Skin trait variation impacts quality-of-life, especially for females from the viewpoint of beauty. To investigate genetic variation related to these traits, we conducted a GWAS of various skin phenotypes in 11,311 Japanese women and identified associations for age-spots, freckles, double eyelids, straight/curly hair, eyebrow thickness, hairiness, and sweating. In silico annotation with RoadMap Epigenomics epigenetic state maps and colocalization analysis of GWAS and GTEx Project eQTL signals provided information about tissue specificity, candidate causal variants, and functional target genes. Novel signals for skin-spot traits neighboured AKAP1/MSI2 (rs17833789; P = 2.2 × 10−9), BNC2 (rs10810635; P = 2.1 × 10−22), HSPA12A (rs12259842; P = 7.1 × 10−11), PPARGC1B (rs251468; P = 1.3 × 10−21), and RAB11FIP2 (rs10444039; P = 5.6 × 10−21). HSPA12A SNPs were the only protein-coding gene eQTLs identified across skin-spot loci. Double edged eyelid analysis identified that a signal around EMX2 (rs12570134; P = 8.2 × 10−15) was also associated with expression of EMX2 and the antisense-RNA gene EMX2OS in brain putamen basal ganglia tissue. A known hair morphology signal in EDAR was associated with both eyebrow thickness (rs3827760; P = 1.7 × 10−9) and straight/curly hair (rs260643; P = 1.6 × 10−103). Excessive hairiness signals’ top SNPs were also eQTLs for TBX15 (rs984225; P = 1.6 × 10−8), BCL2 (rs7226979; P = 7.3 × 10−11), and GCC2 and LIMS1 (rs6542772; P = 2.2 × 10−9). For excessive sweating, top variants in two signals in chr2:28.82-29.05 Mb (rs56089836; P = 1.7 × 10−11) were eQTLs for either PPP1CB or PLB1, while a top chr16:48.26–48.45 Mb locus SNP was a known ABCC11 missense variant (rs6500380; P = 6.8 × 10−10). In total, we identified twelve loci containing sixteen association signals, of which fifteen were novel. These findings will help dermatologic researchers better understand the genetic underpinnings of skin-related phenotypic variation in human populations.

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DEAR EDITOR, A 46-year-old Japanese man had experienced multiple slightly scaly erythematous patches on his flanks, hips and thighs for about 20 years, and had received no medical treatment. The patient noticed a small red nodule on the posterior aspect of his right thigh, which increased in size and ulcerated rapidly over the course of 1 year. The tumour was 4 cm in diameter, forming a central ulcer with yellow and black necrotic tissue ( Fig. 1a,b). A biopsy specimen taken from an erythematous patch showed atypical T-cell infiltration with epidermotropism and multiple Pautrier microabscesses ( Fig. 2a). These cells were positive for CD3 and CD4, but not for CD8 or CD30 ( Fig. 2b-d, and data not shown). The condition was diagnosed as mycosis fungoides (MF).A biopsy specimen taken from the tumour revealed dense infiltration of highly atypical medium-sized lymphocytes in the dermis (Fig. 2e). Pleomorphism and mitotic figures were observed (Fig. 2f). Immunohistochemically, atypical lymphocytes were positive for CD3, CD8 and granzyme B, but not for CD4 or CD30 (Fig. 2g,h, and data not shown). T-cell receptor (TCR) gene rearrangement analysis using polymerase chain reaction (PCR) revealed monoclonal peaks of the same size for the b and c chains of TCR in both lesions (Fig. 2i, j). The tumour was removed surgically. Erythematous lesions were treated with a topical steroid and narrowband ultraviolet B phototherapy. No new nodules or tumours developed for 31 months after the initial diagnosis.

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