INTRODUCTIONThe objective of the study was to determine the trend of malaria, the epidemiological characteristics, the frequency of local transmission and the preventive and control measures taken.

MATERIALS AND METHODSWe analysed the epidemiological records of all reported malaria cases maintained by the Communicable Diseases Division, Ministry of Health, from 1983 to 2007 and the Anopheles vector surveillance data collected by the National Environment Agency during the same period.

RESULTSThe annual incidence of reported malaria ranged from 2.9 to 11.1 per 100,000 population, with a sharp decline observed after 1997. There were 38 deaths, 92.1% due to falciparum malaria and 7.9% due to vivax malaria. Of the reported cases, 91.4% to 98.3% were imported, with about 90% originating from Southeast Asia and the Indian subcontinent. Among the various population groups with imported malaria, the proportion of cases involving work permit/employment pass holders had increased, while that of local residents had decreased. Between 74.8% and 95.1% of the local residents with imported malaria did not take personal chemoprophylaxis when they travelled overseas. Despite the extremely low Anopheles vector population, a total of 29 local outbreaks involving 196 cases occurred. Most of the larger outbreaks could be traced to foreign workers with imported relapsing vivax malaria and who did not seek medical treatment early. One of the outbreaks of 3 cases in 2007 was caused by Plasmodium knowlesi, a newly recognised simian malaria which was probably acquired in a forested area where long-tail macaques had been sighted.

CONCLUSIONSSingapore remains both vulnerable and receptive to the reintroduction of malaria and a high level of vigilance should be maintained indefinitely to prevent the re-establishment of endemicity. Medical practitioners should highlight the risk of malaria to travellers visiting endemic areas and also consider the possibility of simian malaria in a patient who has no recent travel history and presenting with daily fever spikes and with malaria parasite morphologically similar to that of P. malariae.

Adolescent ; Adult ; Animals ; Anopheles ; Child ; Child, Preschool ; Disease Outbreaks ; Emigrants and Immigrants ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Insect Vectors ; Malaria ; epidemiology ; prevention & control ; transmission ; Malaria, Falciparum ; epidemiology ; prevention & control ; transmission ; Malaria, Vivax ; epidemiology ; prevention & control ; transmission ; Male ; Middle Aged ; Plasmodium knowlesi ; Plasmodium malariae ; Population Surveillance ; Recurrence ; Retrospective Studies ; Risk Factors ; Singapore ; epidemiology ; Travel ; Young Adult

BACKGROUND: Various eccrine tumors are rather common diseases in clinicians. However, data on the clinicopathologic features of eccrine tumors in Korea are limited. OBJECTIVE: The purpose of this study was to investigate the clinicopathologic characteristics of eccrine tumors in Korea. METHODS: Two hundred and sixty five cases of eccrine tumors, seen from 2002 to 2004 in Korea, were retrospectively analyzed clinically and histopathologically. RESULTS: The most common eccrine tumors identified within Koreans were syringoma (61%), followed by eccrine poroma (13%), eccrine hidrocystoma (9%), and nodular hidradenoma (6%). Moreover, eccrine tumors were usually found to occur in middle-aged woman as multiple asymptomatic skin-colored papules. The most common site of occurrence was the face (45%), followed by the neck (9%), scalp (5%), foot (5%), abdomen (4%), and vulvar (3%). CONCLUSION: The results of this study will be useful and fundamental data on eccrine tumors for clinicians and pathologists.
Abdomen ; Acrospiroma ; Female ; Foot ; Hidrocystoma ; Humans ; Korea ; Neck ; Poroma ; Retrospective Studies ; Scalp ; Syringoma

BACKGROUND: Data on the clinicopathologic features of hair follicle tumors in Korea are limited. OBJECTIVE: The purpose was to investigate the clinical and histopathologic characteristics of hair follicle tumors in Korea. METHODS: Two hundred sixty four cases of hair follicle tumors seen from 1999 to 2001 in Korea were analyzed clinically and histopathologically. RESULTS AND CONCLUSION: The most common hair follicle tumor in Korea was pilomatricoma(81.0%), followed by trichoepithelioma(6.4%), dilated pore of Winer(3.8%), and proliferating trichilemmal tumor(2.2%). Hair follicle tumors usually occurred as a solitary skin-colored nodule. The most commonly involved site was the face, and the peak age of presentation was 10 to 19. Pilomatricoma usually occurred as a solitary skin-colored nodule. The most commonly involved site was the arm, and more than 50% of tumors occurred before the age of 20. Histopathologically, the tumor was often surrounded by fibrous capsule and was composed of basophilic and shadow cells. It was usually located in the dermis and extended into the subcutis. Retraction spaces between tumor nests and stroma were frequently observed. Trichoepithelioma usually occurred as multiple skin-colored papules on the face. Histopathologically, the tumor was usually located in the dermis with sometimes connected to the epidermis. It frequently showed peripheral palisading. Dilated pore of Winer usually occurred as a solitary brownish to pigmented papule on the face in middle-aged persons. Proliferating trichilemmal tumor occurred as a solitary or multiple tumors. Histopathologically, the tumor was usually surrounded by incomplete fibrous capsule. Tumor cells frequently showed clear cell formation, nuclear atypia, mitosis, peripheral palisading, trichilemmal keratinization, and individual keratinization.
Arm ; Basophils ; Dermis ; Epidermis ; Hair Follicle* ; Hair* ; Humans ; Korea ; Mitosis ; Pilomatrixoma

BACKGROUND: The relative frequency and clinicopathologic characteristics of lymphomas vary according to geography and race. Data on the features of cutaneous lymphoma in Korea are limited. OBJECTIVE: The aim of this study was to document the relative occurrence, the clinical and histopathological features of cutaneous lymphomas in Korea. METHODS: The Korean Dermatopathology Research Group conducted a review of nationwide collection of 80 cutaneous lymphomas, diagnosed at 23 institutes over recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. RESULTS AND CONCLUSION: Korea has a higher rate of T-cell lymphoma and NK/T cell lymphoma and a much lower rate of cutaneous B cell lymphoma. The relative frequency of the major diagnostic group according to WHO classification was as follows: mycosis fungoides/Sezary syndrome, 42.5%; anaplastic large cell lymphoma, 19%; nasal and nasal type NK/T cell lymphoma, 15%; subcutaneous panniculitis-like T cell lymphoma, 11%; peripheral T cell lymphoma, unspecified, 7.5%; follicular lymphoma, 3%; marginal zone lymphoma, 1%; angioimmunoblastic lymphadenopathy, 1%. Compared with Western countries, the rate of nasal and nasal-type NK/T cell lymphoma and subcutaneous panniculitis-like T cell lymphoma were much higher. Therefore, The EORTC classification is not effective in dealing with Korean cases of cutaneous lymphoma. We consider the principles of the WHO classification are applicable to the Korean cases of cutaneous lymphoma.
Academies and Institutes ; Classification ; Continental Population Groups ; Geography ; Humans ; Immunoblastic Lymphadenopathy ; Korea* ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Follicular ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Pathology ; Retrospective Studies

BACKGROUND: Malignant melanoma in Korea has been increasing as in other countries, but there is no nationwide survey of malignant melanoma in Korea. OBJECTIVE: The aim of this study was to document the clinical and histopathological features of cutaneous melanoma in Korea. METHODS: The Dermatopathology Research Group conducted a review of nationwide collection of 109 primary cutaneous melanomas, diagnosed at 23 institutes over a recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. RESULTS AND CONCLUSION: The peak age was the 7th decade with the mean age of 58.1 years. Korea has a higher rate of acral melanoma and much lower rate of lentigo maligna melanoma. .Major component tumor cell was spindle cell type. Clark level of tumor was III or more and Breslow depth was 2mm or more at the time of the first diagnosis in many cases (62%). Pre-existing melanocytic nevus was present in a few cases (3 cases). All these features suggest that the racial difference between the Korean and the Caucasian is evident. We also suggest that an early detection program is very important to cure this malignant tumor.
Academies and Institutes ; Diagnosis ; Humans ; Hutchinson's Melanotic Freckle ; Korea* ; Melanoma* ; Nevus, Pigmented ; Pathology ; Retrospective Studies

BACKGROUND: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that this is a refractory disease which may cause a deleterious effect on patients' quality of life (QOL). OBJECTIVE: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the changes of QOL after treatment. METHODS: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after systemic antifungal treatment. Responses to the questionnaire were scored by f-point scale (0~4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptom and functional impact, patients' views concerning treatment, and relationship with doctor. RESULTS: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients' QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS: from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients' view concerning treatment(AS: from 1.34 to 1.02) 4. The degree of patients' satisfaction at the therapeutic effect was very high - 62.4% (immediately after. treatment) and 65.8% (9 months after initiation of treatment) of patients answered excellent or good. CONCLUSION: This study confirms that toenail onychomycosis has significant Impact on the overall QOL of patients. Also the effect of antifungal therapy on patients' QOL were satisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis.
Female ; Humans ; Korea* ; Male ; Nails* ; Onychomycosis* ; Quality of Life* ; Social Change ; Surveys and Questionnaires