1.A Cross-Sectional Analysis of Psychological and Dermatologic Manifestations Post-February 6Earthquakes in Dermatology Patients
Şule GENÇOĞLU ; Neslihan CANSEL
Annals of Dermatology 2026;38(2):108-116
Background:
Earthquakes are major natural disasters that can trigger both psychological and dermatological disturbances. The complex interaction between post-disaster mental health and skin disease remains underexplored, particularly beyond the acute phase.
Objective:
To investigate the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) and their associations with dermatologic diagnoses in patients attending a dermatology clinic one year after the February 6, 2023 earthquakes in Türkiye.
Methods:
This cross-sectional study included 673 dermatology outpatients who had resided in Malatya during the earthquakes. Sociodemographic and clinical data were collected.Psychological distress was assessed using the Hospital Anxiety and Depression Scale and Posttraumatic Stress Disorder-Short Scale.
Results:
Clinically significant anxiety, depression, and PTSD were observed in 44.0%, 69.2%, and 15.8% of participants, respectively. The most frequent dermatologic diagnoses were telogen effluvium (18.7%), pruritus (16.0%), and urticaria (10.1%). Telogen effluvium was more common among patients with anxiety (p=0.004) and PTSD (p=0.009), whereas alopecia areata and psoriasis showed higher rates in patients with anxiety and depression (p<0.05). Female sex, a history of psychiatric illness, and high education level were associated with the presence of PTSD.
Conclusion
High levels of psychological distress persist among dermatology patients even one year after the earthquakes, underscoring the importance of integrated dermatologic and mental health assessment.
2.Psychopathological Symptoms and Neuroticism in Female Outpatients With Dermatological Conditions:A Comparative Study
Hyun-Seung CHEE ; Solee HAN ; Young LEE ; So-Hyun AHN
Annals of Dermatology 2026;38(2):136-142
Background:
Despite evidence suggesting a bidirectional relationship between psychological factors and skin disease, psychological distress and personality traits remain underexplored in dermatological care.
Objective:
This study aimed to compare psychopathological symptoms and personality traits between female outpatients with dermatological conditions and healthy controls.
Methods:
In total, 159 outpatients with dermatological conditions and 160 healthy controls (all female) completed the Symptom Check List-90-Revised (SCL-90-R), and a shortened version of the NEO-Personality Inventory-Revised. Between-group comparisons were conducted using t-tests, and stepwise regression analysis was used to identify the psychopathological predictors of neuroticism.
Results:
Compared with controls, the dermatology outpatient group demonstrated significantly higher SCL-90-R scores for all nine clinical scales and neuroticism, scoring lower in extraversion, openness, and agreeableness. Within the dermatology outpatient group, neuroticism was positively associated with all psychopathological dimensions (r=0.265–0.583; p<0.01). Depression, somatization, and obsessive-compulsive symptoms were significant predictors of neuroticism (F=33.969; p<0.001).
Conclusion
Female outpatients with dermatological conditions may experience considerable psychological distress and elevated neuroticism, even in the absence of clinical psychiatric diagnoses. Screening for psychological symptoms—including neuroticism, depression, somatization, and obsessive-compulsive features—should be considered in dermatological settings to better address patients’ emotional well-being and optimize care outcomes.
5.Effects of Activin A on Cytokine Expression in Fibroblasts and Keratinocytes Under Atopic Dermatitis-Like Conditions
Young-Min HAN ; Young Il KIM ; Min Kyung SHIN
Annals of Dermatology 2026;38(2):143-149
Background:
Activin A is involved in the inflammatory response, wound repair, and skin fibrosis. Serum activin A concentrations change during the menstrual cycle, and this can lead to periodic exacerbation of atopic dermatitis.
Objective:
To determine the effect of activin A on the cytokine expression profiles of human fibroblasts and keratinocytes under atopic dermatitis-like conditions.
Methods:
Cultured human fibroblasts and keratinocytes were treated with activin A in combination with interleukin (IL)-4 and IL-13 to determine the changes in cytokine concentrations.
Results:
Activin A decreased the expression of IL-1β and IL-23 mRNA in fibroblasts. IL-4 and IL-13 increased the expression of IL-6 and IL-16 and decreased the expression of IL-1α, IL-1β, IL-8, IL-10, and IL-23 in fibroblasts. In keratinocytes, IL-4 and IL-13 increased the expression of IL-1α and IL-1β and decreased the expression of IL-8. Activin A treatment in combination with IL-4 and IL-13 significantly increased the expression of IL-1α, IL-6, IL-8, IL-10, IL-16, and IL-23 and decreased the expression of IL-1β in fibroblasts. In keratinocytes, only IL-8 expression was significantly increased following treatment with activin A, IL-4, and IL-13.
Conclusion
Activin A modulates cytokine expression in a cell type dependent manner under conditions mimicking atopic dermatitis, suggesting its potential involvement in cutaneous inflammatory regulation.
6.Increased Serum Cold-Inducible RNA-Binding Protein Levels in Psoriasis
Jung-Min SHIN ; Jung Eun KIM ; Dongkyun HONG ; Young LEE ; Young-Joon SEO ; Chang Deok KIM ; Kyung Eun JUNG
Annals of Dermatology 2026;38(2):123-128
Background:
Psoriasis is a chronic inflammatory skin disorder typified by well-demarcated erythematous plaques with scales. While considered an immune-driven condition, its underlying molecular triggers remain insufficiently defined. Cold-inducible RNA-binding protein (CIRP), a stress-response protein, has recently been recognized as a damage-associated molecular pattern that can stimulate immune responses.
Objective:
This study aimed to explore the potential association between circulating CIRP levels and the clinical as well as histological characteristics of psoriasis.
Methods:
Serum CIRP concentrations were analyzed in 67 individuals diagnosed with psoriasis and 20 healthy controls. Relationships between CIRP expression and various clinical and histological indices were also examined.
Results:
Patients with psoriasis exhibited significantly elevated serum CIRP levels compared to healthy individuals. Although correlations were observed between CIRP and certain clinical and histological indicators, CIRP levels did not significantly differ based on disease severity (Psoriasis Area and Severity Index score), joint involvement, or nail changes.
Conclusion
Our findings support the notion that CIRP may be involved in the immunopathogenesis of psoriasis and could be considered a prospective target for therapeutic modulation.
7.The Clinical Efficacy and Mechanism of Action of Alitretinoin in the Treatment of Alopecia Areata
Jung-Min SHIN ; Bogyeong GO ; Young-Joon SEO ; Chang Deok KIM ; Kyung Eun JUNG ; Young LEE ; Moon-Bum KIM
Annals of Dermatology 2026;38(2):129-135
Background:
Alitretinoin, a pan-retinoid receptor agonist approved for chronic hand eczema, exhibits immunomodulatory effects that may benefit alopecia areata (AA). However, clinical evidence for its use in AA is limited.
Objective:
To evaluate alitretinoin's clinical efficacy and immunological mechanism in patients with AA.
Methods:
We reviewed retrospectively twenty-one patients with AA who were treated with alitretinoin, either as monotherapy (n=9) or add-on therapy (n=12). Treatment response was assessed using the Severity of Alopecia Tool (SALT) scores, and in vitro studies used human outer root sheath cells stimulated with interferon-γ and polyinosinic:polycytidylic acid to investigate the drug’s effects on inflammatory pathways.
Results:
Both groups showed significant reductions in SALT scores (p=0.04 and p=0.02, respectively). Patients with baseline SALT scores below 50 demonstrated superior improvement.Adverse events were mild, with headache (33.3%) and cheilitis (4.8%) being the most common. In vitro, alitretinoin suppressed interleukin-6 and tumor necrosis factor-α expression, decreased phosphorylation of signal transducer and activator of transcription (STAT) 1/STAT3, and downregulated major histocompatibility complex class I expression, suggesting restoration of hair follicle immune privilege.
Conclusion
Alitretinoin appears to be a safe and potentially effective treatment for patients with mild to moderate AA unresponsive to conventional therapies. Its role as a monotherapy or adjunctive option in selected cases warrants further investigation through larger controlled studies.
8.Beyond the Face: An Exploratory Survey on Facial and Truncal Acne in High School Students
Young Bok LEE ; Minah CHO ; Hei Sung KIM
Annals of Dermatology 2026;38(2):89-97
Background:
Acne vulgaris commonly affects both the face and trunk, yet truncal acne remains underrecognized and less studied in adolescents.
Objective:
This study aimed to assess the prevalence, perceived severity, stress levels, treatment behaviors, and willingness to seek care in adolescents based on acne location.
Methods:
A cross-sectional survey was conducted among 211 first-year high school students (104 males, 107 females) in Incheon, South Korea. A structured questionnaire captured data on acne location, severity, stress, treatment history, and willingness to seek care. Analyses included descriptive statistics, χ2 tests, t-tests, and Spearman correlation.
Results:
Facial acne was reported by 86.7% of participants and truncal acne by 47.4%. The presence of facial and truncal acne was significantly associated (p<0.05), with truncal acne developing approximately one year after facial acne onset (p<0.05). While the mean subjective severity scores for facial (1.61±0.63) and truncal acne (1.57±0.79) were similar (p>0.05), stress levels were significantly higher for facial acne (p<0.05). Treatment rates were substantially lower for truncal acne (17.6%) compared to facial acne (48.6%), despite comparable willingness to seek clinical care.
Conclusion
Truncal acne is common but undertreated in adolescents. Despite comparable willingness to seek care, actual treatment rates remain low, underscoring a critical gap in management. Given the significant co-occurrence and risk of sequelae, clinicians should routinely assess for truncal acne in adolescents with facial acne and adopt a holistic management strategy addressing both areas.
9.Antifungal Effects of Non-Thermal Atmospheric Pressure Plasma In Vitro and Ex Vivo
Hye-Jin AHN ; Jin-Woo LEE ; Woo Yeon HWANG ; Byung Su KWON ; Ki-Heon JEONG ; Min Kyung SHIN
Annals of Dermatology 2026;38(2):98-107
Background:
Non-thermal atmospheric pressure plasma (NTAP) generates reactive oxygen species, reactive nitrogen species, and ultraviolet radiation, which can inactivate microorganisms.Onychomycosis treatment is challenging, and its prognosis is poor owing to mixed infections and dermatophytosis. Although NTAP has shown in vitro antifungal effects against dermatophytes and yeast, its efficacy against non-dermatophyte molds (NDMs) and in clinical or nail model studies remains poorly understood.
Objective:
We evaluated the effects of NTAP on fungi, including NDMs, and infected nail plates.
Methods:
For the in vitro experiments, Trichophyton rubrum, Candida albicans, Aspergillus fumigatus, and Fusarium oxysporum strains were exposed to NTAP. After NTAP exposure (2,4 and 6 minutes), growth curve, cell viability, and biofilm biomass were assessed by absorbance wavelength of 600 nm, XTT assay, and crystal violet staining, respectively. For the ex vivo experiments, infected nail plates were analyzed using a scanning electron microscope.
Results:
T. rubrum and C. albicans showed greater growth inhibition with increasing NTAP exposure time, whereas A. fumigatus showed enhanced growth after 6 minutes exposure. Many fungal elements within the subungual hyperkeratosis of the ex vivo specimen were all damaged following NTAP exposure.
Conclusion
NTAP has antifungal effects on dermatophytes, yeast, and NDMs. We suggest that the intensity and time of NTAP application should be adjusted according to each strain and can be more effective when NTAP directly reaches the hyphae on the nail bed or subungual hyperkeratosis.
10.Association Between Statin Use and Non-Melanoma Skin Cancer Risk:A Distributed Network Analysis of 11 Real-World Databases
Jiyoon AN ; Man S KIM ; Yoonsung LEE ; Bark-Lynn LEW ; Soon-Hyo KWON
Annals of Dermatology 2026;38(2):117-122
Background:
Given the dual potential of statins to act as both carcinogenic and antineoplastic agents, evidence from previous investigations into statin use and the risk of nonmelanoma skin cancer (NMSC) remains inconclusive.
Objective:
To demonstrate the impact of statin exposure on the NMSC risk in Korean patients.
Methods:
We carried out a multicenter cohort study based on electronic health record data aggregated from 11 Korean hospitals. Patients with hyperlipidemia who had been taking antilipidemic agents, including statins were included in this study. We applied 1:1 propensity score matching to create balanced cohorts and used Cox regression to assess the hazard ratio (HR) for NMSC.
Results:
A total of 18,579 statin users and a matched number of non-users were included across 11 databases. Statin use showed no significant association with an increased risk of NMSC (HR, 1.03; 95% confidence interval, 0.75–1.43). Subgroup analyses of drug exposure, age, and sex depicted no significant HR trends.
Conclusion
Statin exposure demonstrated no significant association with NMSC development in Korean patients with hyperlipidemia.

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