Shiho Tamiya

A novel case of nocardiosis with skin lesion due to Nocardia araoensis.

Nocardiosis is caused by Gram‐positive aerobic actinomycetes that live in soil and are known to be responsible for opportunistic infections. The condition mostly affects the lung, brain or skin. Here, we present a 24‐year‐old Japanese woman who had had systemic lupus erythematosus since the age of 20 years, and lupus nephritis since the age of 23 years. She developed cutaneous lymph duct‐type nocardiosis due to Nocardia araoensis while on immunosuppressant therapy. The patient had cutaneous findings from the right inguinal region to the right lower thigh and did not have lesions on the rest of the body. Minocycline and co‐trimoxazole were co‐administrated, and her condition improved. To our knowledge, this is the first case in which N. araoensis was detected by analysis on rRNA base sequence in skin lesions.

A novel splicing variant of CADM2 as a protective transcript of psoriasis

CADM2, a candidate gene for psoriasis, was identified by a genome-wide association study using microsatellites in the Japanese population (561 cases and 561 controls). Moreover, haplotype analysis included an additional 68 SNPs and indicated that a 110-kb haplotype block was detected for the protective risk haplotype of psoriasis. We also identified an initial exon of novel splicing variants in this haplotype block. A functional analysis by qRT-PCR using RNAs from the blood of 56 cases and 64 controls significantly demonstrated an inverse correlation between expression frequencies in a novel splicing variant and the number of alleles associated with psoriasis. To confirm these results, we must perform replication studies using other ethnic groups and more functional analysis particularly for skin tissues.

Diagnostic usefulness of findings in Doppler sonography for amelanotic melanoma

To evaluate the diagnostic usefulness of Doppler sonography for amelanotic melanoma (AM), the correspondence between the findings of dermoscopy and Doppler sonography was investigated in AM in comparison with other hypopigmented tumors. Seven cases with AM and 11 cases with squamous cell carcinoma (SCC), 10 cases with non‐ or hypopigmented basal cell carcinoma (NP‐BCC) and six cases with eccrine poroma (EP) as hypopigmented tumors were investigated. EP is readily recognized by differences from AM and SCC based on a single vertical and non‐torvtuous vessels. NP‐BCC is distinguished from AM based on tortuosity running in a vertical direction. Though findings of tortuosity in vessels and heterogeneity of vessel size are recognized both in AM and SCC: (i) abundant blood flow was recognized more clearly in AM; (ii) total blood flow was more than 40% in most cases of AM (average, 60.9%); and (iii) more vessels which flow into a tumor are found in AM (85.7%). There is no relationship between dermoscopic findings of vessel types and Doppler sonography findings of vessels. In this study, the diagnostic usefulness of the above‐mentioned specific findings in examination may suggest using Doppler sonography for AM as one non‐invasive method.

Development of psoriasis 10 years after allogeneic hematopoietic cell transplantation from non‐psoriatic donor: Further evidences for genetics and immunopathogenesis of psoriasis

Japan and only five instances from other countries. This scarcity of papers on adalimumab for GPP highlights the significance of our report. The case we experienced was rare in that GPP developed in a PsA patient, who refused infusion. Adalimumab elicited a favorable response to the concomitant GPP. No similar reports have been published except for a case reported by Zangrilli et al. More case records should be collected to establish evidence that adalimumab is a safe and effective treatment, even for GPP patients judged as having primary or secondary failure to infliximab therapy.