Previous studies have shown that tricuspid regurgitation (TR) can be developed in patients with atrial fibrillation (AF) due to annular dilatation. This study aimed to investigate the incidence and predictors of the progression of TR in patients with persistent AF. A total of 397 patients (66.9±11.4 years, 247 men; 62.2%) with persistent AF were enrolled between 2006 and 2016 in a tertiary hospital, and 287 eligible patients with follow-up echocardiography were analyzed. They were divided into two groups according to TR progression (progression group [n=68, 70.1±10.7 years, 48.5% men] vs. non-progression group [n=219, 66.0±11.3 years, 64.8% men]). Among 287 patients in the analysis, 68 had worsening TR severity (23.7%). Patients in the TR progression group were older and more likely to be female. Patients with left ventricular ejection fraction ＜50% were less frequent in the progression group than those in the non-progression group (7.4% vs. 19.6%, p=0.018). Patients with mitral valve disease were more frequent in the progression group. Multivariate analysis with COX regression demonstrated independent predictors of TR progression, including left atrial (LA) diameter ＞54 mm (HR 4.85, 95%CI 2.23-10.57, p＜0.001), E/e’ (HR 1.05, 95%CI 1.01-1.10, p=0.027), and no use of antiarrhythmic agents (HR 2.20, 95%CI 1.03-4.72, p=0.041). In patients with persistent AF, worsening TR was not uncommon. The independent predictors of TR progression turned out to be greater LA diameter, higher E/e’, and no use of antiarrhythmic agents.

In this study, the Search Your Mind (S.Y.M., 心) project aimed to collect prospective digital phenotypic data centered on mood and anxiety symptoms across psychiatric disorders through a smartphone application (app) platform while using both centralized and decentralized research designs: the centralized research design is a hybrid of a general prospective observational study and a digital platform-based study, and it includes face-to-face research such as informed written consent, clinical evaluation, and blood sampling. It also includes digital phenotypic assessment through an application-based platform using wearable devices. Meanwhile, the decentralized research design is a non-face-to-face study in which anonymous participants agree to electronic informed consent forms on the app. It also exclusively uses an application-based platform to acquire individualized digital phenotypic data. We expect to collect clinical, biological, and digital phenotypic data centered on mood and anxiety symptoms, and we propose a possible model of centralized and decentralized research design.

BACKGROUND: Generalized pustular psoriasis (GPP) and subcorneal pustular dermatosis (SPD) are clinically and histopathologically difficult to distinguish. There have been no comparative studies examining these two diseases in Korea. OBJECTIVE: To investigate the clinical and histopathological characteristics of GPP and SPD. METHODS: We evaluated the clinical features, laboratory, and histopathological findings in 16 patients with generalized pustular eruption who had visited our hospital over the past 10 years and reviewed the literature. RESULTS: Ten GPP and six SPD patients were included in the study. The mean age at diagnosis was 44.4 years in the GPP group and 50 years in the SPD group. The number of patients with previous personal history of psoriasis vulgaris was 2 (20%) for GPP and 0 (0%) for SPD. The number of patients with history of recent exposure to medications was 1 (10%) and 0 (0%) in the GPP and SPD groups, respectively. Symptoms of fever, arthralgia, and mucosal involvement were reported in 10%, 20%, and 10% of GPP patients and 16.7%, 16.7%, and 0% of SPD patients, respectively. Leukocytosis, eosinophilia, elevated ESR/CRP, and elevated AST/ALT were reported in 25%, 0%, 25%, and 50% of GPP patients and in 20%, 0%, 40%, and 40% of SPD patients, respectively. On histological findings, in the GPP group, spongiosis, and psoriasiform changes including hyperkeratosis/parakeratosis, and rete ridge changes were more apparent than in the SPD group. The mean period of clinical improvement was 32.9 days with 40% recurrence in the GPP group and 38.3 days with 66.7% recurrence in the SPD group. CONCLUSION: Although GPP and SPD exhibit clinical and laboratory findings that are similar and difficult to differentiate, systematic analyses including clinical course, laboratory findings, and histopathological findings are helpful for an accurate differential diagnosis.
Arthralgia ; Diagnosis ; Diagnosis, Differential ; Eosinophilia ; Fever ; Humans ; Korea* ; Leukocytosis ; Psoriasis* ; Recurrence ; Skin Diseases, Vesiculobullous* ; Tertiary Care Centers*

No abstract available.
Dermatofibrosarcoma* ; Nose*

Wolf's isotopic response is defined as the occurrence of a new skin disorder at the site of another unrelated skin disease that has already healed. In most cases of isotopic response, the initial dermatosis is herpes infection, and the most frequent second dermatoses are granulomatous reactions. Various interpretations of this phenomenon have been attempted. However, the exact mechanism has not been identified yet. Herein, we report a case in which the secondary disease was segmental vitiligo that appeared over the same dermatomes of herpes zoster. A 71-year-old woman presented with well-defined, depigmented patches on the left chest and back. She had been diagnosed with herpes zoster on the same dermatomes and treated with an antiviral agent 3 years ago. Histological examination showed decreased basal melanin pigments and melanocytes. Consequently, the patient was diagnosed with segmental vitiligo based on the clinical and histological findings.
Aged ; Female ; Herpes Zoster* ; Humans ; Melanins ; Melanocytes ; Skin ; Skin Diseases ; Thorax ; Vitiligo*

Verruca plana is a subtype of warts, which are one of the most common dermatological diseases. A 37-year-old man presented with multiple asymptomatic skin-colored, 1∼2-mm, flat-topped papules on both arms, neck, and face. The patient had ulcerative colitis, which had been treated with immunosuppressants for 15 years. After skin biopsy, verruca plana was confirmed. The patient was treated with 5% imiquimod cream for 6 months. However, only mild improvement was observed. Acitretin was then added to the treatment regimen. After 44 weeks of treatment, acitretin was stopped. Dramatic and rapid clinical improvement was achieved after 3 weeks of treatment, and no sign of recurrence after treatment cessation has been reported for 60 weeks. Consequently, the combination of oral acitretin and topical 5% imiquimod cream should be recommended for the effective and safe treatment of recalcitrant verruca plana in immunosuppressed patients.
Acitretin* ; Adult ; Arm ; Biopsy ; Colitis, Ulcerative ; Humans ; Immunosuppressive Agents ; Neck ; Recurrence ; Skin ; Warts* ; Withholding Treatment

No abstract available.
Lipomatosis* ; Neoplasm Metastasis* ; Small Cell Lung Carcinoma*

BACKGROUND: Eyelid tumors are common neoplasms encountered in daily dermatology practices and encompass a wide variety of benign and malignant tumors, since the eyelid has many tissue types. These tumors sometimes mimic common inflammatory conditions. Nonetheless, clinical investigation of these conditions remains limited. OBJECTIVE: To investigate the clinical and histopathological characteristics of eyelid skin tumors. METHODS: We retrospectively reviewed the medical records and clinical photographs of 148 patients with eyelid skin tumors confirmed by skin biopsy examination between January 2009 and May 2016. RESULTS: The mean patient age was 50.0 years, and the male-to-female ratio was 1:1.11. Malignant eyelid skin tumors accounted for 17.3% of the total number, and older patients were more likely to be affected by malignant tumors than benign tumors (66.2 years vs. 46.4 years). Epidermal cysts (15.5%), seborrheic keratosis (14.9%), and melanocytic nevus (14.2%) were the most common benign eyelid skin tumors. Basal cell carcinoma was the most common malignant tumor (69.2%), followed by squamous cell carcinoma (11.5%). Malignant skin tumors, especially basal cell carcinoma, predominantly involved the lower eyelid. No patient showed metastasis from the malignant skin tumors, and no case of recurrence was observed after wide excision of the tumors. CONCLUSION: Our findings suggest that various tumors, including malignant ones, can affect the eyelid area. This study provides useful data on the incidence and characteristics of eyelid skin tumors. Further investigation with a large group of patients is necessary to better understand the epidemiology of eyelid skin tumors.
Biopsy ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Epidemiology ; Epidermal Cyst ; Eyelids* ; Humans ; Incidence ; Keratosis, Seborrheic ; Korea* ; Medical Records ; Neoplasm Metastasis ; Nevus, Pigmented ; Recurrence ; Retrospective Studies ; Skin* ; Tertiary Care Centers*

BACKGROUND: Eyelid tumors are common neoplasms encountered in daily dermatology practices and encompass a wide variety of benign and malignant tumors, since the eyelid has many tissue types. These tumors sometimes mimic common inflammatory conditions. Nonetheless, clinical investigation of these conditions remains limited. OBJECTIVE: To investigate the clinical and histopathological characteristics of eyelid skin tumors. METHODS: We retrospectively reviewed the medical records and clinical photographs of 148 patients with eyelid skin tumors confirmed by skin biopsy examination between January 2009 and May 2016. RESULTS: The mean patient age was 50.0 years, and the male-to-female ratio was 1:1.11. Malignant eyelid skin tumors accounted for 17.3% of the total number, and older patients were more likely to be affected by malignant tumors than benign tumors (66.2 years vs. 46.4 years). Epidermal cysts (15.5%), seborrheic keratosis (14.9%), and melanocytic nevus (14.2%) were the most common benign eyelid skin tumors. Basal cell carcinoma was the most common malignant tumor (69.2%), followed by squamous cell carcinoma (11.5%). Malignant skin tumors, especially basal cell carcinoma, predominantly involved the lower eyelid. No patient showed metastasis from the malignant skin tumors, and no case of recurrence was observed after wide excision of the tumors. CONCLUSION: Our findings suggest that various tumors, including malignant ones, can affect the eyelid area. This study provides useful data on the incidence and characteristics of eyelid skin tumors. Further investigation with a large group of patients is necessary to better understand the epidemiology of eyelid skin tumors.
Biopsy ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Epidemiology ; Epidermal Cyst ; Eyelids* ; Humans ; Incidence ; Keratosis, Seborrheic ; Korea* ; Medical Records ; Neoplasm Metastasis ; Nevus, Pigmented ; Recurrence ; Retrospective Studies ; Skin* ; Tertiary Care Centers*

BACKGROUND: By magnifying the scalp and structure of hair, trichoscopy enables easy differentiation among various hair loss diseases. OBJECTIVE: To measure the frequency of representative trichoscopic findings in outpatients with androgenetic alopecia and alopecia areata and the frequency of various trichoscopic findings depending on the disease severity of androgenetic alopecia. METHODS: This cross-sectional study included 87 patients with androgenetic alopecia (n=57) and alopecia areata (n=30) treated over a year (2014∼2015). Three dermatologists assessed the trichoscopic findings (hair shaft, hair follicle opening, and perifollicular epidermis) in these patients. RESULTS: Vellus hair was observed in 21 of the 30 patients (70%) with alopecia areata and 20 of the 57 patients (35%) with androgenetic alopecia. Among the patients with androgenetic alopecia, as the disease severity increased, the portion of patients with vellus hair, thickness heterogeneity, and honeycomb pigmentation also increased (p<0.05). CONCLUSION: Trichoscopy is very useful for the diagnosis of androgenetic alopecia and alopecia areata. Additionally, the severity of androgenetic alopecia can be assessed using trichoscopy.
Alopecia Areata* ; Alopecia* ; Cross-Sectional Studies ; Diagnosis ; Hair ; Hair Follicle ; Humans ; Outpatients* ; Pigmentation ; Population Characteristics ; Scalp