ABSTRACT
BACKGROUND@#Cyclosporine (CS) is widely used to treat various skin diseases. Gastrointestinal (GI) discomfort is the most common adverse effect of orally administered CS for dermatologic indications. However, few studies on CS-associated adverse GI events have been conducted.@*OBJECTIVE@#In this study, we aimed to describe the major features of adverse GI events associated with CS therapy using a validated symptom questionnaire, and to investigate the factors contributing to their development. We also evaluated the effectiveness of three empirical GI medications in relieving adverse GI events.@*METHODS@#This study consisted of 2 phases. Phase I was a prospective observational cohort study to investigate the characteristics of CS-associated adverse GI events in 942 consecutive patients treated with CS. Phase II was a randomized controlled trial to evaluate the efficacy of three different classes of GI medications.@*RESULTS@#CS-associated adverse GI events occurred in 119 patients (12.6%). GI complications were more common in female patients (p=0.04), patients with a history of GI disorders (p=0.02), and patients whose initial CS doses were greater than 3 mg/kg/day (p=0.05). In patients treated with any one of the three GI medications, the mean Gastrointestinal Symptom Rating Scale scores significantly decreased (p<0.001).@*CONCLUSION@#This study demonstrated that adverse GI events are common during early CS treatment, especially in women, patients receiving high doses of CS, and those with a history of GI disorders. Our results suggest that new-onset CS-associated GI side effects can be effectively managed with the addition of GI medications.
ABSTRACT
With increasing public concern about facial wrinkles and loss of skin elasticity due to aging, diverse devices have been proposed as treatment modalities for facial wrinkles and laxity. Recently, ultrasonography was introduced as a new treatment modality for therapeutic and cosmetic purposes. High-intensity focused ultrasonography (HIFU) may be the best example of this technique. It is based on the principle of induction of tissue damage and regeneration of the target area selectively via coagulation by generating microthermal injury lesions through the accumulation of high-frequency ultrasonography beams at the specific tissue site without any damage to the epidermis and adjacent tissue. Current studies reveal that HIFU significantly improves facial wrinkles and skin contours, with generally mild and transient side effects. However, serious adverse events could occur when skillful techniques are not used. These events should be prevented and treated immediately upon presentation to avoid permanent complications. In this article, the authors reviewed the background, principle, treatment outcomes, and side effects of HIFU to improve its efficacy and safety as a new modality for facial rejuvenation.
Subject(s)
Aging , Elasticity , Epidermis , Regeneration , Rejuvenation , Skin , UltrasonographyABSTRACT
BACKGROUND: It has been reported that nail psoriasis is common in psoriatic arthritis (PsA) patients, however, studies on the prevalence of PsA with nail psoriasis and the relationship between the severity of the diseases has not previously been reported in Korea. OBJECTIVE: The aim of this study was to investigate nail psoriasis and its relation to psoriasis and PsA. METHODS: After researching past medical records, 48 patients with nail psoriasis and 247 patients without nail psoriasis were enrolled in this study. Nail psoriasis was classified according to the morphologic types of nails and severity was evaluated using the modified nail psoriasis severity score index (mNAPSI). We assessed the severity of psoriasis and PsA by psoriasis area and severity index (PASI), and swollen and tender joint counts (STJC), respectively. Finally, we analyzed the relationship between mNAPSI, PASI, and STJC. RESULTS: Nail involvement was observed in 48 (16.3%) of 295 patients. Prevalence of PsA was higher in nail psoriasis (31.3%) than in uncomplicated psoriasis (9.3%, p<0.001). mNAPSI showed a positive correlation with STJC (p=0.002, Pearson correlation=0.427), but not with PASI (p=0.094, Pearson correlation=0.202). CONCLUSION: The results show that PsA is more common and severe in psoriatic patients with nail involvement than in uncomplicated psoriasis. Clinicians should be alert to nail involvement in psoriatic patients, as it could be related to the disease course and prognosis of PsA.