The role of online ethics consultation on mental health.

Background: Nurses experience moral distress when they cannot do what they believe is right or when they must do what they believe is wrong. Given the limited mechanisms for managing ethical issues for nurses in Japan, an Online Ethics Consultation on mental health (OEC) was established open to anyone seeking anonymous consultation on mental health practice.

Research Objective: To report the establishment of the Online Ethics Consultation and describe and evaluate its effectiveness.

Cutaneous Pseudallescheria boydii/Scedosporium apiospermum Complex (Molecular type: Scedosporium apiospermum [Clade 4]) Infection: A Case Report and Literature Review of Cases from Japan.

We report a case of subcutaneous Pseudallescheria boydii/Scedosporium apiospermum complex infection occurring in a 77-year-old Japanese female farmer suffering from interstitial pneumonia. Seven months prior to the current presentation, she noticed nodes on her right forearm after pulling up weeds, and the nodes grew larger. Two soft dome-shaped, protruded nodes ( 15 mm and 30 mm in size ) had fused together on the extensor surface of the right forearm.

[MRSA clones identified in outpatient dermatology clinics].

To know the characteristics of methicillin-resistant Staphylococcus aureus (MRSA) strains disseminating through the Japanese community, we have determined types of Staphylococcal cassette chromosome mec (SCCmec) elements, Multi-Locus Sequence Typing (MLST), and carriages of four exotoxin genes (toxic-shock syndrome toxin, Panton-Valentine Leukocidine, and exfoliative toxins a and b) using 54 MRSA strains isolated from outpatients attending dermatology clinics at the four university hospitals of Juntendo University. Ten clonal complexes and 12 SCCmec types have been identified. As a result, more than 15 MRSA clones that were defined by the combination of genotype and SCCmec type, were identified.

[A case of secondary cutaneous cryptococcosis manifesting as rapidly enlarging skin ulcers on the dorsal surface of the hand and the left thigh].

 In April 2012 an 88-year-old woman, who was receiving oral prednisolone (15 mg/day) for the treatment of chronic inflammatory demyelinating polyneuropathy, was admitted to our hospital with suspected pneumonia. The patient was diagnosed with pulmonary cryptococcosis based on the findings from chest radiography and computed of tomographic imaging and observation of a high cryptococcal antigen titer. The general condition of the patient, including her fever, improved after initiation of an intravenous infusion of fluconazole (200 mg/day).

Successful treatment of relapsing neuro-Sweet's disease with corticosteroid and dapsone combination therapy.

Sweet's disease with central nervous system involvement, tentatively named neuro-Sweet's disease, has rarely been reported. Although systemic corticosteroid therapy is highly effective for neurologic symptoms in neuro-Sweet's disease, relapse is common. Here, we describe the case of a 38-year-old Japanese man who presented with relapsing neuro-Sweet's disease that was successfully treated with a combination of corticosteroid and dapsone.

Detergent-induced epidermal barrier dysfunction and its prevention.

Various detergents are used as skin cleansing products. In some cases, skin cleanser removes not only dirt but also valuable skin lipids. Therefore, detergents may disrupt epidermal barrier function despite that using of detergents are required for good skin hygiene.