ABSTRACT
BACKGROUND: Herpes zoster (HZ) is generally thought to occur once in a lifetime and recurrence is considered to be limited to immunocompromised individuals. Although HZ recurrence rates seem to be increasing, there have been few studies exploring these rates in the general population. We investigated the recurrence rate and associated risk factors in the general population. METHODS: We used the population-based samples of the National Health Insurance Service database to identify cases of initial HZ episodes from January 1, 2002 to December 31, 2013. We also followed up on these cases through December 31, 2013 to identify recurrence. RESULTS: Overall, the incidence rate of HZ is 5.1 per 1,000 person years and the recurrence rate is 12.0 per 1,000 person years. There were 2,100 recurrent cases out of 39,441 initial episodes with 4.4 years of the mean follow-up period. We identified significant risk factors for recurrence such as old age (51–70 years) (hazard ratio [HR], 1.447; 95% confidence interval [CI], 1.311–1.598), women (1.476; 1.345–1.619), zoster-related pain (ZRP) longer than 30 days (cases of ZRP lasting 31–90 days [1.200; 1.042–1.383], and ZRP lasting longer than 90 days [2.293; 1.990–2.643]). Concurrent hematologic malignancies (2.864; 1.929–4.251), autoimmune diseases (1.466; 1.252–1.715), dyslipidemia (1.390; 1.263–1.530), and hypertension (1.222; 1.107–1.350) were also significant risk factors. CONCLUSION: Our results suggest that the recurrence of HZ is much more common than generally expected, and that the associated risk factors can play an important role in predicting recurrence.
Subject(s)
Female , Humans , Autoimmune Diseases , Cohort Studies , Dyslipidemias , Epidemiology , Follow-Up Studies , Hematologic Neoplasms , Herpes Zoster , Hypertension , Incidence , National Health Programs , Recurrence , Risk FactorsABSTRACT
BACKGROUND: Treatment of congenital melanocytic nevi (CMN) with intense pulsed light (IPL) has recently produced promising results. OBJECTIVE: To evaluate the clinical and histological outcomes of small-to-medium sized CMN treated with IPL alone and in combination with erbium: yttrium-aluminum-garnet (Er: YAG) laser. METHODS: We performed a retrospective chart review of 26 small-to-medium sized CMN treated as described above. The reduction in visible pigmentation, signs of recurrence and any adverse skin changes were evaluated by two independent clinicians. RESULTS: Seventeen patients completed treatment and were followed-up. Nine were not able to complete treatment due to work, change in residence, and treatment related stress. Ten patients received IPL alone (mean: 10.5 sessions) and 7 underwent treatment with IPL (mean: 7.7 sessions) and Er: YAG/IPL combination therapy (mean: 4.7 sessions). The initial treatment outcome was cleared in 5 patients and excellent in 12. Fourteen patients (82.4%) showed CMN recurrence one year after treatment completion. The histological results from a patient with an excellent clinical outcome showed remnant nevus cells nests in the deep dermis. CONCLUSION: IPL treatment alone and in combination with Er: YAG laser are not definitive treatments for CMN and should not be considered as first-line treatment.
Subject(s)
Humans , Dermis , Erbium , Intense Pulsed Light Therapy , Lasers, Solid-State , Nevus , Nevus, Pigmented , Pigmentation , Recurrence , Retrospective Studies , Skin , Treatment OutcomeABSTRACT
BACKGROUND: Treatment of congenital melanocytic nevi (CMN) with intense pulsed light (IPL) has recently produced promising results. OBJECTIVE: To evaluate the clinical and histological outcomes of small-to-medium sized CMN treated with IPL alone and in combination with erbium: yttrium-aluminum-garnet (Er: YAG) laser. METHODS: We performed a retrospective chart review of 26 small-to-medium sized CMN treated as described above. The reduction in visible pigmentation, signs of recurrence and any adverse skin changes were evaluated by two independent clinicians. RESULTS: Seventeen patients completed treatment and were followed-up. Nine were not able to complete treatment due to work, change in residence, and treatment related stress. Ten patients received IPL alone (mean: 10.5 sessions) and 7 underwent treatment with IPL (mean: 7.7 sessions) and Er: YAG/IPL combination therapy (mean: 4.7 sessions). The initial treatment outcome was cleared in 5 patients and excellent in 12. Fourteen patients (82.4%) showed CMN recurrence one year after treatment completion. The histological results from a patient with an excellent clinical outcome showed remnant nevus cells nests in the deep dermis. CONCLUSION: IPL treatment alone and in combination with Er: YAG laser are not definitive treatments for CMN and should not be considered as first-line treatment.
Subject(s)
Humans , Dermis , Erbium , Intense Pulsed Light Therapy , Lasers, Solid-State , Nevus , Nevus, Pigmented , Pigmentation , Recurrence , Retrospective Studies , Skin , Treatment OutcomeABSTRACT
BACKGROUND: Sarcoidosis is a multisystem granulomatous disease of unknown cause that commonly affects the lungs, but frequently involves the skin. Sarcoidosis occurs worldwide and affects all ages and races that is more frequent away from the equator. The clinical presentation and severity of the disease vary between different ethnicities and races. OBJECTIVE: The purpose of this study was to investigate the clinical spectrum and outcome of cutaneous sarcoidosis in Korean patients and to compare them with other ethnic groups. METHODS: A total of 33 patients diagnosed by histologic examination from January 2003 to August 2013 with cutaneous sarcoidosis were enrolled. The clinical features were obtained by reviewing medical records, clinical photographs, and radiological images. RESULTS: The male to female ratio was 1:1.8, and the distribution of sarcoidosis by age showed peaks at the fourth decade, which was younger than other studies conducted in Korea. In our study, the most common cutaneous lesions were nodules (42%) while popular lesions were more commonly observed in the studies conducted in Taiwan and Spain. Systemic organ involvement was observed in 11 patients (34%) in our study but was observed in more than 60% of the patients in other ethnic groups. CONCLUSION: In the present study, cutaneous sarcoidosis was characterized by a marked female predominance and by high frequency in the fourth decade. Extracutaneous involvement was lower compared with other ethnic groups. The clinical spectrum of sarcoidosis in Koreans differed from other ethnic groups.
Subject(s)
Female , Humans , Male , Racial Groups , Epidemiology , Ethnicity , Korea , Lung , Medical Records , Sarcoidosis , Skin , Spain , TaiwanABSTRACT
OBJECTIVE: The Revised Obsessive Intrusion Inventory (ROII) is a 52-item scale that evaluates obsessional intrusive thoughts. The aim of the present study was to validate a short, 20-item Korean version of the ROII (ROII-20). METHODS: Of the 1125 participants who completed the ROII-20, 895 participants completed the scale to examine the factor structure of the scale. A subgroup of these participants (n=53) completed the scale twice to determine test-retest reliability. To establish external validity, 230 participants completed the scale and other questionnaires. RESULTS: Exploratory factor analyses suggested a hierarchical model comprising two higher order factors of autogenous obsessions (resulting from aggressive thoughts and sexual thoughts) and reactive obsessions (resulting from thoughts about contamination, thoughts about accidents, and thoughts about dirt). Confirmatory factor analyses supported this model. The results indicated good internal consistency and test-retest reliability. External validity was supported by relationships with obsessive-compulsive symptoms and general distress. CONCLUSION: The ROII-20 presents good psychometric properties and may be considered as a promising instrument for measuring obsessional intrusions.