Effects of Oral Health Behavior and Mental Health on Metabolic Syndrome in Korean Adults / 치위생과학회지

Background@#Integrated management of general, mental, and oral health is necessary to improve an individual’s quality of life. This study aimed to identify the effects of mental and oral health behaviors on metabolic syndrome. @*Methods@#A total of 4,227 Korean adults aged 20 years or older were selected as study subjects using raw data from the first year (2019) of the 8th period of the Korea National Health and Nutrition Examination Survey (KNHANES). A complex sample chi-square test and a complex sample logistic regression analysis were performed using the PASW Statistics ver. 18.0 program. @*Results@#The effect on metabolic syndrome was significantly higher in male than in 1.833 times in male, 2.914 times in 30∼49 years old, and 3.855 times in 50∼64 years old, and 3.929 times in people over 65 years old compared to 20∼29 years old, and compared to those with a college degree or higher, those with a middle school degree or lower are 2.116 times, those with lower income levels are 1.507 times higher, those with middle-lower are 1.359 times higher, those with middle-high are 1.401 times. Compared to non-smokers, smokers were 1.570 times higher than non-smokers and compared to those without speech problem and chewing difficulty, they were 1.717 times and 1.397 times higher, respectively and 1.973 times higher in those with 0∼1 brushing times per day. Mental health did not affect prevalence of metabolic syndrome. @*Conclusion@#It is necessary to improve maintain a healthy lifestyle to lower the risk of metabolic syndrome. It is necessary to establish effective dental hygiene customized education and an efficient health management system at the national level that can induce improvement of oral health behavior for the prevention and management of metabolic syndrome.

The Perception of Laymen and Experts Toward Mobile Applications for Self-monitoring of Diet Based on in-depth Interviews and Focus Group Interviews / 대한지역사회영양학회지

OBJECTIVES: We conducted a qualitative study to explore the feasibility of mobile applications for self-monitoring of diet. METHODS: We conducted in-depth and focus group interviews with eight laymen who had used mobile dietary applications and eight experts. Interviews were audio-recorded and analyzed using an open coding method. RESULTS: The qualitative data of our study revealed two key themes: (1) perceptions, opinions and attitudes towards mobile applications of self-monitoring of diet and (2) future directions to improve mobile applications. CONCLUSIONS: Our qualitative study suggested the potential use of mobile applications as a food-tracking and dietary monitoring tool and the need for improved mobile applications for self-monitoring of diet. The results of our study may provide insights into how to technically improve mobile applications for self-monitoring of diet, how to utilize dietary data generated through mobile applications, and how to improve individual's health though mobile applications.

The Perception of Laymen and Experts Toward Mobile Applications for Self-monitoring of Diet Based on in-depth Interviews and Focus Group Interviews / 대한지역사회영양학회지

OBJECTIVES: We conducted a qualitative study to explore the feasibility of mobile applications for self-monitoring of diet. METHODS: We conducted in-depth and focus group interviews with eight laymen who had used mobile dietary applications and eight experts. Interviews were audio-recorded and analyzed using an open coding method. RESULTS: The qualitative data of our study revealed two key themes: (1) perceptions, opinions and attitudes towards mobile applications of self-monitoring of diet and (2) future directions to improve mobile applications. CONCLUSIONS: Our qualitative study suggested the potential use of mobile applications as a food-tracking and dietary monitoring tool and the need for improved mobile applications for self-monitoring of diet. The results of our study may provide insights into how to technically improve mobile applications for self-monitoring of diet, how to utilize dietary data generated through mobile applications, and how to improve individual's health though mobile applications.

The Associated Factors with Scaling Experience among Some Workers in Small and Medium-Sized Companies / 치위생과학회지

The prevalence of periodontal disease was steadily increased. The best prevention methods for periodontal disease are teeth brushing and scaling. The purpose of this study was to investigate the status of scaling experience and related factors among some workers. Total 455 workers in 5 manufacturing companies in Gwangju were selected using convenience sampling method. General characteristics, work-related characteristics, oral health-related characteristics and scaling experience were collected by self-reported questionnaires. Chi-square tests, t-tests and multiple logistic regression analysis were performed to investigate the factors influencing the scaling experience using SPSS software. Statistical significance was defined as a p-value<0.05. The proportion of scaling experience during the past year was 47.0%. In simple analysis, age, current working position, number of oral disease, interest in oral health, use of secondary oral products, oral health screening use, oral health education experience and awareness of scaling inclusion in the National Health Insurance (NHI) coverage were associated with scaling experience. Finally, the odds ratios (ORs) for scaling experience were significantly higher in younger subjects (adjusted OR [aOR], 3.09; 95% confidence internal [CI], 1.60∼5.96), assistant manager (aOR, 2.68; 95% CI, 1.55∼4.63), subjects with high interest in oral health (aOR, 2.15; 95% CI, 1.02∼4.52), subjects with oral health screening use (aOR, 2.76; 95% CI, 1.50∼5.11) and awareness of scaling inclusion in the NHI coverage (aOR; 2.91, 95% CI, 1.80∼4.72) in multiple logistic regression analysis. Scaling experience was relatively low (47.0%). The related factors with scaling experience were age, working position, use of screening and awareness of scaling inclusion in the NHI coverage. Considering these factors will increase the utilization rate of scaling.

A Case of Epidermodysplasia Verruciformis Associated with Squamous Cell Carcinoma and Actinic Keratosis / 대한피부과학회지

Epidermodysplasia verruciformis is a very rare, chronic disease that's characterized by persistent human papillomavirus infection. This type of lesion may transform into malignant skin tumors, usually after the age of 30 years. We report here on a 33-year-old woman who presented with squamous cell carcinoma and actinic keratosis that developed from epidermodysplasia verruciformis. Her malignant skin lesions were effectively treated by surgical excision, cryotherapy and topical application of imiquimod.

The Long Term Efficacy and Relapse Rate of Itraconazole Pulse Therapy Versus Terbinafine Continuous Therapy for Toenail Onychomycosis: a 96-week follow-up study / 대한의진균학회지

No abstract available.

Size-reductive Neoadjuvant Immunotherapy using Imiquimod in Squamous Cell Carcinoma of the Lower Lip

rcinoma (SCC) is the second most common skin cancer. In particular, invasive SCC has a high risk of metastasis and sometimes, this can be fatal. At present, the treatment of choice for invasive SCC is complete excision with a proper surgical margin, but most cases of SCC develop on cosmetically-sensitive areas, so sometimes significant scarring or deformities can lead to an unhappy result. An 80 year-old female presented with a 4x1.5cm sized SCC on her lower lip. Although surgery was the first line therapy for this invasive SCC, a cosmetically poor outcome was expected. Thus the patient did not want to undergo a surgical operation, so we had to explore other treatment options. Recently there have been many reports that show imiquimod 5% cream is effective in the treatment of invasive SCC. Therefore we started topical therapy with imiquimod 5% cream five times a week. After 6 months, the lesion size was reduced to 2x1.5cm and we could remove the remnant tumor by wedge resection with cosmetically acceptable result. We suggest this neo-adjuvant immunotherapy can be an alternative for the treatment of cosmetically-critical SCC and present this case as a good example that has shown successful size-reductive neoadjuvant immunotherapy using imiquimod in invasive SCC.

Treatment of Extramammary Paget's Disease with Topical Imiquimod / 대한피부과학회지

BACKGROUND: Extramammary Paget's disease (EMPD) is an intraepidermal adenocarcinoma which usually affects elderly individuals. Due to its multifocal nature and indistinct demarcation from normal skin, recurrences are common, even after invasive surgical treatment. Topical application of imiquimod, an immune response modifier, has been reported to be effective in the treatment of not only anogenital warts, but also cutaneous malignancies such as actinic keratoses and basal cell carcinoma. There are only a few case reports on the treatment of EMPD with topical imiquimod in the literature. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of topical imiquimod for the treatment of EMPD. METHODS: Seven elderly patients (6 male and 1 female), whose ages ranged from 60 to 81 years (average, 68.4 years), were diagnosed with anogenital EMPD, which were further confirmed by skin biopsy. None of the patients were found to have associated internal neoplasms. Considering the patients' ages and morbidity associated with invasive treatment options, they were instructed to topically apply 5% imiquimod cream on their skin lesions once to three times a week. Imiquimod was applied for an average of 29.5 weeks. The patients were followed up on a monthly or bimonthly basis for any adverse affects or changes to the lesions. Residual lesions were surgically excised in 2 patients after 5 and 8 months of imiquimod application. RESULTS: With long-term imiquimod application, all 7 subjects experienced transient irritation, erythema, focal erosion, or hypopigmentation of the application site. One patient experienced flu-like symptoms. Clinical cure was observed in all 7 patients during treatment, and/or early observation period. However, a pathologic cure was observed in 2 patients only. The lesions recurred in 3 patients during the follow-up period. CONCLUSION: Since imiquimod has strong advantages in the preservation of function and cosmetics, it could be an effective primary treatment option for primary limited cutaneous EMPD, especially in elderly patients.

Basal Cell Carcinoma on the Nose Tip Treated with the Island Flap / 대한피부과학회지

Basal cell carcinoma gap (BCC) is the most common malignant tumor of the skin and often occurs on the face. Many types of local flaps are used to reconstruct the skin defect after excision. We report a case of basal cell carcinoma located on the nose tip, treated with an island flap.

Squamous cell carcinoma of the finger and toe / 대한피부과학회지

BACKGROUND: Squamous cell carcinoma of the finger and toe is a relatively rare disorder which has often been misdiagnosed for years before definite diagnosis. Squamous cell carcinoma of the finger has usually been found to be associated with type 16 human papillomavirus (HPV). OBJECTIVES: To describe the clinical and histological features of 12 squamous cell carcinomas of the finger and toe, and to evaluate these lesions for the presence of HPV. METHOD: The clinical and histological features were reviewed. Immunohistochemical staining and PCR were performed in paraffin embedded tissue sections for detection of the presence of HPV infection. RESULTS: Patients presented with an erosive or a verrucous papule. Histologically, 2 lesions demonstrated bowenoid features, 9 lesions demonstrated well differentiated squamous cell carcinoma, and 1 lesion demonstrated verrucous carciroma-like features. By immunohistochenical staining and PCR, we could not demonstrate any evidence of HPV infection in any of the cases. The affected digit was amputated in 10 cases, and complete excision of the skin lesion was done in 2 cases. CONCLUSION: Squamous cell carcinoma of the finger and toe is not as rare as has been implied by early literature. It is important to carry out the skin biopsy from all recalcitrant lesions of the finger and toe.

A Staged Supra-auricular Interpolation Pedicle Flap for Upper Helical Ear Reconstruction / 대한피부과학회지

Reconstruction of partial ear defects presents a unique and notable challenge to the dermatologist. This is due to the complex architecture of the external ear which is difficult to duplicate surgically. Several procedures are available for correction of defects to the external ear. However, the diversity of external ear shapes shows how difficult it is to achieve a certain solution to this problem. We report a case of auricular squamous cell carcinoma in which the skin defect is reconstructed by a staged supra-auricular interpolation pedicle flap.

A Case of a Bitemporal Atrophic Scar induced by Morphea, and treated by Autologous Fat Transplantation / 대한피부과학회지

A contour change induced by a subcutaneous depleting disorder such as lupus or morphea can be corrected by filling the defect with an artificial or natural materials of the types of fillers, autologous fat is popularly utilized for volumetric correction. Autologus fat has many advantages, such as easy harvesting, free volume, and non-immunogenicity. Herein, we report a case who of a bilateral atrophic scar on the temple area induced by morphea which was successfully treated by autologous fat transplantation.

A Case of Multiple Cutaneous Plexiform Schwannomas Accompanying Neurologic Deficits / 대한피부과학회지

Plexiform schwannoma is a rare variant of benign schwannoma characterized by a multinodular and plexiform growth pattern. Schwannomatosis is a recently recognized disorder, defined as multiple, pathologically-proven schwannoma without vestibular tumors, diagnostic of neurofibromatosis 2. Although plexiform schwannoma is usually solitary, multiple plexiform schwannomas do also occur as an isolated finding or in association with neurofibromatosis 2. We describe a 7-year-old girl who had multiple cutaneous plexiform schwannomas and neurologic deficits such as sensorineural hearing loss and amblyopia on her left side. Brain magnetic resonance imaging and ophthalmologic examination was negative for vestibular schwannoma and eye stigmata of neurofibromatosis 2. However, as there is a possibility that the patient may eventually develop additional cranial tumors such as meningiomas or vestibular schwannomas, we therefore recommend that she is periodically screened.

A Case of Pilar Sheath Acanthoma / 대한피부과학회지

Pilar sheath acanthoma is one of the benign follicular hamartoma, with a level of differentiation between trichofolliculoma and dilated pore of Winer. It differentiates toward infundibulum, isthmus, and rarely, sebaceous duct, apocrine, inner root sheath, and hair bulb components. It is a dome-shaped, symmetrical, sharply-circumscribed neoplasm that measures about 1cm in diameter. We herein report a case of pilar sheath acanthoma on the forehead of a 62-year-old male patient.

A Case of Desmoplastic Trichoepithelioma, Showing Similar Histological Features to Microcystic Adnexal Carcinoma / 대한피부과학회지

Desmoplastic trichoepithelioma is a rare benign tumor which is most commonly found on the face of young females. The tumor has a raised, annular border and a depressed center. The histologic features are often confused with other skin diseases, especially with microcystic adnexal carcinoma. We report, herein, a case of desmoplastic trichoepithelioma in a 26-year-old man, confirmed by re-biopsy and CEA immunohistochemical study.

Use of Subcutaneous Pedicle Flap in Nasolabial Reconstruction / 대한피부과학회지

BACKGROUND: Surgery of the nasolabial area is susceptible to the distortion of lips, commissure and nasal ala. A subcutaneous pedicle flap is suitable for surgical treatment of mid-size facial defects. OBJECTIVE: To evaluate the effectiveness of a subcutaneous pedicle flap for surgical defects of the nasolabial area. METHOD: We reviewed the medical records and evaluated clinical aspects and surgical treatment outcomes. RESULTS: Total number of patients was 13, including 8 males and 5 females. Mean age was 67.7years-old. Surgical defects were present on the alar crease in 9 cases, and upper lip in 4 cases. Mean size of defects was 1.6 by 1.3 cm. Flaps were well adopted, and no surgical scars were visible. No distortion of the adjacent structures were left. However, the alar crease was slightly blunted in one patient. CONCLUSION: A subcutaneous pedicle flap is suitable for reconstruction of nasolabial area defects.

Reconstruction of Surgical Lip Defects after Malignant Tumor Excision / 대한피부과학회지

BACKGROUND: The lips have an asethetic and functional importance. There are various types of lip defects, and these are mainly due to tumor excision. Although there are numerous techniques available to repair the lips, no universal reconstruction method is presently available, and reconstruction of lip defects are inherently difficult. OBJECTIVE: To report surgical reconstruction results of lip defects. METHOD: Our study involved eleven patients, who had visited our dermatologic surgery clinic between 1995 and 2003, and had been histopathologically diagnosed as having either a basal cell carcinoma or squamous cell carcinoma on the lips. The medical records were reviewed, and clinical features, surgical methods, and cosmetic and functional results were evaluated. RESULTS: Wedge resection, resection with W-plasty, the subcutaneous pedicle flap, and dual mucosal flap technique were used to repair lip defects surgically. The vermilion border was aligned well in all the patients, and a post-operative scar was not apparent. However, a microstomia developed in one patient. CONCLUSION: The dermatologic surgeon should be familiar with various reconstruction options for lip defects. An appropriate choice depends on the size, location and depth of the defect. Specific functional and aesthetic aspects of the lips should be taken into account when planning and performing an operation.

Study of the Correlation Among p53 Expression, Epidermal Hyperplasia, Dermal Inflammation, p21 Expression, and Ki-67 Expression in the Actinic Keratosis / 대한피부과학회지

BACKGROUND: Actinic keratosis is a proliferation of transformed neoplastic keratinocytes that are confined to the epidermis, and is induced by exposure to UV radiation in sunlight. The neoplastic transformation is primarily due to p53 gene mutation. OBJECTIVE: Our purpose was to study the correlation among p53 expression, epidermal hyperplasia, dermal inflammation, Ki-67 expression, and p21 expression in the actinic keratosis. METHODS: We reviewed the histopathologic slides of 21 cases of actinic keratosis. We performed immunoperoxidase staining using monoclonal antibody to p53 protein, Ki-67 antigen, p21 protein on the specimen. We stastically analyzed the correlation among p53 expression, epidermal hyperplasia, and dermal inflammation, Ki-67 expression, and p21 expression. RESULT: We found higher expression of p53 in the actinic keratosis with hyperplastic epidermis but this finding was not stastically siginificant (p=0.233). There was no correlation between the expression level of p53 and the severity of dermal inflammation (p=0.755). The expression level of p53 had the significant positive correlation with the expression level of Ki-67 (p=0.001). There was no correlation between the expression level of p53 and the expression level of p21 (p=0.116). CONCLUSION: We observed that p53 expression had a significant positive correlation to only Ki-67 expression. We suggested that further study would be needed on the correlation among p53 expression, epidermal hyperplasia, dermal inflammation, and p21 expression in actinic keratosis.

Epstein-Barr Virus Associated Lymphoproliferative Lesion Presenting as a Hydroa Vacciniforme-like Eruption / 대한피부과학회지

BACKGROUND: There have been several reports of patients with a severe hydroa vacciniforme (HV)-like eruption from Asia and Latin America. The cutaneous lesions are present in both sun-exposed and nonexposed areas in these patients unlike true HV. Several patients have died of malignant hematologic malignancies. The latent Epstein-Barr virus (EBV) infection has been detected in the skin lesions of the patients. OBJECTIVE: To describe clinical, histological, immunohistochemical, and molecular pathological features of the patients with EBV associated lymphoproliferative lesion presenting as a HV-like eruption. METHODS: The clinical, histological, and immunohistochemical features of 16 patients were reviewed. The presence of T-cell receptor (TCR)-gamma gene rearrangement was investigated using polymerase chain reaction (PCR) technique. Photoprovocation by repetitive UVA exposure was performed in five patients. In situ hybridization was performed to detect mRNA for EBV in the lesional skin biopsy specimen, lymph node biopsy specimen, mucosal biopsy specimen of stomach, and the skin biopsy specimen of photo-provoked site. PCR was performed to detect DNA for EBV in the skin biopsy specimens of 6 patients and peripheral mononuclear cells of 2 patients. RESULTS: The severity of the skin lesion and the clinical course varied among the patients. Skin biopsy specimens obtained from a papule or a vesicle showed perivascular and periadnexal infiltrate of lymphoid cells with T-cell phenotype. However, clonal TCR-gamma gene rearrangement was not detected in all 8 patients. Papules or vesicles were induced by repetitive UVA exposure in 5 patients. A latent EBV infection was demonstrated in all the tested samples, such as lesional skin, lymph node, gastric mucosa, peripheral blood mononuclear cells, and the photo-provoked lesion. CONCLUSION: EBV associated lymphoproliferative lesion presenting as a HV-like eruption is a novel disease that is not related to classic HV. Repetitive irradiation of UVA can induce the skin lesion in some patients with EBV associated lymphoproliferative lesion presenting as a HV-like eruption.

Two Cases of Prurigo Pigmentosa: A Histopathologic Anaylsis / 대한피부과학회지

Prurigo pigmentosa - a rare dermatosis described first by Nagashima in 1971 - presents as intensely pruritic papules arranged in a reticular pattern and distributed symmetrically on the back of young women. Individual lesions involute within weeks, leaving net-like pigmentation, but recurrences are the rule. According to the recent report of Ackerman et al., prurigo pigmentosa shows discernable characteristic histopathologic stages successively in its natural course. We report two cases of prurigo pigmentosa with clinico-histopathologic analysis - one, occurred in 24-year old man who recovered spontaneously after 7 months of morbidity and the other, occurred in 23-year old woman who responded dramatically to dapsone.