An 83 years old woman had been bedridden for several years, and was neither able to move her limbs or speak being at home in local city of Japan. One night, the woman’s family forgot that their small canine (Shih Tzu) entered her room and was leaving overnight. When the family went to the room the following morning, they discovered that the skin of the woman’s right eyelid had been gnawed away by all the layers by the dog.

Dermatologist can diagnose many internal disorders by skin examination called skin markers.

Considered to be an emergent disease, Cutaneous Leishmaniasis (CL) happens every 20 seconds in the world.

Dermatology is mainly an outpatient clinic although it is necessary in the care of in-patients. Skin disorders can show an underlying systemic disease or a primary cutaneous disorder. More than 20% of the general population have a skin disease, so it seems dermatology consultation may play an important role in in-patients. The number of patients admitted in the hospital by dermatologists has been decreasing, whereas more nondermatologists are admitting patients to hospitals with primary skin disease or with cutaneous findings of systemic disease.[1-3]

Pattern Recognition Receptors" (PRRs) are innate immunity receptors involved in antiinfectious defense of the organism [1]. There are several classes of PRRs: the "Toll-Like-Receptors" (TLRs), the "Retinoic acid inducible gene-I-Like Receptors" (RLRs), the "Nod-Like Receptors" (NLRs) and the "C-type Lectin-Receptors" (CLRs) [2]. NOD2/CARD15 (nucleotide binding oligomerisation domain 2/ caspase-recruitment domain containing protein 15) is an intracytoplasmic receptor from the NLRs family. It is composed of three parts: two N-terminal domains of recruitment and activation of caspases (CARD), a Nucleotide-Binding Domain (NBD) in the middle and a C-terminal domain composed of Leucin-Rich-Repeats (LRRs).