ABSTRACT
Background@#Guselkumab is a monoclonal antibody that selectively targets interleukin-23 in the treatment of moderate to severe psoriasis. Several multinational clinical studies have reported on its efficacy. However, data on its efficacy and safety in Korean patients are currently very limited. @*Objective@#This study evaluated the real-world efficacy and safety of guselkumab for treating patients with moderate to severe psoriasis in Korea. @*Methods@#This single-center retrospective study included 40 patients treated with guselkumab for at least 12 weeks.Electronic medical records were reviewed for demographics, clinical characteristics, psoriasis area and severity index (PASI) score, body surface area, and adverse events. @*Results@#The average PASI score at baseline (12.0±8.3) was significantly reduced to 3.3±3.8 at week 12, 2.2±2.2 at week 36, and 1.6±1.5 at week 52. At week 60, 93%, 60%, and 33% of patients achieved a PASI of 75, 90, and 100, respectively. Obesity, psoriatic arthritis, and previous biologics treatment experience were not significant indicators of guselkumab treatment efficacy. Seven patients reported adverse events; however, none discontinued guselkumab treatment. @*Conclusion@#Guselkumab is an effective and safe treatment option for moderate to severe psoriasis in Korea.
ABSTRACT
Background@#Currently, there is no consensus on the treatment of psoriasis in Korean patients. @*Objective@#This study aimed to establish a consensus on the basic therapeutic principles for Korean patients with plaque psoriasis. @*Methods@#Using the modified Delphi method, a steering committee proposed 53 statements for the first Delphi round, which covered five subjects: (1) the goal of treatment and evaluation of disease severity, (2) topical therapy, (3) phototherapy, (4) conventional systemic therapy, and (5) biologic therapy. The panel of dermatologists scored the level of agreement for each statement on a ten-point scale with scores ranging from 1 (strongly disagree) to 10 (strongly agree). After discussing the results of the first round, the committee reformulated 41 statements. Finally, consensus was defined as more than 70% of the second round scores being ≥7. @*Results@#The panel participants strongly agreed that the ideal treatment goals for Korean patients with plaque psoriasis should include complete skin clearance and high dermatological quality of life. A strong consensus was also reached on the use of topical agents for psoriasis of any severity, the consideration of phototherapy before biologics therapy, the conventional systemic agents for moderate-to-severe psoriasis, and the recommendation of biologic for retractable psoriasis to conventional systemic therapy and phototherapy. @*Conclusion@#This modified Delphi panel established an expert consensus on the therapeutic approach for Korean patients with plaque psoriasis. This consensus may improve the treatment outcomes for psoriasis in Korea.
ABSTRACT
Background@#Psoriasis imposes a significant treatment burden on patients, particularly impacting well-being and quality of life (QoL). The psychosocial impact of psoriasis treatments remains unexplored in most patient populations. @*Objective@#To assess the impact of adalimumab on health-related QoL (HRQoL) in Korean patients with psoriasis. @*Methods@#This 24-week, multicenter, observational study, assessed HRQoL in Korean patients treated with adalimumab in a real-world setting. Patient-reported outcomes (PROs) including European Quality of Life-5 Dimension scale (EQ-5D), EQ-5D VAS, SF-36, and DLQI were evaluated at week 16 and 24, versus baseline. Patient satisfaction was assessed using TSQM. @*Results@#Among 97 enrolled patients, 77 were assessed for treatment effectiveness. Most patients were male (52, 67.5%) and mean age was 45.4 years. Median baseline body surface area and Psoriasis Area and Severity Index (PASI) scores were 15.00 (range 4.00~80.00) and 12.40 (range 2.70~39.40), respectively. Statistically significant improvements in all PROs were observed between baseline and week 24. Mean EQ-5D score improved from 0.88 (standard deviation [SD], 0.14) at baseline to 0.91 (SD, 0.17) at week 24 (p=0.0067). The number of patients with changes in PASI 75, 90, or 100 from baseline to week 16 and 24 were 65 (84.4%), 17 (22.1%), and 1 (1.3%); and 64 (83.1%), 21 (27.3%), and 2 (2.6%), respectively. Overall treatment satisfaction was reported, including effectiveness and convenience. No unexpected safety findings were noted. @*Conclusion@#Adalimumab improved QoL and was well-tolerated in Korean patients with moderate to severe psoriasis, as demonstrated in a real-world setting. Clinical trial registration number (clinicaltrials.gov: NCT03099083).
ABSTRACT
Background@#Dermatophyte infection is one of the most common skin diseases affecting the skin, hair, and nails. Despite widespread recognition of the disease, missing details and misperceptions are commonplace in the general population. @*Objective@#This study aimed to investigate the public perception and behavior regarding dermatophytosis of the hands and feet. @*Methods@#This results from an online survey conducted between July 2022 and August 2022. The survey included 1,000 Korean participants aged 20 to 69 years, of whom 60% experienced symptoms of tinea pedis or onychomycosis. The questionnaire focused on the awareness and personal experience of tinea pedis and perception of the treatment of dermatophytosis. @*Results@#Of the 1,000 participants, nearly 80% regarded tinea pedis as a common skin condition by which anyone can be affected. Furthermore, 88.4% had heard that the treatment of tinea pedis could be harmful, causing skin rash (60.4%) and worsening liver function (48.5%). Among 896 participants who noticed suspicious symptoms, 81.2% did not visit the clinic because it was not severe (50.1%) and seemed easily manageable (25.7%). Of the respondents, 84.4% preferred to meet dermatologists rather than non-dermatologist doctors regarding skin diseases, mainly because of trust in experts and belief in a faster cure. @*Conclusion@#Providing accurate and detailed information via online media, educational campaigns, and medical papers can rectify misconceptions and improve patient appliance, contributing to public skin health.
ABSTRACT
Disseminated superficial actinic porokeratosis (DSAP) is a type of porokeratosis that is characterized by multiple small lesions on the sun-exposed areas of the body. The presence of dermal amyloid deposition associated with disseminated superficial porokeratosis has rarely been reported in the literature. A 69-year-old female presented to our department with multiple pruritic brownish macules. Physical examination revealed scattered 2∼3-mm-sized, brownish-colored, round to annular macules limited to the sun-exposed areas, such as the forearms, lower legs, and upper trunk. Dermoscopy revealed a peripheral rim and central white hub surrounded by brown pigmentation. Skin biopsy of the leg showed not only the typical finding of DSAP, including the cornoid lamella, but also deposits of eosinophilic amorphous materials in the dermis. After Congo red staining, the dermal deposits were confirmed to be amyloid. Herein, we report a rare case of DSAP with dermal amyloid deposition and dermoscopic presentation.
ABSTRACT
Background@#The role of vitamin D deficiency and vitamin D receptor (VDR) gene polymorphisms has been established in many autoimmune diseases, including vitiligo, but the result is still controversial. @*Objectives@#The aim of this study was to investigate the serum vitamin D levels in vitiligo patients and to compare the association of VDR gene polymorphisms in vitiligo patients and healthy controls. @*Methods@#We collected the data of age, sex, serum 25-hydroxy vitamin D (25[OH]D) level, thyroid autoantibodies, disease duration, types of vitiligo, family history and the affected body surface area of vitiligo from 172 patients. And we analyzed the VDR gene polymorphisms in 130 vitiligo and 453 age-sex-matched control subjects. @*Results@#The mean serum level of 25(OH)D in 172 vitiligo patients was 18.75 ± 0.60 ng/mL, which had no significant difference with a mean serum value of 25(OH)D in the Korean population. However, there were significant differences according to the duration of the disease and family history. Also, there were no significant differences in the genotypic and allelic distributions of 37 examined SNPs of VDR gene between vitiligo patients and healthy controls. @*Conclusion@#Serum level of 25(OH)D in vitiligo patients was not significantly different from the mean serum value of the Korean population. Also, there were no significant differences in the genotypic distributions of VDR gene between vitiligo patients and healthy controls.
ABSTRACT
Background@#Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. @*Objective@#To investigate the economic burden of psoriasis in Korea. @*Methods@#The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. @*Results@#The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. @*Conclusion@#This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.
ABSTRACT
Buschke-Ollendorff syndrome (BOS) is a rare autosomal dominant inherited genetic cutaneous disorder characterized by connective tissue nevi that may or may not be accompanied by sclerotic bone lesions (osteopoikilosis). BOS is caused by loss-of-function mutations in LEMD3. Skin lesions appear in childhood and may increase in size and number with age and primarily manifest as yellow or skin-colored plaques or papules. A 21-year-old male presented with brownish, firm plaques on his back and buttocks since childhood. He revealed a history of similar skin lesions in his mother and brother. He was incidentally diagnosed with osteopoikilosis, 2 years prior to presentation. Histopathological examination of a skin biopsy specimen revealed increased collagenous stroma. We report a rare case of Buschke-Ollendorff syndrome that presented with brownish plaques.
ABSTRACT
Background@#Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. @*Objective@#To investigate the economic burden of psoriasis in Korea. @*Methods@#The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. @*Results@#The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. @*Conclusion@#This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.
ABSTRACT
Buschke-Ollendorff syndrome (BOS) is a rare autosomal dominant inherited genetic cutaneous disorder characterized by connective tissue nevi that may or may not be accompanied by sclerotic bone lesions (osteopoikilosis). BOS is caused by loss-of-function mutations in LEMD3. Skin lesions appear in childhood and may increase in size and number with age and primarily manifest as yellow or skin-colored plaques or papules. A 21-year-old male presented with brownish, firm plaques on his back and buttocks since childhood. He revealed a history of similar skin lesions in his mother and brother. He was incidentally diagnosed with osteopoikilosis, 2 years prior to presentation. Histopathological examination of a skin biopsy specimen revealed increased collagenous stroma. We report a rare case of Buschke-Ollendorff syndrome that presented with brownish plaques.
ABSTRACT
Background@#Atopic dermatitis is a chronic, inflammatory disease affecting the skin including the scalp, nails, and lips. One of the main pathogenesis of atopic dermatitis is skin barrier impairment. Transepidermal water loss is a noninvasive measurement of water loss across the stratum corneum for assessing skin barrier function. @*Objective@#This study aimed to evaluate the skin barrier function of various skin sites including hairy skin, non-keratinized areas, and hard keratin in patients with atopic dermatitis. Furthermore, the relationship between the severity of atopic dermatitis and transepidermal water loss was investigated. @*Methods@#In total, 73 patients with atopic dermatitis and 65 age-matched healthy controls were included in this study. Transepidermal water loss was measured at 8 different skin sites including hairy skin (vertex, occiput), the cheek, non-keratinized area (lower lip), lateral side of the upper arm, flexor side of the forearm, extensor side of the forearm, and hard keratin (fingernail). The severity of atopic dermatitis was assessed using the eczema area and severity index. @*Results@#Transepidermal water loss was observed to be higher at all the measured sites including the scalp, nails, and lips of atopic dermatitis patients in comparison with that of the age-matched controls. Transepidermal water loss were correlated with the severity of atopic dermatitis in the cheek, lips, upper arm, and forearm. @*Conclusion@#Patients with atopic dermatitis have impaired skin barrier function, including in regions of hairy skin, non-keratinized areas, and hard keratin areas. Barrier dysfunction is associated with the severity of atopic dermatitis.
ABSTRACT
Secondary neoplasms in nevus sebaceous can develop during adolescence and adulthood. Trichoblastoma and syringocystadenoma papilliferum are the most common benign neoplasms, but poroma is rarely reported. A 28-year-old female presented with an asymptomatic mass on the scalp.She has had a hairless lesion on the scalp since birth. A soft mass developed on that lesion four years prior. Physical examination revealed a localized 1 cm×2.5 cm-sized brownish, verrucous-surfaced plaque with a 1 cm×1 cm-sized pedunculated erythematous tumor on the scalp. We performed skin biopsy on both the plaque and tumor lesions. The histopathological findings demonstrated the plaque lesion consistent with nevus sebaceous and the tumor lesion consistent with eccrine poroma. Surgical mass excision was performed.The patient was eventually diagnosed with eccrine poroma arising within nevus sebaceous. To the best of our knowledge, there are only six reported cases on poroma arising within nevus sebaceous. Although rarely documented in the literature, it should be considered as a secondary neoplasm within nevus sebaceous.
ABSTRACT
No abstract available.
Subject(s)
Skin Abnormalities , Herpesviridae Infections , Pigmentation Disorders , HamartomaABSTRACT
No abstract available.
Subject(s)
Diagnosis, Differential , Histiocytoma, Benign Fibrous , Xanthogranuloma, JuvenileABSTRACT
BACKGROUND@#Laser therapy can be used as an alternative treatment for onychomycosis; however, there are somelimitations to its efficacy as a single agent.@*OBJECTIVE@#To evaluate the effectiveness of combination therapy with 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and topical efinaconazole in onychomycosis treatment and identify factors influencing the therapeutic outcomes of combination treatment.@*METHODS@#Big toenails with onychomycosis were treated by 1,064-nm Nd:YAG laser at 4-week intervals with daily application of topical efinaconazole. Therapeutic response was assessed through onychomycosis severity index (OSI) and percentage of nail infected (PNI), and its association with a variety of factors that may affect treatment outcome was evaluated.@*RESULTS@#One hundred big toenails were included in the study and significant clinical improvements were observed after treatment (OSI improvement score = 76.68 ± 28.83, PNI improvement score = 72.37 ± 30.37). There was no difference in treatment response according to the number of laser treatments, onychomycosis clinical type, or initial severity. However, patient age was negatively correlated with clinical improvement (p = 0.019). Also, female patients had better therapeutic responses than male patients.@*CONCLUSION@#Combined treatment with Nd:YAG laser and topical efinaconazole has a significant therapeutic effect on onychomycosis. A randomized controlled trial is warranted in the future.
ABSTRACT
PURPOSE: This descriptive study was aimed to examine trends in the incidence of melanoma and nonmelanoma in South Korea. MATERIALS AND METHODS: The nationwide incidence data for melanoma and non-melanoma skin cancer was obtained from the Korea Central Cancer Registry. Age-standardized rates were calculated and analyzed, using a Joinpoint regression model. RESULTS: The incidence of basal cell carcinoma has increased dramatically both in men (average annual percentage change [AAPC], 8.0 [95% confidence interval (CI), 6.0 to 10.1]) and women (AAPC, 9.0 [95% CI, 7.5 to 10.4]). Squamous cell carcinoma has also steadily increased both in men (AAPC, 3.3 [95% CI, 2.6 to 4.0]) and women (AAPC, 6.8 [95% CI, 5.3 to 8.4]). Cutaneous melanoma increased continuously from 1999 to 2014 inwomen (AAPC, 3.5 [95% CI, 2.4 to 4.6]), whilst rapidly increasing in men until 2005 (APC, 7.9 [95% CI, 2.4 to 13.7]) after which no increase has been observed (APC, -0.2 [95% CI, -2.3 to 2.0]). CONCLUSION: The incidence rates of melanoma and non-melanoma skin cancer have increased over the past years, with the exception of melanoma in men. Further studies are required to investigate the reasons for the increased incidence of these skin cancers in South Korea.