Overview of the departmentWe are responsible for the treatment of patients with skin cancer, such as malignant melanoma, and various skin diseases for which treatment is difficult in other hospitals. On June 1, 2013, Prof. Hasegawa arrived in his new post. He has treated a large number of patients with collagen disease, such as systemic scleroderma, and those with inflammatory diseases of the skin. We will make efforts to treat patients with inflammatory diseases, such as atopic dermatitis and psoriasis, in addition to those with skin cancer and collagen disease.
Consultation system/therapeutic strategies
Concerning malignant tumors of the skin, treatment for squamous cell carcinoma, basal cell carcinoma, extramammary Paget’s disease, malignant melanoma, and malignant lymphoma of the skin is performed. As a rule, standard treatment is selected according to the guidelines. Based on an accurate diagnosis and evaluation of the condition, treatment that is necessary/sufficient for patients is provided.
Patients with collagen disease and those with inflammatory diseases, such as atopic dermatitis, are treated by Prof. Hasegawa,et al. A large number of patients have consulted our department with scleroderma from other prefectures. In collagen/skin disease treatment, we are making efforts to understand patients’ stress/anxiety regarding the diseases and considerately manage them. In patients with severe psoriasis, the most advanced treatment with biological preparations is conducted in addition to ultraviolet radiation therapy.
Bio (psoriasis)-Outpatient Clinic (Friday morning, reservation system)
Biological preparations are termed biologics. A reservation system-based outpatient clinic (Dr. Tokuriki), specializing in biological antibody treatment, has been established for patients in whom the cure of psoriasis cannot be achieved by standard treatment. On the initial consultation, please consult the outpatient clinic of the Department of Dermatology. Patients requiring the introduction of biologics are instructed to consult the specialized outpatient clinic (consultations in the outpatient clinic on the initial consultation are also possible).
Advanced medical practice
Sentinel lymph node biopsy
In surgery for skin cancer and malignant melanoma, regional lymph nodes have been extensively extirpated (dissected) to prevent relapse, increasing postoperative stress. There have often been cases in which cancer cells were absent in dissected lymph nodes; dissection was unnecessary.
Sentinel lymph node biopsy is a method to investigate the presence or absence of cancer cells in lymph nodes that cancer cells may initially reach, using pigments and radioisotopes. This method has made it possible to evaluate whether or not dissection is necessary and determine an accurate extent of dissection. It clarifies treatment that is necessary/sufficient for patients, reducing postoperative stress.
Primary examinations and explanations
This procedure facilitates observation of exanthema at a magnification of 10 to 30. Jelly is placed on the skin, and a lens is pushed onto the skin for observation. There is no pain or sequelae. This procedure is useful for differentiating pigmentary lesions. A diagnosis can be accurately made without damaging the skin, differing from biopsy.
As a procedure that can replace conventional PUVA therapy with long-wavelength ultraviolet rays, narrow-band UVB therapy, in which a narrow wavelength distributed at 311 to 312 nm is utilized, is performed. It is effective for vitiligo, psoriasis, and atopic dermatitis. In addition, it is effective for various diseases for which conventional treatment is difficult.
Ruby laser therapy was introduced in April 2010. Our department is equipped with a Q-switch ruby laser IB101 system (MM & Niic Co., Ltd.). Ruby laser is laser light with a wavelength of 694 nm. The Q switch facilitates more effective irradiation. As pigmentary lesions, “bruises” and “brown spots”, such as nevus of Ota, ectopic Mongolian spots, traumatic tattoos, and nevus spilus, are covered by health insurance, ruby laser therapy is performed to treat patients with these diseases. Initially, please consult a physician in the morning from Monday to Friday. A reservation will be made at the Laser Specialized Outpatient Clinic (Wednesday afternoon).
This is a test to investigate the etiology of contact dermatitis or drug eruption. The etiology of idiopathic dermatitis can be clarified, and symptoms markedly resolve in some patients. For this test, please consult our outpatient clinic on Monday. Patients must also consult it on Wednesday and Thursday of the same week, and, if possible, on Monday of the following week.