Background: The inflammasome, a multiprotein complex, is crucial in the pathogenesis of various autoinflammatory disorders. In particular, the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome has recently been associated with diseases such as psoriasis, vitiligo, lupus, and alopecia areata (AA). Objective: The objective of this study is to investigate the potential involvement of the inflammasome in the pathogenesis of AA and to determine its correlation with clinical manifestations. Methods: A total of 144 patients with AA and 22 healthy controls were included. Scalp skin and serum samples were collected to assess the levels of NLRP3-related molecules in lesional tissue and blood, respectively. Additionally, we performed immunostaining to measure the expression of NLRP3 and caspase-1 in the outer root sheath (ORS). Results: Lesional interleukin-1β expression was significantly elevated in patients with AA at all stages compared with controls. In the progressive stage, lesional C-X-C motif chemokine ligand 10 levels were markedly higher than those in controls and other stages. Serum interferon-γ levels were also significantly increased during the progressive stage of AA compared with controls. Immunostaining revealed strong NLRP3 and caspase-1 positivity in the ORS during the initial and progressive stages of AA, in contrast to the recovery stage. Conclusion These results highlight the functional role of the inflammasomes in the pathogenesis of AA.

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.

Background: Dutasteride, a 5-alpha reductase inhibitor, is prescribed for male androgenetic alopecia (AGA) in Korea and Japan. Despite its efficacy, its use is limited by its long half-life, potent dihydrotestosterone suppression, and adverse effects. Objective: To investigate the efficacy and safety of 0.2 mg dutasteride for male AGA. Methods: Patients with male AGA were randomized to receive 0.2 mg dutasteride, placebo, or 0.5 mg dutasteride (2:2:1) once daily for 24 weeks. Safety and efficacy endpoints were assessed. Results: Overall, 139 men were analyzed. At week 24, the change in hair count within the target area at the vertex from baseline was significantly higher in the 0.2 mg dutasteride group than in the placebo group (21.53 vs. 5.96, p=0.0072). Dutasteride (0.2 mg) treatment led to greater hair growth improvement, as assessed by investigators at week 24 (p=0.0096) and an independent panel at weeks 12 and 24 (p=0.0306, p=0.0001). For all efficacy endpoints, 0.2 mg dutasteride was as effective as 0.5 mg dutasteride. The incidence of adverse events was low and not statistically different between the 0.2 mg dutasteride and placebo groups. The limitation of this study is the limited number of participants. Conclusion Low-dose (0.2 mg) dutasteride for male AGA showed significant efficacy and favorable safety profile.Trial Registration: ClinicalTrials.gov Identifier: NCT04825561

Background: Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed. Objective: This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based recommendations. Methods: The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved. Results: This guideline provides treatment guidance on advanced systemic treatment modalities for AD. In particular, the guideline offers up-to-date treatment recommendations for biologics and Janus-kinase inhibitors used in the treatment of patients with moderate to severe AD.It also provides guidance on other therapies for AD, along with tailored recommendations for children, adolescents, the elderly, and pregnant or breastfeeding women. Conclusion KADA’s updated AD treatment guidelines incorporate the latest evidence and expert opinion to provide a comprehensive approach to AD treatment. The guidelines will help clinicians optimize patient-specific therapies.

Background: Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed. Objective: This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based practices. Methods: The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved. Results: The guidelines provide detailed recommendations on foundational therapies, including the use of moisturizers, cleansing and bathing practices, allergen avoidance, and patient education. Guidance on topical therapies, such as topical corticosteroids and calcineurin inhibitors, is also provided to help manage inflammation and maintain skin barrier function in patients with AD. Additionally, recommendations on conventional systemic therapies, including corticosteroids, cyclosporine, and methotrexate, are provided for managing moderate to severe AD. Conclusion KADA’s updated AD guidelines offer clinicians evidence-based strategies focused on basic therapies, topical therapies, and conventional systemic therapies, equipping them to enhance quality of care and improve patient outcomes in AD management.

Background: Hydrochlorothiazide (HCTZ) has carcinogenic effects owing to its photosensitizing properties. Recent studies have reported inconsistent results regarding the association between HCTZ and skin cancer. Objective: This study aimed to clarify the effects of HCTZ on the risk of developing nonmelanoma skin cancer (NMSC) in Korean patients with hypertension. Methods: This multicenter, retrospective cohort study was conducted using clinical data from 11 hospitals in Korea, and converted to the Observational Medical Outcomes Partnership-Common Data Model. Large-scale 1:1 propensity score-matching was conducted to balance the target and comparator cohorts. Cox regression analysis was used to examine the hazard ratio (HR) for NMSC in HCTZ users compared to HCTZ never-users. Results: 8,821 patients and same number of controls were pooled from 11 databases. HCTZ use was not associated with a decreased risk of NMSC (HR, 1.01; 95% confidence interval [CI], 0.70–1.47). In the dose-response analysis, no significant correlation was found between NMSC risk and HCTZ dose for <1 year (HR, 1.17; 95% CI, 0.64–2.17) and ≥1 year (HR, 1.02; 95% CI, 0.64–1.61). No significant increase in the risk of NMSC was observed in the subgroup analyses for either age or sex. Conclusion HCTZ was not associated with the development of NMSC in a Korean hypertensive population, regardless of the duration of drug exposure.

Alopecia areata (AA) is common causes of non-scarring hair loss. Recently, a relationship with inflammatory bowel disease (IBD) was observed. Herein, we introduced cases of AA in patients with IBD. Six patients were diagnosed with AA and IBD. Three presented with alopecia totalis (AT), two presented with patchy-type AA, and one demonstrated acute diffuse and total alopecia. The most frequent type of IBD was ulcerative colitis (UC), except for one Crohn’s disease. The onset of AA relative to that of IBD was mixed; AA developed previously in all adolescents. Only one was receiving anti-tumor necrosis factor-alpha agents for IBD treatment and the hair loss worsened. Patients with patchy-type AA demonstrated favorable outcomes rather than patients with AT. This study confirmed that the ratio of AT and UC was high, suggesting that alopecia is more strongly associated with UC.Also, we emphasize the importance of careful observation of IBD symptoms in patients with AA, especially in adolescents.

Background: Primary cicatricial alopecia (PCA) is a rare disease that causes irreversible destruction of hair follicles and affects the quality of life (QOL). Objective: We aimed to investigate the disease awareness, medical use behavior, QOL, and real-world diagnosis and treatment status of patients with PCA. Methods: A self-administered questionnaire was administered to patients with PCA and their dermatologists. Patients aged between 19 and 75 years who visited one of 27 dermatology departments between September 2021 and September 2022 were included. Results: In total, 274 patients were included. The male-to-female ratio was 1:1.47, with a mean age of 45.7 years. Patients with neutrophilic and mixed PCA were predominantly male and younger than those with lymphocytic PCA. Among patients with lymphocytic PCA, lichen planopilaris was the most common type, and among those with neutrophilic PCA, folliculitis decalvans was the most common type. Among the total patients, 28.8% were previously diagnosed with PCA, 47.0% were diagnosed with PCA at least 6 months after their first hospital visit, 20.0% received early treatment within 3 months of disease onset, and 54.4% received steady treatment. More than half of the patients had a moderate to severe impairment in QOL. Topical/intralesional steroid injections were the most common treatment. Systemic immunosuppressants were frequently prescribed to patients with lymphocytic PCA, and antibiotics were mostly prescribed to patients with neutrophilic PCA. Conclusion This study provides information on the disease awareness, medical use behavior, QOL, diagnosis, and treatment status of Korean patients with PCA. This can help dermatologists educate patients with PCA to understand the necessity for early diagnosis and steady treatment.

Alopecia areata (AA) is common causes of non-scarring hair loss. Recently, a relationship with inflammatory bowel disease (IBD) was observed. Herein, we introduced cases of AA in patients with IBD. Six patients were diagnosed with AA and IBD. Three presented with alopecia totalis (AT), two presented with patchy-type AA, and one demonstrated acute diffuse and total alopecia. The most frequent type of IBD was ulcerative colitis (UC), except for one Crohn’s disease. The onset of AA relative to that of IBD was mixed; AA developed previously in all adolescents. Only one was receiving anti-tumor necrosis factor-alpha agents for IBD treatment and the hair loss worsened. Patients with patchy-type AA demonstrated favorable outcomes rather than patients with AT. This study confirmed that the ratio of AT and UC was high, suggesting that alopecia is more strongly associated with UC.Also, we emphasize the importance of careful observation of IBD symptoms in patients with AA, especially in adolescents.

Alopecia areata (AA) is common causes of non-scarring hair loss. Recently, a relationship with inflammatory bowel disease (IBD) was observed. Herein, we introduced cases of AA in patients with IBD. Six patients were diagnosed with AA and IBD. Three presented with alopecia totalis (AT), two presented with patchy-type AA, and one demonstrated acute diffuse and total alopecia. The most frequent type of IBD was ulcerative colitis (UC), except for one Crohn’s disease. The onset of AA relative to that of IBD was mixed; AA developed previously in all adolescents. Only one was receiving anti-tumor necrosis factor-alpha agents for IBD treatment and the hair loss worsened. Patients with patchy-type AA demonstrated favorable outcomes rather than patients with AT. This study confirmed that the ratio of AT and UC was high, suggesting that alopecia is more strongly associated with UC.Also, we emphasize the importance of careful observation of IBD symptoms in patients with AA, especially in adolescents.