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A 54-year-old female with dermatomyositis treated with cyclosporine and methylprednisolone presented with multiple subcutaneous nodules on her upper and lower extremities on December 2011. The number of lesions gradually increased. She had a history of surgical intervention such as debridement, skin graft of right lower leg due to trauma and subsequent bacterial infection on August 2011. Culture from a skin lesion on June 2012 confirmed Mycobacterium chelonae, which was susceptible to clarithromycin (CAM). We started treatment with CAM, imipenem/cilastatin (IPM/CS) and tobramycin (TOB) for 2 weeks. Then CAM monotherapy was continued, however CAM was discontinued because of liver dysfunction. In September 2012 new nodular lesions were observed on the left arm and right leg. We administrated azithromycin, IPM/CS and TOB. Subcutaneous nodules were partially improved, but new lesions appeared on her right leg. A culture of skin lesion yielded M. chelonae, which was highly resistant to CAM and IPM/CS. Based on the sensitivity test, moxifloxacin was used. However, there was no significant improvement in her skin lesions, so we started thermal therapy on day 57 after admission. She showed an excellent response to thermal therapy, and there has been no recurrence.

A 48-year-old man presented at the hospital because of neck swelling and pain. A diagnosis of esophageal cancer with subcutaneous abscess was made based on examination and biopsy results. The cancer was Ce T4NxMx Stage III-IVa. Curative surgery was considered impossible, so chemoradiation therapy was performed (5-FU 500 mg + CDDP 5 mg/day + 2 Gy/day x 31 days) after drainage. During the therapy, an esophago-tracheal fistula was observed, but it later vanished. After chemoradiation therapy, the abscess and tumor vanished. No serious adverse reactions were observed. Now, 2 years after therapy, no recurrence has been found. The patient is now in good health with no symptoms and undergoes regular check-ups. Chemoradiation therapy is effective for inoperable advanced esophageal cancer.

In the dermatological field, interferon is used in clinical trials for viral skin diseases and for malignant skin tumors such as malignant melanoma. In regard to viral diseases, clinical trials have shown promising results in viral warts, herpes simplex and herpes zoster. In the double-blind trial, patients with bilateral common warts of the extremities were treated at weekly intervals with intralesional injections of either human fibroblast interferon or placebo. More than 81% of the interferon-treated extremities were either cured by or responded effectively to the therapy, while only 17% of the placebo responded. Although our data has confirmed that interferon is effective in the treatment of common warts diseases, the method of application and repeated injections indicate that this therapy may not be helpful in routine cases but only in selected patients in whom other therapy has failed. However, development of new delivery systems or modification of dosages may increase the value of interferon therapy for warts disease. Interferon seems also effective for herpes zoster. But herpes zoster usually regresses spontaneously within three weeks, therefore, it is not easy to define efficacy of interferon in this disease. Therefore, we need to examine the effect of interferon on herpes zoster both in placebo controlled and double-blind trials involving patients with immunocompromised diseases.