Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 53
Filter
Add filters








Year range
1.
Article in English | WPRIM | ID: wpr-938515

ABSTRACT

Background@#Risankizumab is a humanized immunoglobulin G1 monoclonal antibody that selectively binds to the p19 subunit of interleukin-23. Risankizumab has demonstrated rapid and excellent therapeutic effects in several clinical trials. Although a growing number of studies have reported data on the real-world efficacy and safety of risankizumab for the treatment of psoriasis, no such study has been conducted in Korea. @*Objective@#We evaluated the real-world efficacy and safety of risankizumab for the treatment of moderate-to-severe plaque psoriasis in Korean patients. @*Methods@#This was a retrospective single-center study. A total of 33 patients treated with risankizumab, for at least 16 weeks, were enrolled. Based on electronic medical records, the clinical characteristics, psoriasis area and severity index (PASI) score, body surface area, and adverse events were investigated. @*Results@#The mean PASI score was significantly reduced at 4 weeks of risankizumab treatment (3.27±2.15) and gradually reduced at week 16 (1.06±0.97) and week 52 (0.24±0.63) (p<0.05). At week 16, all patients achieved a PASI 75 response, and 66.7% and 27.3% of patients achieved PASI 90 and PASI 100 responses, respectively. Obese patients (body mass index, BMI≥25 kg/m2 ) showed a lower PASI 90 response than non-obese patients (BMI<25 kg/m2 ) at week 16. Older patients (age≥65 years) showed significantly higher PASI scores than younger patients (age<65 years) at week 16. Mild to moderate adverse events were reported in four patients; however, no patient discontinued treatment. @*Conclusion@#Risankizumab was very effective in a real-world clinical practice with a favorable safety profile in Korean patients with moderate-to-severe psoriasis.

2.
Article in English | WPRIM | ID: wpr-901986

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.

3.
Article in English | WPRIM | ID: wpr-894282

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.

4.
Annals of Dermatology ; : 77-81, 2021.
Article in English | WPRIM | ID: wpr-874115

ABSTRACT

Recently, biologic therapy has become a major advance in the management of moderate-to-severe psoriasis. Although the overall safety profile of biologics is favorable, primary infection or reactivation of latent tuberculosis (TB) is the major concern in the setting of tumor necrosis factor-alpha inhibitor therapy. Therefore, the treatment of latent tuberculosis infection (LTBI) before starting biologics is mandatory to prevent the reactivation of LTBI. A 27-year-old female was treated with adalimumab due to psoriasis. As latent TB was detected by the interferon-γ release assay, we started isoniazid treatment (300 mg/day) 3 weeks before starting adalimumab and maintained this for 6 months. Although the patient’s psoriatic skin lesions improved, after 45 weeks of adalimumab therapy, she visited the emergency department because of fever and back pain for 2 weeks. Abdominopelvic computed tomography (CT) and chest CT revealed multiple nodular lesions on both lungs, peritoneal wall, mesentery, and spleen, along with ascites. In the ascitic fluid, adenosine deaminase was increased to 96.4 U/L, and Mycobacterium tuberculosis grew in an acid-fast bacilli culture. The patient was diagnosed with disseminated TB and treated with conventional TB medication with discontinuation of adalimumab.Five months after the completion of TB treatment, the ustekinumab, an interleukin (IL)-12/IL-23 inhibitor, was administered. Until now, her skin lesions are under excellent control without reactivation of TB for 9 months after starting ustekinumab.

5.
Annals of Dermatology ; : 154-162, 2021.
Article in English | WPRIM | ID: wpr-874100

ABSTRACT

Background@#Dental caries is the most prevalent chronic infectious oral disease of multifactorial etiology. Increased risk of dental caries development in patients with asthma and allergic rhinitis has been frequently reported. In contrast, only a few studies on dental caries in patients with atopic dermatitis (AD) have been reported. @*Objective@#We investigated the association between AD and dental caries development in an adult population in the Republic of Korea. @*Methods@#A total of 21,606 adults who participated in the Korean National Health and Nutrition Examination Survey, a nationwide, population-based, cross-sectional survey between 2010 and 2015, were included in the study. Multiple logistic regression analyses with confounder adjustment suggested odds ratios (ORs) to identify the possible association between AD and decayed, missing, filled teeth (DMFT) experience compared to non-AD participants. Multiple Poisson regression analyses estimated the mean ratio of the DMFT index according to the presence of AD. @*Results@#After adjusting for various confounding factors, the prevalence of DMFT was significantly associated with AD (OR, 1.58; 95% confidence interval (CI), 1.08∼2.29; p=0.017). In addition, the mean value of the DMFT index was significantly different between the AD and non-AD groups (mean ratio, 1.07; 95% CI, 1.00∼1.14; p= 0.046). @*Conclusion@#AD was significantly associated with the development of dental caries. Dermatologists should be aware of the dental manifestations of AD patients and recommend regular dental check-ups for the early detection of caries.

7.
Article in English | WPRIM | ID: wpr-901924

ABSTRACT

Ectopic nails are rare and characterized by the growth of nail-like structures in a location other than the typical nail unit. Diagnosis of the ectopic nail is based on histologic examination consistent with a fully developed nail plate and matrix structure. Surgical resection of the entire matrix of ectopic nails is the gold standard for management.Cases of acquired ectopic nails without traumatic events have rarely been reported. A 25-year-old woman presented with a 15-year nail-like structure below the 4th fingernail of the left hand. She denied any history of trauma.Histologically, the keratinous structure was consistent with the nail plate. Plain radiography revealed an osteolytic lesion on the distal phalanx. However, she refused further evaluation and surgical excision. Herein, we report a unique case of an acquired ectopic nail without trauma.

8.
Article in English | WPRIM | ID: wpr-894220

ABSTRACT

Ectopic nails are rare and characterized by the growth of nail-like structures in a location other than the typical nail unit. Diagnosis of the ectopic nail is based on histologic examination consistent with a fully developed nail plate and matrix structure. Surgical resection of the entire matrix of ectopic nails is the gold standard for management.Cases of acquired ectopic nails without traumatic events have rarely been reported. A 25-year-old woman presented with a 15-year nail-like structure below the 4th fingernail of the left hand. She denied any history of trauma.Histologically, the keratinous structure was consistent with the nail plate. Plain radiography revealed an osteolytic lesion on the distal phalanx. However, she refused further evaluation and surgical excision. Herein, we report a unique case of an acquired ectopic nail without trauma.

9.
Article | WPRIM | ID: wpr-832665

ABSTRACT

Xanthelasma palpebrarum (XP) is the most common type of xanthoma. It is a benign condition characterized by bright yellowish plaque-like lesions that appear near the inner epicanthus showing symmetrical distribution. It may be accompanied with some familial lipoprotein disorders and systemic hyperlipidemia. A 28-year-old man visited our department with complaints of periorbital hyperpigmentation and linear yellow plaques along the bilateral upper and lower eyelids for 5 years. His father has hyperlipidemia. Laboratory investigations revealed an increase in low density lipoprotein-cholesterol and triglyceride levels. Histopathologic examination showed diffused infiltration of foamy cells and histiocytes in the upper dermis. The patient was diagnosed with XP based on the clinical and histopathological findings. XP usually present as yellow plaques on the upper eyelids. Here, we report a rare case of XP confined to the eyelines.

10.
Article | WPRIM | ID: wpr-832645

ABSTRACT

Hidroacanthoma simplex (HAS) is a rare benign intraepidermal neoplasm arising from the eccrine duct. Histologically, HAS exhibits the “Borst-Jadassohn phenomenon” and consists of intraepidermal cell nests, which resemble the features of clonal seborrheic keratosis. An 86-year-old woman presented a more than 10-year history of a 7.5 cm×5.6-cm brown verrucous plaque on her right pelvis. Histopathological examination showed intraepidermal clonal cell expansion of polygonal basaloid cells. The lesions were removed by CO2 laser, but polypoid papules recurred after 3 months. Histologic examination showed proliferation of polygonal basaloid cells with atypia and frequent mitosis. In addition, findings suggestive of syringofibroadenoma were observed. The tumor cells were positive for epithelial membrane antigen (EMA) and periodic acid-Schiff (PAS) staining. Based on these findings, we diagnosed the patient with HAS combined with variable eccrine tumors. Herein, we report a case of giant HAS combined with variable eccrine tumors showing a natural progression of eccrine tumors from HAS to eccrine porocarcinoma in situ.

11.
Annals of Dermatology ; : 115-121, 2020.
Article in English | WPRIM | ID: wpr-811087

ABSTRACT

BACKGROUND: Recently, the number of nationwide medical researches on psoriasis using the National Health Insurance Service database has been on the rise. However, identification of psoriasis using diagnostic codes alone can lead to misclassification. Accuracy of the diagnostic codes and their concordance with medical records should be validated first to identify psoriasis patients correctly.OBJECTIVE: To validate the diagnostic codes of psoriasis (International Classification of Diseases, 10th Revision L40) and to find the algorithm for the identification of psoriasis.METHODS: We collected medical records of patients who received their first diagnostic codes of psoriasis during 5 years from five hospitals. Fifteen percent of psoriasis patients were randomly selected from each hospital. We performed a validation by reviewing medical records and compared 5 algorithms to identify the best algorithm.RESULTS: Total of 538 cases were reviewed and classified as psoriasis (n=368), not psoriasis (n=159), and questionable (n=11). The most accurate algorithm was including patients with ≥1 visits with psoriasis as primary diagnostic codes and prescription of vitamin D derivatives. Its positive predictive value was 96.5% (95% confidence interval [CI], 93.9%~98.1%), which was significantly higher than those of the algorithm, including patients with ≥1 visits with psoriasis as primary diagnostic codes or including ≥1 visits with diagnostic codes of psoriasis (primary or additional) (91.0% and 69.8%). Sensitivity was 90.8% (95% CI, 87.2%~93.4%) and specificity was 92.5% (95% CI, 86.9%~95.9%).CONCLUSION: Our study demonstrates a validated algorithm to identify psoriasis, which will be useful for the nationwide population-based study of psoriasis in Korea.


Subject(s)
Classification , Electronic Health Records , Humans , International Classification of Diseases , Korea , Medical Records , National Health Programs , Prescriptions , Psoriasis , Sensitivity and Specificity , Vitamin D
12.
Article in Korean | WPRIM | ID: wpr-759764

ABSTRACT

Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by typical cutaneous manifestation and inflammation of the skeletal muscles. However, this progressive symmetric proximal muscle weakness may be minimal or absent in clinically amyopathic DM (CADM). Importantly, DM has been associated with malignancy, which is related to poor prognosis. Therefore, every newly diagnosed patient with DM should undergo thorough screening investigations for hidden internal malignancy. We report a case of CADM, with severe intractable itching, which was finally diagnosed as paraneoplastic dermatomyositis associated with gastric cancer in a 77-year-old woman. The patient had typical cutaneous features of DM and mild elevation of muscle enzymes without muscle weakness.


Subject(s)
Aged , Dermatomyositis , Female , Humans , Inflammation , Mass Screening , Muscle Weakness , Muscle, Skeletal , Myositis , Paraneoplastic Syndromes , Prognosis , Pruritus , Stomach Neoplasms
13.
Article in English | WPRIM | ID: wpr-759708

ABSTRACT

Cheilitis granulomatosa (CG) is a subset of orofacial granulomatosis (OFG) and considered to be a monosymptomatic form of Melkersson-Rosenthal syndrome (MRS), which is characterized by the triad of chronic lip swelling, facial paralysis, and fissured tongue. The labial swelling is thought to be associated with an orofacial swelling, which affects the chin, cheeks, and oral mucosa. Histologically, it is distinguished by noncaseating granulomas consisting of lymphohistiocytes and giant cells. Although systemic steroids with or without intralesional triamcinolone injections are the mainstay of treatment, and various agents have been proposed for this rare disease, no successful treatment modality has been reported in the literature yet. Herein, we present our experience with three different CG cases, which showed a varied level of positive response to the combination therapy.


Subject(s)
Cheek , Cheilitis , Chin , Facial Paralysis , Giant Cells , Granuloma , Granulomatosis, Orofacial , Lip , Melkersson-Rosenthal Syndrome , Mouth Mucosa , Rare Diseases , Steroids , Tongue, Fissured , Triamcinolone
14.
Article in English | WPRIM | ID: wpr-759698

ABSTRACT

No abstract available.


Subject(s)
Female , Humans , Nevus
15.
Annals of Dermatology ; : 110-112, 2019.
Article in English | WPRIM | ID: wpr-739346

ABSTRACT

No abstract available.


Subject(s)
Fibroma , Hand , Tendons , Zea mays
17.
Article in Korean | WPRIM | ID: wpr-714500

ABSTRACT

BACKGROUND: Adverse cutaneous drug reactions (ACDRs) are common and are responsible for increased morbidity, mortality, and socioeconomic costs. OBJECTIVE: The purpose of our study was to investigate the common drugs and clinical patterns related to ACDRs using an electronic drug adverse reaction reporting system at a single secondary referral center. METHODS: We conducted a retrospective analysis of the ACDR database between January 2014 and April 2016 at the Ilsan Paik Hospital. RESULTS: The study analyzed 320 patients with ACDRs (male:female ratio=93:227; mean age 50.8±17.8 years). Using a Korean causality evaluation algorithm, the percentage of drugs with a possible relationship with ACDRs was calculated to be 50.6%, while the percentage with a probable relationship was 44.7%. Antibiotics (44.0%), radiocontrast media (15.1%), and non-steroidal anti-inflammatory drugs (NSAIDs) (14.3%) were the most commonly implicated drugs. Antibiotics, including cephalosporins (30.6%) and quinolones (10.2%), were responsible for the majority of the ACDRs. Acetic acid (5.9%) and propionic acid (5.9%) derivatives of NSAIDs were also common causative agents. The most common clinical presentations were maculopapular exanthema (33.4%), pruritus (30.9%), and urticaria (25.7%). Severe ACDRs were significantly associated with older age, eosinophilia, and underlying heart and renal diseases (p<0.05). CONCLUSION: Antibiotics, radiocontrast media, and NSAIDs were identified as common causes of ACDRs. Older age, eosinophilia, heart disease, and renal disease were associated with severe ACDRs.


Subject(s)
Acetic Acid , Adverse Drug Reaction Reporting Systems , Anti-Bacterial Agents , Anti-Inflammatory Agents, Non-Steroidal , Cephalosporins , Contrast Media , Diethylpropion , Drug-Related Side Effects and Adverse Reactions , Eosinophilia , Exanthema , Heart , Heart Diseases , Humans , Mortality , Pruritus , Quinolones , Retrospective Studies , Secondary Care Centers , Urticaria
18.
Article in Korean | WPRIM | ID: wpr-109987

ABSTRACT

BACKGROUND: Melasma, a common chronic pigmentary disorder, is resistant to various treatments. Recently, pulse-in-pulse type of intense pulsed light (PIP IPL) has been introduced as a treatment for melasma. It can emit multiple peaks during one pulse wave to deliver photothermal energy more effectively with gentle and even low energy so that complications are minimal. OBJECTIVE: The purpose of this study was to compare the efficacy and safety of PIP IPL to low-fluence, multi-pass, Q-switched Nd:YAG laser in the treatment of facial melasma. METHODS: Fifteen female patients with melasma who had Fitzpatrick skin type III or IV were enrolled in this study between November 2014 and April 2015. Patients underwent 6 sessions of treatment at an interval of 1 week. One half of each patient's face was treated with 2 passes of PIP IPL with a fluence of 13~15 J/cm₂. The other half of the face was treated with 4 passes of Q-Switched Nd:YAG laser with a fluence of 1.6~1.8 J/cm₂. Results were evaluated at every visit, including modified Melasma Area and Severity Index (MASI) score, subject's global assessment, and investigator's global assessment. RESULTS: Modified MASI scores were significantly (p<0.05) reduced in both groups after 6 treatment sessions. Q-Switched Nd:YAG laser treatment was more effective than PIP IPL for the treatment of melasma, although the two treatments did not significantly (p=0.44) differ in effectiveness. However, the discomfort levels of patients in the PIP IPL group following procedures were significantly lower compared to those in the Q-Switched Nd:YAG group. CONCLUSION: The current investigation demonstrated that PIP IPL treatment for melasma in Korean women was not inferior to collimated low fluence Q-switched Nd:YAG laser treatment.


Subject(s)
Female , Humans , Melanosis , Skin
20.
Article in Korean | WPRIM | ID: wpr-46515

ABSTRACT

BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a syndrome involving multiple organs. Due to a variable clinical presentation and uncertain definition, diagnosis is often delayed or misdiagnosed. OBJECTIVE: The purpose of this study was to investigate the common causative drugs of DRESS and differences according to drugs, clinical features, and prognosis of DRESS, and secondly to compare the differences between steroid use group versus non-use group. METHODS: Medical records of hospitalized patients at the Sanggye Paik Hospital from January 2001 to December 2015 were collected. DRESS patients were enrolled retrospectively using the RegiSCAR diagnostic criteria. RESULTS: A total of 65 patients were included. The four most common causative drug groups were antibiotics (27.7%), anticonvulsants (20%), antituberculosis agents (16.9%), and allopurinol (16.9%). The mean incubation period was 4 weeks, significantly shorter in antibiotics (2 weeks, p < 0.001) and significantly longer in anticonvulsants (6.5 weeks, p=0.033). Sixty-three patients fully recovered with a mean recovery time of 3.1 (standard deviation 2.2) weeks, one patient had sequelae, and one patient died. Recovery time tended to increase with longer duration of diagnosis from rash onset (p < 0.001, correlation coefficient=0.419) and higher serum aspartate aminotransferase levels (p=0.024, correlation coefficient=0.297). The mean recovery time was 1 week shorter for the systemic steroid use group, but it was not statistically significant (p=0.056). CONCLUSION: DRESS may be a heterogeneous syndrome with specific characteristics related to different drugs. The prognosis of DRESS is relatively good and the role of systemic steroid therapy is unclear. Prompt diagnosis and immediate discontinuation of the causative drug are essential for early recovery.


Subject(s)
Allopurinol , Anti-Bacterial Agents , Anticonvulsants , Aspartate Aminotransferases , Diagnosis , Drug Hypersensitivity , Drug Hypersensitivity Syndrome , Drug-Related Side Effects and Adverse Reactions , Exanthema , Humans , Medical Records , Prognosis , Retrospective Studies
SELECTION OF CITATIONS
SEARCH DETAIL