old man presented with a black nodule on the right forearm. One year after excision, a bluish-gray macular lesion developed distal to the surgical scar. Histopathology of the primary lesion revealed features of high-CSD melanoma with bullous solar elastosis forming cleft-like spaces in the superficial and mid-dermis, containing scattered melanoma cells. The recurrent lesion demonstrated a widespread band-like distribution of melanoma cells along bullous solar elastosis. This case suggests that cleft-like spaces in bullous solar elastosis may act as conduits for horizontal tumor spread, resulting in clinicopathological features that are distinct from conventional metastasis. Recognition of this pathway may improve diagnostic accuracy and understanding of cancer behavior in chronically sun-exposed skin.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Minimal Blistering Dose-Based Versus Conventional Excimer Laser Therapy for Vitiligo.","authors":"Aya Yamamoto, Yuki Enomoto, Mai Sakurai, Oki Watanabe, Yoshifumi Kanayama, Yumi Koike, Takashi Sakaida, Akimichi Morita","doi":"10.1111/1346-8138.70247","DOIUrl":"https://doi.org/10.1111/1346-8138.70247","url":null,"abstract":"<p><p>Excimer laser therapy is an established treatment for vitiligo, but the optimal irradiation protocol remains unclear. Irradiation based on the minimal blistering dose (MBD) was recently proposed, but its efficacy relative to conventional protocols has not been systematically evaluated. In this study, we retrospectively analyzed 43 patients with vitiligo who underwent more than 20 sessions of excimer laser therapy at Nagoya City University Hospital, including 29 treated with the conventional protocol and 14 with the MBD protocol. In the conventional group, treatment was initiated at half the minimal erythema dose (MED) and gradually increased, whereas in the MBD group, treatment was initiated at twice the MED and maintained at the MBD, with further increases after photohardening. Treatment efficacy was assessed using the Vitiligo Area Scoring Index (VASI) at baseline, and after the 10th and 20th irradiation sessions. The MBD group showed significantly greater improvement in VASI (%) compared with the 1/2 MED group (p = 0.0041). The area under the curve (AUC_₀-₂₀) for ΔVASI% over 20 sessions was also significantly higher in the MBD group (p < 0.0001). Furthermore, Kaplan-Meier analysis of time to VASI 50 achievement demonstrated that patients in the MBD group reached VASI 50 significantly earlier than those in the 1/2 MED group. Adverse events, including erythema, burning, and blistering, were mild and transient and resolved without treatment discontinuation. In conclusion, MBD-based excimer laser irradiation achieved earlier repigmentation with fewer sessions compared with the conventional protocol without a statistically significant increase in cumulative irradiation dose. This approach may reduce the treatment burden and accelerate clinical improvement in patients with vitiligo.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Cosmetics of Secondary Intention Healing for Facial Skin Cancer: A Single-Center Retrospective Study.","authors":"Arisa Kimura, Takayuki Ishii, Naohito Hatta","doi":"10.1111/1346-8138.70298","DOIUrl":"https://doi.org/10.1111/1346-8138.70298","url":null,"abstract":"<p><p>Reconstruction after facial skin cancer excision requires balancing oncologic safety with cosmetic outcomes. Secondary intention healing (SIH) is a simple and cost-effective wound management approach that avoids complex reconstruction and permits close oncologic surveillance; however, it remains underutilized because of concerns regarding prolonged healing and unpredictable cosmetic results. Moreover, whether evidence derived primarily from Western populations can be extrapolated to Asian patients remains unclear. In this retrospective study, we reviewed 129 Japanese patients who underwent facial skin cancer excision, including 103 basal cell carcinomas and 26 squamous cell carcinomas. Among them, 87 patients were treated with SIH and 42 with surgical closure (SC). Cosmetic outcomes were evaluated in 48 patients by 10 independent evaluators using standardized postoperative photographs obtained approximately 1 year after surgery and assessed with a three-point scale ('noticeable', 'noticeable on close inspection', and 'not noticeable'). In the SIH group, the mean time to epithelialization was 39.51 ± 16.42 days, and defect size showed a significant positive correlation with epithelialization time. The median cosmetic score was 6.5 in the SIH group and 7.5 in the SC group, with no significant difference between groups (p = 0.755). Receiver operating characteristic curve analysis demonstrated that defects ≤ 14 mm in size were associated with a higher likelihood of favorable cosmetic outcomes. In univariate analysis, smaller defect size and concave surfaces of NEET (nose, eye, ear, and temple) location were associated with favorable cosmetic outcomes, whereas multivariate analysis identified defect size and female sex as independent predictors of unfavorable outcomes. These findings suggest that SIH is a cosmetically acceptable and clinically feasible reconstructive option after facial skin cancer excision in Japanese patients, in carefully selected cases with respect to sex, defect size and tumor location.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunohistochemistry Revealed Distinct IL-36γ Localization Among Different Skin Diseases.","authors":"Megumi Kishimoto, Miho Kimura-Sashikawa, Mayumi Komine","doi":"10.1111/1346-8138.70291","DOIUrl":"https://doi.org/10.1111/1346-8138.70291","url":null,"abstract":"<p><p>IL-36γ is highly expressed in psoriatic skin lesions and promotes neutrophil infiltration through the induction of neutrophil chemotactic chemokines. While IL-36γ has been established to play an important role in the pathogenesis of psoriasis, its localization in the psoriatic epidermis has not been fully elucidated, and the difference in its expression patterns among other inflammatory skin diseases remains unclear. We investigated IL-36γ localization using immunohistochemistry in skin specimens from patients with psoriasis vulgaris (n = 36), generalized pustular psoriasis (n = 11), pyoderma gangrenosum (n = 6), palmoplantar pustulosis (n = 6), tumor necrosis factor inhibitor-induced paradoxical reaction (n = 3), pustular drug eruption (n = 5), atopic dermatitis (n = 11), tinea infection (n = 3), and mycosis fungoides (n = 9), as well as uninvolved skin adjacent to benign tumors (n = 4). Staining scores were assessed based on intensity and distribution, and nuclear positivity was compared among diseases. IL-36γ was strongly expressed in the upper epidermis of psoriasis vulgaris and generalized pustular psoriasis, with staining scores significantly higher than those in atopic dermatitis and adjacent normal skin. Expression in pyoderma gangrenosum, palmoplantar pustulosis, paradoxical reaction, and pustular drug eruption was comparable to psoriasis vulgaris. Nuclear staining of IL-36γ was frequent in psoriasis vulgaris (33/36, 92%) and generalized pustular psoriasis (11/11, 100%), but absent in pyoderma gangrenosum. The difference in nuclear positivity between psoriasis and pyoderma gangrenosum was statistically significant. These findings confirm that IL-36γ is highly expressed in psoriatic lesions but is not specific to psoriasis, as it is also upregulated in other inflammatory skin diseases. Nuclear staining was observed in psoriasis but not in pyoderma gangrenosum, suggesting a potential disease-specific localization pattern. The biological significance and mechanism of nuclear localization remain unclear, as the IL-36γ molecule lacks a nuclear localization signal. Our findings highlight that the localization of IL-36γ differs among inflammatory skin diseases, suggesting that it may reflect pathogenic differences and warrant further investigation.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Annular Pustular Psoriasis Possibly Triggered by Cabozantinib and Edoxaban During Nivolumab Therapy.","authors":"Mana Nagatake, Hiroto Horikawa, Risa Kakuta, Takeya Adachi, Keishiro Fukumoto, Masayuki Amagai, Yoshihiro Ito","doi":"10.1111/1346-8138.70301","DOIUrl":"https://doi.org/10.1111/1346-8138.70301","url":null,"abstract":"","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erythropoietic Protoporphyria and Surgery: A Case of Successful Mastectomy With Perioperative Light Shielding Strategies Based on Light-Induced Hemolytic Threshold Assessment.","authors":"Fumika Tateishi, Naoya Murayama, Ruri Nakamuta, Masahisa Watanabe, Aya Tanaka, Hiroyuki Murota","doi":"10.1111/1346-8138.70269","DOIUrl":"https://doi.org/10.1111/1346-8138.70269","url":null,"abstract":"<p><p>A 50-year-old female patient was referred to our department for consultation regarding perioperative management of breast cancer surgery. She had a history of photosensitivity since childhood and was diagnosed with erythropoietic protoporphyria (EPP) during her first pregnancy. Because EPP is classified as a cutaneous porphyria that can cause hemolysis and liver impairment upon light exposure, we conducted a light-induced hemolysis test to determine intraoperative and postoperative exposure thresholds. Hemolysis was observed after 4 h of surgical light exposure. To minimize light-induced hemolysis during surgery, we applied optical films blocking light around the 400 nm wavelength range to the shadowless operating light, monitors, and overhead lamps. Under these conditions, a four-hour surgical procedure was successfully completed. No liver dysfunction or elevation of plasma protoporphyrin levels was observed intraoperatively or postoperatively. This case provided practical guidance for perioperative light management in EPP.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Tsutsugamushi Mite Infestation With Multiple Larvae Visibly Attached to the Skin.","authors":"Ai Yoshizaki, Yasuo Wada, Masako Andoh, Gyohei Egawa","doi":"10.1111/1346-8138.70300","DOIUrl":"https://doi.org/10.1111/1346-8138.70300","url":null,"abstract":"","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophilic Pustular Folliculitis-Like Eruption Limited to the Lower Legs.","authors":"Miyu Tsuritani, Teruhiko Makino, Megumi Mizawa, Keita Takemoto, Tadamichi Shimizu","doi":"10.1111/1346-8138.70235","DOIUrl":"10.1111/1346-8138.70235","url":null,"abstract":"","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":"e418-e419"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood Granulomatous Periorificial Dermatitis With Extrafacial Involvement.","authors":"Hyuga Kitagawa, Yuki Mizutani, Akinobu Hayashi, Keiichi Yamanaka","doi":"10.1111/1346-8138.70208","DOIUrl":"10.1111/1346-8138.70208","url":null,"abstract":"","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":"e380-e381"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}