ABSTRACT
Immune checkpoint inhibitor (ICI), including programmed cell death protein 1 and cytotoxic T-lymphocyte-associated protein 4 inhibitors, has emerged as a pillar in the management of advanced malignancies. A drug-induced sarcoidosis-like reaction (DISR) is a rare cutaneous adverse event of ICI. A 47-year-old male presented with one-month history of a solitary erythematous nodule on his forehead. He had been diagnosed with metastatic adenocarcinoma of the lung and was treated with nivolumab and ipilimumab for three months. Histological findings revealed multinucleated giant cells forming non-caseating granulomas with moderate peripheral lymphocyte infiltration in the dermis. Also, new hilar lymphadenopathy of the lung was identified in a systemic evaluation. Given the temporal relationship with ICI treatment, the final diagnosis was ICI-induced sarcoidosis-like reaction. To our knowledge, this is the first report of a case of DISR that developed following ICI treatment in the dermatologic literature in Korea.
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Background@#The phenotypic heterogeneity of psoriasis is suspected to reflect differences in its pathogenesis, but not yet completely elucidated. Studies of the Th1 and Th17 cytokines associated with different phenotypes of psoriasis have yielded inconsistent results. @*Objective@#To investigate the tissue expression levels of Th1 and Th17 cytokines among patients with chronic plaque psoriasis, acute guttate psoriasis, and healthy control. @*Methods@#A total of 20 patients with psoriasis (10 with chronic plaque type and 10 with acute guttate type) and 5 healthy controls were enrolled. The tissue mRNA and protein levels of following cytokines were measured: interleukin (IL)-12, IL-2, interferon (IFN)-γ, IL-23, IL-17A, and IL-22. @*Results@#The tissue mRNA levels of IL-12, IFN-γ, IL-23, IL-17A, IL-22 and the protein levels of IL-12, IL-2, IFN-γ, IL-17A, IL-22 were significantly increased in the psoriasis patients compared with the healthy controls. In comparisons of the subtypes, the tissue mRNA level of IFN-γ was increased in acute guttate psoriasis, whereas the protein levels of IL-12 and IL-17A were significantly increased in chronic plaque psoriasis. The cytokine ratios of IL-17A/IL-2 and IL-22/IL-2 were significantly higher in chronic plaque psoriasis than in acute guttate psoriasis. @*Conclusion@#We confirmed that the tissue levels of Th1 and Th17 cytokines were increased in psoriasis patients compared with healthy controls. The increased IFN-γ mRNA level in acute guttate psoriasis and increased IL-12 and IL-17A protein levels in chronic plaque psoriasis suggest that an imbalance between Th1 and Th17 cytokines may play a role in the phenotypic transition of psoriasis.
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Objectives@#This study aimed to examine oral health literacy (OHL) in mothers and the factors that influence it. @*Methods@#A total of 431 mothers of preschool children were chosen as study participants using the convenience sampling method. A self-administered questionnaire was used in this study. The survey contents included the socioeconomic characteristics of the participants as well as their level of oral health literacy. @*Results@#In total, 44.8 percent of the participants had a low level of verbal oral health literacy (0-6 grade), and 16.9 percent had a low functional oral health literacy (≤6). Educational level and family income were significantly associated with the participants’ oral health literacy (Pearson correlation). Verbal oral health literacy of the participants was related to their family’s income, whereas their functional oral health literacy was related to their educational level. @*Conclusions@#Many of the participants had a low level of oral health literacy. For mothers, to improve their oral health literacy, an oral health literacy program must be in place. Oral health literacy programs should be targeted toward mothers with low socioeconomic status.
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Objectives@#This study aimed to examine oral health literacy (OHL) in mothers and the factors that influence it. @*Methods@#A total of 431 mothers of preschool children were chosen as study participants using the convenience sampling method. A self-administered questionnaire was used in this study. The survey contents included the socioeconomic characteristics of the participants as well as their level of oral health literacy. @*Results@#In total, 44.8 percent of the participants had a low level of verbal oral health literacy (0-6 grade), and 16.9 percent had a low functional oral health literacy (≤6). Educational level and family income were significantly associated with the participants’ oral health literacy (Pearson correlation). Verbal oral health literacy of the participants was related to their family’s income, whereas their functional oral health literacy was related to their educational level. @*Conclusions@#Many of the participants had a low level of oral health literacy. For mothers, to improve their oral health literacy, an oral health literacy program must be in place. Oral health literacy programs should be targeted toward mothers with low socioeconomic status.
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Background@#In recent years, large amounts of data generated by patients have been accumulated on social media.We explored patients’ perspectives and experiences with vitiligo using web scraping data from the open internet community, NAVER Cafe. @*Objective@#To understand patients’ real concerns and thoughts about vitiligo. @*Methods@#Using vitiligo as a keyword, 1000 posts on NAVER Cafe were collected and categorized as follows: requests for recommendations for dermatology clinics; inquiries regarding vitiligo diagnosis, disease characteristics of vitiligo, and management of vitiligo; and advertisements. Essential contents were collected for each category to summarize patients’ perspectives and experiences. @*Results@#Of the 1000 posts, 284 were requests for clinical recommendations, 203 inquiries for diagnosis of their white spots, 132 inquiries regarding characteristics of vitiligo, 118 described experiences and emotions related to vitiligo, 105 inquiries regarding management of vitiligo, 103 advertisements, and 55 not related to vitiligo.Concerning the authors, 209 and 522 posts were written by patients and parents of children with vitiligo, respectively. @*Conclusion@#Patients with vitiligo have considerable concerns regarding their condition and actively communicate with each other through social media. Data mining on social media can provide a deeper understanding of patients’ thoughts and emotional distress with vitiligo as well as their families’.
ABSTRACT
Since nonsurgical treatment of vitiligo is not always successful, surgical interventions are viable options for patients with refractory vitiligo. Surgical treatment is a method in which melanocytes of normal skin are transplanted into vitiligo lesions and provided as a repigmentation source. Such treatments are primarily divided into tissue grafting and cellular grafting, depending on the nature of the graft. Tissue grafting includes split-thickness skin grafting, suction blister grafting, punch grafting, hair follicle transplantation, and smashed-skin grafting. Cellular grafting includes non-cultured epidermal cell suspension transplantation, non-cultured follicular cell suspension transplantation, and cultured epidermal cell suspension transplantation. Among these, suction blister grafting and micro-punch grafting have been widely performed for localized refractory vitiligo, and non-cultured epidermal cell suspension transplantation is adopted as the standard treatment for extensive vitiligo. Research on cultured cellular grafting to treat larger vitiligo areas is also ongoing. Selecting patients with stable vitiligo that has not spread for over 12 months is the most critical factor in the surgical outcome. It is also important to choose an appropriate surgical modality for each patient, and a combination of various procedures often improves the overall outcome. In conclusion, surgical intervention can be an effective and safe option for patients with vitiligo refractory to conventional treatments. Non-cultured epidermal cell suspension transplantation, which was denied by New Health Technology Assessment in Korea, should be approved to benefit patients with refractory vitiligo.
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Background@#Micropigmentation is a medical tattooing procedure in which pigments are implanted into the superficial dermis using a manual or electrically driven needle. @*Objective@#We aimed to assess the benefit and risk of micropigmentation in the treatment of acral vitiligo refractory to the conventional treatment. @*Methods@#An open-label study was conducted from December 2018 to March 2019. A total of 12 patients with 20 acral vitiligo lesions were treated with micropigmentation using an electric tattooing machine. The micropigmentation treatment was repeated for a few sessions to achieve optimal pigmentation. Color matching between the lesion and peri-lesional skin was assessed using a 4-point grading scale (poor, fair, good, and excellent). @*Results@#Overall, 85% (17 of 20) showed excellent color matching after a median of 2 (range: 1∼5) treatment sessions. The post-treatment color was darker than the surrounding skin immediately after the procedure, but it gradually faded over time. Pain during the procedure was not mild, but local anesthetic injection was not required. Post-treatment erythema and swelling occurred, but they resolved within a few days. No allergic reaction to the pigment or koebnerization of the vitiligo was noted. @*Conclusion@#Micropigmentation could be a promising treatment option for refractory acral vitiligo. A few treatment sessions (i.e., retouch) may be required for desired outcomes. The crucial parts of micropigmentation are pigment selection and implantation depth. It does not require injection of local anesthetics and provides immediate treatment effects after the procedure.
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Background@#In recent years, large amounts of data generated by patients have been accumulated on social media.We explored patients’ perspectives and experiences with vitiligo using web scraping data from the open internet community, NAVER Cafe. @*Objective@#To understand patients’ real concerns and thoughts about vitiligo. @*Methods@#Using vitiligo as a keyword, 1000 posts on NAVER Cafe were collected and categorized as follows: requests for recommendations for dermatology clinics; inquiries regarding vitiligo diagnosis, disease characteristics of vitiligo, and management of vitiligo; and advertisements. Essential contents were collected for each category to summarize patients’ perspectives and experiences. @*Results@#Of the 1000 posts, 284 were requests for clinical recommendations, 203 inquiries for diagnosis of their white spots, 132 inquiries regarding characteristics of vitiligo, 118 described experiences and emotions related to vitiligo, 105 inquiries regarding management of vitiligo, 103 advertisements, and 55 not related to vitiligo.Concerning the authors, 209 and 522 posts were written by patients and parents of children with vitiligo, respectively. @*Conclusion@#Patients with vitiligo have considerable concerns regarding their condition and actively communicate with each other through social media. Data mining on social media can provide a deeper understanding of patients’ thoughts and emotional distress with vitiligo as well as their families’.
ABSTRACT
Since nonsurgical treatment of vitiligo is not always successful, surgical interventions are viable options for patients with refractory vitiligo. Surgical treatment is a method in which melanocytes of normal skin are transplanted into vitiligo lesions and provided as a repigmentation source. Such treatments are primarily divided into tissue grafting and cellular grafting, depending on the nature of the graft. Tissue grafting includes split-thickness skin grafting, suction blister grafting, punch grafting, hair follicle transplantation, and smashed-skin grafting. Cellular grafting includes non-cultured epidermal cell suspension transplantation, non-cultured follicular cell suspension transplantation, and cultured epidermal cell suspension transplantation. Among these, suction blister grafting and micro-punch grafting have been widely performed for localized refractory vitiligo, and non-cultured epidermal cell suspension transplantation is adopted as the standard treatment for extensive vitiligo. Research on cultured cellular grafting to treat larger vitiligo areas is also ongoing. Selecting patients with stable vitiligo that has not spread for over 12 months is the most critical factor in the surgical outcome. It is also important to choose an appropriate surgical modality for each patient, and a combination of various procedures often improves the overall outcome. In conclusion, surgical intervention can be an effective and safe option for patients with vitiligo refractory to conventional treatments. Non-cultured epidermal cell suspension transplantation, which was denied by New Health Technology Assessment in Korea, should be approved to benefit patients with refractory vitiligo.
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OBJECTIVES: The purpose of this study was to determine the level of dental neglect in mothers and their children and to analyze the factors that were associated with it. METHODS: The subjects included in this study were 431 mothers with preschool children. The participants were given a self-report questionnaire for the study. The survey collected data on sociodemographic characteristics and dental neglect. For dental neglect, the Adelaide dental neglect scale was used for measurement. RESULTS: The percentage of mothers with a high level (≥15 points) of dental neglect was 52.7%. In terms of dental neglect in mothers and their children, 37.1% showed feeding of snacks before and after meals, followed by postponement of dental treatment for mothers at 22.8%, and dental treatment postponed due to children 21.7%. The demographic factors affecting the mother's dental neglect were found to be age of the mother, whether the mother was employed or not, and household income. The lower was the age of the mother, the higher was the level of dental neglect. In addition, when mothers had jobs, dental neglect was high, and the lower was the household income, the higher was the level of dental neglect. CONCLUSIONS: The level of dental neglect for mothers and their children was found to be high. Thus, this should be considered in the design of national oral health promotion strategies for children. In addition, the importance of dental neglect should be emphasized.
Subject(s)
Child , Child, Preschool , Humans , Demography , Family Characteristics , Meals , Mothers , Oral Health , SnacksABSTRACT
OBJECTIVES: This study aimed to investigate the lost school days due to dental diseases among adolescents and to assess their oral health in relation to their socio-demographic characteristics. METHODS: A total of 881 adolescents (middle school: 453, high school: 428) were surveyed using a self-administered questionnaire. The questionnaire was composed of questions relating to the subject's socio-demographic characteristics and lost school days due to dental diseases. The lost school days due to dental diseases included absence and early leave. The differences in the lost school days by socio-demographic characteristics were analyzed by chi-square test and t-test. RESULTS: In the past year, 2% of adolescents were absent from school (approximately 2 days of absence), 7.6% left school early (about 3 days of early leave), and 8.3% were absent from school or left school early (about 4 days of absence and early leave) because of dental diseases. The most common reason for absence from school was dental caries (31.8%), followed by malocclusion (9.3%), periodontal disease (7%), and maxillofacial trauma (2.3%). Dental caries was the most common reason (18%) for early leave, followed by malocclusion (8.8%), maxillofacial trauma (2.6%), and periodontal disease (1.8%). Absence from school was higher when the educational background of the respondent's father was middle-school graduate or lower (5.6%: middle-school graduates or lower, 1.6%: high-school graduates, 1.8%: college graduates or higher). High school students with dental diseases (11.7%) were absent or went on early leave to a greater extent than middle school students (5.1%). CONCLUSIONS: To reduce lost school days due to dental diseases among adolescents, different strategies are required including prevention and early treatment of dental caries and avoidance of maxillofacial trauma.
Subject(s)
Adolescent , Humans , Dental Caries , Fathers , Malocclusion , Oral Health , Periodontal Diseases , Stomatognathic DiseasesABSTRACT
OBJECTIVES: The purpose of this study was to compare the value and utility of certain oral health indicators in adults. METHODS: The data used for analysis was obtained from the 6(th) Korean National Health and Nutrition Examination Survey (2013-2014). The study subjects were 7,729 adults aged between 20 and 64 years. The oral health indicators used for the analysis were T-Health (tissue health index), FS-T (functioning teeth index), and DHC of 1st molar (dental health capacity of the first molars). Descriptive statistical indices for oral health indicators were obtained (mean, skewness and kurtosis, and coefficient of variation). The correlation among oral health indicators, DMF, and sound tooth structure was analyzed. RESULTS: The oral health indicator scores had an abnormal distribution. DHC of 1st molar is found to be the most reliable indicator because it most accurately reflects the oral health decline that occurs as a result of aging. In all ages, DHC of 1st molar marked the lowest value in skewness and kurtosis. However, the skewness and kurtosis values of T-Health in adults younger than 44 years old were found to be the lowest among all age groups. FS-T is believed to most accurately reflect oral health status as it has a high correlation with sound tooth structure and sound tooth surfaces. T-Health is evaluated to most accurately reflect oral disease indicators as it appears to have a high correlation with DMF and high caries risk. CONCLUSIONS: The oral health indicators T-Health, DHC of 1st molar, and FS-T have distinct characteristics that can serve as different health indices. Therefore, they can each be utilized in various fields of oral epidemiology.
Subject(s)
Adult , Humans , Aging , Epidemiologic Measurements , Epidemiology , Molar , Nutrition Surveys , Oral Health , ToothABSTRACT
OBJECTIVES: The purpose of this study was to examine the association between vitamin C, vitamin D, and periodontal diseases in adults. METHODS: The data used for analysis were obtained from the sixth Korean National Health and Nutrition Examination Survey (2013-2014). Subjects were 2,702 adults aged from 19 to 64 years. Complex Chi-square tests and complex logistic regression analyses were used to assess the association between vitamins and periodontal status. RESULTS: There is no statistically significant association between vitamin C intake and periodontal status. Periodontal status of subjects with a low vitamin D (25-hydroxyvitamin D) level was better than that of the subjects with a high level (P<0.05). However, multivariate analysis demonstrated that this association is not statistically significant. CONCLUSIONS: More follow-up studies are necessary to determine the association of the vitamins C and D with the periodontal diseases.
Subject(s)
Adult , Humans , Ascorbic Acid , Cross-Sectional Studies , Follow-Up Studies , Logistic Models , Multivariate Analysis , Nutrition Surveys , Periodontal Diseases , Vitamin D , VitaminsABSTRACT
OBJECTIVES: The purpose of this study was to analyze the pattern of dental caries in a high-risk group of Korean adolescents. METHODS: Raw data on 10,542 adolescents between the ages of 12 and 15 years from the 2012 Korean National Oral Health Survey was used. The subjects were divided into a high caries risk group and non-high caries risk group for analysis. For the statistical analyses, we utilized a frequency analysis, descriptive statistics, and a multidimensional scaling analysis. RESULTS: The pattern of dental caries in the high caries risk group were divided into six classifications for 12-year-olds and five for 15-year-olds, including the mandibular first molar occlusal surface (Cluster 1). In the high caries risk group, the frequency of Cluster 1 was approximately 4-times higher in 12-year-olds than that in the non-high caries risk group of Cluster 1, and about 3-times higher in 15-year-olds. The multidimensional scaling analysis found that in the high caries risk group, the same types of tooth surfaces formed separate groups. The prevalent dental caries pattern of 12-year-olds in the high caries risk group was left-right symmetry, while in the 15-year-olds of the high caries risk group, the caries pattern also included the antagonistic teeth, along with left-right symmetry. However, the non-high caries risk group had a pattern of left-right symmetry only in the 15-year-olds. CONCLUSIONS: When dental caries occur in the first molar, there is a high possibility of being classified into the high caries risk group. Therefore, preventative measures should focus on the antagonistic teeth and the teeth on the opposite side.
Subject(s)
Adolescent , Child , Humans , Classification , Dental Caries , Dentition, Permanent , Molar , Oral Health , ToothABSTRACT
OBJECTIVES: The purpose of this study was to evaluate the prediction validity of the caries activity test with a sulfisomidine mixture (SAHS test). METHODS: This longitudinal follow-up study was conducted for 3 years. The subjects were 155 elementary schoolchildren. Oral examination was performed by examining each tooth surface of the subjects. The number of teeth with new caries lesions was calculated by comparing between the baseline data of the initial oral examination and the results of the second oral examination performed after 3 years. The Dentocult SM test was used as the reference in the analysis of the caries prediction validity of the SAHS test. The items of the validity test for carries prediction were as follows: sensitivity, specificity, predictive value, and likelihood ratio. RESULTS: The correlation between new caries lesions and the SAHS test scores was greater than that between new caries lesions and the Dentocult SM test scores. The receiver-operating analysis revealed that the area under the curve of the SAHS test was higher than that of the Dentocult SM test. The caries prediction validity of the SAHS test (grade 12) was as follows: sensitivity, 0.71-0.70; specificity, 0.60-0.58; positive predictive value, 0.79-0.78; negative predictive value, 0.49 (screening criterion 5). The SAHS test scores were similar to or higher than the scores in the items of the Dentocult SM test. CONCLUSIONS: The SAHS test is considered useful for clinical applications.
Subject(s)
Child , Humans , Dental Caries , Dental Caries Activity Tests , Diagnosis, Oral , Follow-Up Studies , ROC Curve , Sensitivity and Specificity , Sulfisomidine , ToothABSTRACT
OBJECTIVES: The purpose of this study was to understand the dental caries pattern in permanent dentition among Korean adolescents aged 12-16 years. METHODS: This study comprised 5,301 teenagers, aged 12-16 years. We analyzed the dental caries pattern in patients with permanent dentition using data from the 2006 Korean National Oral Health Survey. The methods used for data analysis included frequency analysis, correlation analysis, cluster analysis, and multidimensional scaling (MDS). RESULTS: With cluster analysis, it was difficult to clearly distinguish between anterior and posterior caries, and categorization was difficult owing to the mandibular first premolar and maxillary lateral incisor. The molars had severe caries, and results of the cluster analysis categorized this as clusters independent from other teeth; therefore, efforts must be made to prevent dental caries in molars. The maxillary premolars had the highest incidence of caries followed by the molars, and accordingly, these formed independent clusters, with the exception of the molar. During the eruption stage, despite the secondary premolar erupting later than the first premolar, there was a higher caries incidence in the secondary premolar. Out of the anterior teeth, the maxillary later incisor had the highest incidence of caries and formed an independent cluster. The multidimensional scaling (MDS) results clearly showed the molar teeth cluster. CONCLUSIONS: For epidemiological research on dental caries, a caries pattern analysis should be conducted, and information on the caries pattern in permanent dentition can be used for the prevention and management of dental caries.
Subject(s)
Adolescent , Humans , Bicuspid , Cluster Analysis , Dental Caries , Dentition, Permanent , Incidence , Incisor , Molar , Oral Health , Statistics as Topic , ToothABSTRACT
OBJECTIVES: This study aimed to (1) survey cases of maxillofacial trauma in adolescents and (2) analyze the relationship between maxillofacial trauma and activity restriction. METHODS: This cross-sectional study included 881 participants selected using the convenience sampling method in the Jeollanam-do and Jeollabuk-do regions. Individual self-reporting questionnaire surveys were performed. RESULTS: It was found that 17.2% of adolescents experienced maxillofacial traumas, and 45.3% of them reported activity restrictions caused by the the traumas. The occurrence ratio of maxillofacial trauma was higher in male students (20.6%) than in female students (14.0%). Among the activity restrictions caused by maxillofacial traumas, chewing disturbance was the most frequent activity restriction type, showing an incidence of 54.6%, and taste disturbance was the least frequent, showing an incidence of 9.3%. All the activity restrictions in adolescents were found to have relationships with maxillofacial trauma occurring within the recent one year. Among the activity restrictions, chewing disturbance was most closely related with the trauma. CONCLUSIONS: Since maxillofacial traumas cause activity restrictions in adolescents, it is necessary to prepare policies for the prevention of maxillofacial trauma. Furthermore, it is necessary to intensify the education regarding treatment methods for maxillofacial trauma.