Onychopapilloma: a single medical center experience in Southern Taiwan.

Background: Onychopapilloma is an uncommon benign tumor of the nail bed and the distal matrix. Objectives: We aimed to investigate the clinical and pathological features of onychopapilloma in Taiwan.Materials and methods: We conducted a retrospective analysis of 12 patients with histopathologically proven onychopapilloma in a medical center in southern Taiwan from 2017 to 2023. Results: This case series consisted of 5 men and 7 women aged 29 to 38, with a mean age of 41.25 years. The clinical features were as follows: distal subungual hyperkeratosis (100%), longitudinal erythronychia (50%), longitudinal leukonychia (50 %), distal onycholysis (41%), and distal nail plate fissuring (41%). The duration of the disease varied greatly, ranging from 1 month to several years. Most patients were asymptomatic (58%), while some presented tenderness (41%). Fingernail involvement was more prevalent than toe involvement, with the thumb being the most commonly affected site. Most of the patients presented with a solitary onychopapilloma. None of the seven patients who underwent surgery and were available for follow-up experienced recurrence.Conclusions: This study highlights that longitudinal erythronychia and leukonychia emerged as the predominant clinical presentations of onychopapilloma. Furthermore, our findings suggest that surgical excision appears to be an effective method for onychopapilloma.

Leukemia cutis in a medical center in southern Taiwan: A retrospective study of 42 patients.

BACKGROUND/PURPOSE: Leukemia cutis (LC), by definition, is the infiltration of neoplastic leukocytes in the skin. The overall incidence of LC is rare. We aimed to investigate the association between clinical characteristics, classifications and prognosis among different types of LC in Taiwan. METHODS: We performed a retrospective analysis of forty-two patients with histopathology proven LC based on skin biopsies in a medical center in Southern Taiwan from 1997 to 2018. The study involved medical records of the patients, clinical manifestations, and outcomes according to different types of leukemia. RESULTS: This series consisted of 27 males and 15 females, and the mean age was 55.7 years old. The most common cutaneous features were papules (38%) and nodules (29%), followed by plaques (16%) and ulcers (10%). The most commonly affected sites were the trunk (33%) and extremities (31.5%), although generalized distribution (14%) was not rare. The prognosis of LC was very poor, 76.2% of patients (32/42) died during the follow-up, and the median survival time was 7.2 months (95% CI, 4.53-9.87 months). No statistical significance was found (P = 0.068 for survival curves) among different types of LC. CONCLUSION: This study was the first large-scale research in regarding to LC of Han Chinese. The commonest clinical presentations were papules and nodules, and the predilection sites were trunk and extremities. Besides, there was the high frequency of LC from AML and MDS in Taiwan. Clinicians should pay more attention to the leukemia patients with extramedullary manifestations due to poor survival outcomes.

A growing trend of females and dermatologists among top medical graduates in 30 years.

BACKGROUND: Career outcomes of top medical graduates (TMG) are seldom studied. The Tsungming Tu Foundation (TTF) has awarded the number one graduate from each medical school in Taiwan since 1981. We aimed to study whether TMG differ from all medical graduates (AMG) in gender, specialty, and geographic regions in the last 30 years. METHODS: Overall, 322 TMG and 40,075 AMG were identified from 1981 to 2017 from TTF and Taiwan healthcare public data, respectively. Subjects were further grouped by their graduation year: 1981-1994, 1995-2001, 2002-2011, and after 2012. Ranges were based on implementation dates of new health care policies. RESULTS: The percentages of female AMG increased from 10.9% before 1994 to 32.6% after 2012 (linear trend, P < 0.001). Similarly, the percentages of female TMG increased from 23.1% before 1994 to 42.4% after 2012 (linear trend, P = 0.003). In contrast to 2% of AMG, the percentages of TMG who became dermatologists increased from 11% to 20.5% (linear trend, P = 0.024). TMG favored dermatology, ophthalmology, and neurology, and avoided general surgery (P < 0.001). While still higher than AMG, the percentages of TMG working in medical centers dropped significantly from 58% during 1981-1994 to 33.3% during 1995-2001 (P = 0.035). This coincided with the launch of National Health Insurance in 1995. Finally, though more than half of TMG previously worked in Northern Taiwan, they have recently moved to Central Taiwan. CONCLUSIONS: The percentages of female AMG and TMG reached 32.6% and 42.4%, respectively, after 2012. TMG prefer to choose dermatology, ophthalmology, and neurology, but avoid general surgery. Changes in health policy, reimbursement policy, and medical education may be associated with AMG and TMG career choices.