[noun] + を皮切りに [noun] + を皮切りにして [noun] + を皮切りとして
The grammar structure を皮切りに (also を皮切りにして or を皮切りとして) means "starting with" or "beginning with", and conveys the idea that one initial event triggered a series of subsequent events or developments. The word かわきり皮切り literally means "the first cut" – historically referring to the first incision in moxibustion therapy – and by extension it means "the beginning" or "the start of something."
This expression is used when describing a chain reaction or spread of events that followed after an initial trigger. It carries a sense of momentum: once the first event happened, many similar things followed one after another.
All three forms – を皮切りに, を皮切りにして, and を皮切りとして – are interchangeable in meaning:
Unlike から ("from"), which is neutral and simply indicates a starting point, を皮切りに emphasizes that the first event set things in motion and led to a succession of related events. をはじめ ("starting with") lists representative examples rather than describing a chain reaction of events triggered by the first one.