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Background/PurposeAtopic dermatitis (AD) is an inflammatory skin disease characterized by a chronic course of exacerbations and remissions. High‐dose ultraviolet A‐1 (UVA‐1) phototherapy has been effective in the treatment of acute exacerbations of AD. However, there have been no case studies in Asian patients to date. We investigated the effectiveness of high‐dose UVA‐1 phototherapy for treating acute exacerbation of AD in Asian patients.MethodThis study included 16 patients with acute exacerbation of AD. High‐dose (100 J/cm2) regimens of UVA‐1 therapy were employed. Therapeutic effectiveness was assessed based on the findings of clinical examinations and scoring of AD (SCORAD) index before treatment and after the 5th and 10th sessions of treatment. Additionally, side effects and recurrence during follow‐up were retrospectively evaluated.ResultsThe patients were between 7 and 50 years of age, with a mean age of 25.8 years. The SCORAD index was between 41 and 89.5, with a mean score of 64.9. Among the 16 patients, two patients discontinued treatment due to the aggravation of erythema and pruritus. Of the 14 patients who completed the 10 sessions of high‐dose UVA‐1 phototherapy, nine patients (64.3%) showed complete remission and five patients (35.7%) showed partial remission. The mean SCORAD index reduced from 64.9 (before treatment) to 23.3 (after the 10th session of treatment).ConclusionThis is the first case study of high‐dose UVA‐1 phototherapy for acute exacerbation of AD in Asian patients, suggesting that high‐dose UVA‐1 phototherapy can be a well‐tolerated and effective treatment for acute exacerbated AD. Future large‐scale prospective studies are needed.

Since large cell acanthoma (LCA) has many overlapping clinical and histopathological features with other epidermal pigmented tumours, an additional method to differentiate it would be of great clinical significance. A retrospective study was performed on 33 lesions (26 patients) to identify distinct dermoscopic findings of LCA and to describe dermoscopic‐histopathological correlations. The results revealed that dermoscopy significantly aids in the distinction of LCA from other epidermal tumours included in the differential diagnosis. Yellow opaque homogeneous background, brown dots, and moth‐eaten border are common findings, and prominent skin markings and short white streaks are additional distinguishing features. Several important findings that are common in other diseases are rare in LCA.

Primary cutaneous CD30 + lymphoproliferative disorders are the second most common cutaneous T-cell lymphoma. In the case of solitary or localized primary cutaneous anaplastic large cell lymphoma (PCALCL), surgical excision or radiotherapy are the first-line treatments. However, those options can lead to significant functional or cosmetic morbidities. Low-dose methotrexate has not been established in treatment for solitary or localized PCALCL. Furthermore, even in multifocal PCALCL, low-dose methotrexate has been proposed as first-line therapy based on only a limited number of studies. There has been no report of long-term follow-up data focused specifically on Asian patients with PCALCL treated with low-dose methotrexate. This study suggests that low-dose MTX treatment should be established as an effective alternative in the treatment guidelines for solitary or localized PCALCL, in which surgical excision and/or radiotherapy is not feasible. Although low-dose methotrexate (MTX) has been used widely in treatment of a variety of dermatological diseases, including multifocal primary cutaneous anaplastic large cell lymphoma (PCALCL), it has not been established for use in the treatment guidelines for solitary or localized PCALCL. Furthermore, there has been no report of long-term follow-up data in Asian patients with PCALCL treated with low-dose MTX. To investigate the effectiveness and clinical outcome of treatment with low-dose MTX, clinical and longterm follow-up data of 7 patients with solitary or localized PCALCL were analysed retrospectively. Of the 7 patients, 6 (85.7%) showed a complete response and 1 (14.3%) showed partial remission. During follow-up, mean duration of 92.1 months, 5 patients developed one or more cutaneous relapses. At the last follow-up, all of the patients with PCALCL were alive without disease. These results indicate that low-dose MTX is a highly effective and safe treatment for solitary or localized PCALCL as well as multiple relapsed lesions.