Background: The fatality rate of patients with coronavirus disease 2019 (COVID-19) varies among countries owing to demographics, patient comorbidities, surge capacity of healthcare systems, and the quality of medical care. We assessed the clinical outcomes of patients with COVID-19 during the first wave of the epidemic in Korea. Methods: Using a modified World Health Organization clinical record form, we obtained clinical data for 3,060 patients with COVID-19 treated at 55 hospitals in Korea. Disease severity scores were defined as: 1) no limitation of daily activities; 2) limitation of daily activities but no need for supplemental oxygen; 3) supplemental oxygen via nasal cannula; 4) supplemental oxygen via facial mask; 5) non-invasive mechanical ventilation; 6) invasive mechanical ventilation; 7) multi-organ failure or extracorporeal membrane oxygenation therapy; and 8) death. Recovery was defined as a severity score of 1 or 2, or discharge and release from isolation. Results: The median age of the patients was 43 years of age; 43.6% were male. The median time from illness onset to admission was 5 days. Of the patients with a disease severity score of 3–4 on admission, 65 (71.5%) of the 91 patients recovered, and 7 (7.7%) died due to illness by day 28. Of the patients with disease severity scores of 5–7, 7 (19.5%) of the 36 patients recovered, and 8 (22.2%) died due to illness by day 28. None of the 1,324 patients who were < 50 years of age died; in contrast, the fatality rate due to illness by day 28 was 0.5% (2/375), 0.9% (2/215), 5.8% (6/104), and 14.0% (7/50) for the patients aged 50–59, 60–69, 70–79, and ≥ 80 years of age, respectively. Conclusion In Korea, almost all patients of < 50 years of age with COVID-19 recovered without supplemental oxygen. In patients of ≥ 50 years of age, the fatality rate increased with age, reaching 14% in patients of ≥ 80 years of age.

No abstract available.
Child* ; Humans ; Nevus, Epithelioid and Spindle Cell*

Poroid hidradenoma is a benign tumor that is classified as a poroid neoplasm, and is so called because of its morphology, which is intermediate between the cytological features of a poroid neoplasm (poroid and cuticular cells) and the architectural features of a hidradenoma (solid and cystic areas, and tumor cells restricted to the dermis). As these tumors are cystic and superficially located, fine needle aspiration cytology has been useful, but the diagnosis relies on the histological examination. A 79-year-old woman presented with a solitary walnut-sized, soft, tender, reddish-to-bluish nodular lesion that had been enlarging steadily over a period of two years. Histopathologic examination of the cutaneous lesion showed a well-demarcated tumor composed of poroid and cuticular cells in the dermis not connected to the overlying epidermis, consistent with poroid hidradenoma. Herein, we present a rare case of poroid hidradenoma arising in an unusual location.
Acrospiroma* ; Aged ; Biopsy, Fine-Needle ; Dermis ; Diagnosis ; Epidermis ; Female ; Humans ; Poroma

No abstract available.
Child* ; Humans ; Syringoma* ; Vulva

BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged 73.5 +/- 5.2 years) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.
Aged* ; Classification ; Female ; Humans ; Male ; Malnutrition* ; Mass Screening* ; Medical Records ; Nutrition Assessment ; Sensitivity and Specificity

A calf suffering from diarrhea was admitted to the Animal and Plant Quarantine Agency for diagnostic evaluation. Postmortem examination revealed that the mesenteric lymph node was enlarged and small intestine wall was thin. Microscopically, a large number of small round organisms were attached to the small intestine villi. Villous atrophy and proprial neutrophil infiltration were also observed. Based on modified Ziehl-Neelsen staining, electron microscopy, and ELISA results, the calf was diagnosed with fatal cryptosporidiosis.
Animals ; Atrophy ; Autopsy ; Cryptosporidiosis* ; Cryptosporidium parvum ; Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Intestine, Small ; Lymph Nodes ; Microscopy, Electron ; Neutrophil Infiltration ; Oocysts ; Plants ; Quarantine

BACKGROUND: Dermoscopy is a real-time, noninvasive technique that increases the diagnostic accuracy of clinical evaluation by the dermatologist. Characterization of facial actinic keratosis via dermoscopy is valuable in guiding the dermatologist in the differential diagnosis of facial skin lesions. To our knowledge, dermoscopic evaluation of actinic keratosis has not yet been reported in Korean literature. OBJECTIVE: The purpose of this study was to investigate the dermoscopic features of facial actinic keratosis in Koreans. METHODS: We examined 60 patients with facial actinic keratosis using dermoscopy. We determined the frequency of specific features revealed by dermoscopy across the Korean patient population and compared our results with those of other published studies. RESULTS: A total of 67 facial actinic keratoses were observed in 60 patients. The common features of non-pigmented actinic keratoses revealed by dermoscopy were a red pseudo-network (66%), white-to-yellow surface scales (48.9%), linear wavy vessels (38.3%), and targetoid hair follicles (42.6%). The common features of pigmented actinic keratoses revealed by dermoscopy were slate-grey dots (55%) and globules (30%), annular-granular pattern (35%), a brown-to-gray pseudo-network (40%), and targetoid hair follicles (30%). The frequency of specific features revealed by dermoscopy across the analyzed patient population was not significantly different from that reported in other studies, except for rhomboidal structures (5%), which was lower in Koreans than in other populations (35.8%, p<0.05). The frequency of dermoscopic features was different according to histopathologic subtypes (hypertrophic, atrophic, bowenoid, acantholytic actinic keratosis). CONCLUSION: Dermoscopy revealed specific features of facial actinic keratosis that can be utilized to evaluate and diagnose facial skin lesions.
Actins ; Dermoscopy* ; Diagnosis, Differential ; Hair Follicle ; Humans ; Keratosis, Actinic* ; Skin ; Weights and Measures

Leser-Trelat sign is a rare paraneoplastic dermatosis that is characterized by the eruptive and rapid development of multiple seborrheic keratosis that coincides with an internal malignancy. Eruptive seborrheic keratosis can be pruritic and appear in a "Christmas-tree pattern." This sign occurs in association with a number of cancers, such as adenocarcinoma of the gastrointestinal tract and various lymphoproliferative disorders. However, Leser-Trelat sign associated with a malignant melanoma is very rare. A 58-year-old male patient presented with an asymptomatic black mass on the penile orifice and patch on the glans penis. He complained of gross hematuria. At the same time, he developed asymptomatic multiple brown papules and plaques on the back. The histopathologic findings of the glans and back lesions were consistent with malignant melanoma and seborrheic keratosis, respectively. Here, we describe a rare case of Leser-Trelat sign associated with malignant melanoma.
Adenocarcinoma ; Gastrointestinal Tract ; Hematuria ; Humans ; Keratosis, Seborrheic ; Lymphoproliferative Disorders ; Male ; Melanoma* ; Middle Aged ; Penis ; Skin Diseases

Crohn's disease is a systemic inflammatory and granulomatous disease, mainly involving the gastrointestinal tract with extraintestinal manifestations such as the skin, liver and bone. Cutaneous manifestations of Crohn's disease are relatively common; however, the groin is an unusual site for cutaneous Crohn's disease. A 36-year-old male presented with mild pruritic nodules on the left groin for 2 months. Nine years ago, he was diagnosed with intestinal Crohn's disease by endoscopic biopsy. Histopathologic examination of the cutaneous lesion showed non-caseating granulomatous reactions composed of multinucleated giant cells with lymphohistiocytic infiltration in the dermis. Staining for periodic acid-Schiff and acid-fast bacilli was negative. From these findings, we diagnosed these lesions as cutaneous Crohn's disease. The lesions were markedly improved with three rounds of intralesional steroid injection.
Adult ; Biopsy ; Crohn Disease* ; Dermis ; Gastrointestinal Tract ; Giant Cells ; Groin* ; Humans ; Liver ; Male ; Skin

Erythema annulare centrifugum is an inflammatory skin disorder of unknown etiology characterized by erythematous urticarial papules that enlarge in a centrifugal pattern to form annular appearance. These lesions are usually asymptomatic. Erythema annulare centrifugum generally tends to be a chronic condition. It develops most frequently in adults between 30 and 50 years of life, and only a few infantile cases have been reported in the English literature. Herein, we present an additional case of infantile erythema annulare centrifugum with a review of the literature.
Adult ; Erythema* ; Humans ; Infant ; Skin