Purpose: To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data. Materials and Methods: Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups. Results: The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities. Conclusion This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.

Purpose: To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data. Materials and Methods: Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups. Results: The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities. Conclusion This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.

Purpose: To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data. Materials and Methods: Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups. Results: The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities. Conclusion This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.

Purpose: To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data. Materials and Methods: Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups. Results: The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities. Conclusion This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.

Purpose: To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data. Materials and Methods: Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups. Results: The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities. Conclusion This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.

Background: s/Aims: This study was performed to reveal the usefulness of the trabecular bone score (TBS) in assessing bone strength in patients with ankylosing spondylitis (AS) in comparison with dual-energy X-ray absorptiometry (DXA) methods. Methods: A total of 215 AS patients (75.8% male) were enrolled from a single university hospital in Korea. Demographic and clinical information were assessed. Patients completed X-rays of the cervical and lumbar spine (L-spine), and spinal ankyloses were quantified using the modified Stoke AS Spine Score (mSASSS). Hip, anteroposterior and lateral L-spine bone mineral density (BMD) and TBS were assessed by DXA methods. Clinical characteristics and bone strength measurement results were compared between male and female AS patients. The accuracy of each bone strength evaluation method in predicting Fracture Risk Assessment Tool (FRAX) scores indicating moderate or higher fracture risk was compared by receiver operating characteristic curves in patients aged ≥ 40 years. Correlations between each bone strength measurement method and mSASSS were examined. Results: Male patients showed higher mSASSS and less prevalent peripheral joint involvement compared to female patients (p < 0.05). TBS, hip BMD, and L-spine lateral BMD showed comparably high areas under the curve (AUCs) for predicting FRAX-major osteoporotic fractures (MOF) ≥ 10% (AUC ranged 0.72 to 0.76). TBS negatively correlated with mSASSS in both male and female patients (p < 0.01). Conclusions TBS could predict the risk of MOF and is not influenced by spinal osteoproliferation in AS patients, even in those with advanced spinal changes.

Background: s/Aims: This study was performed to reveal the usefulness of the trabecular bone score (TBS) in assessing bone strength in patients with ankylosing spondylitis (AS) in comparison with dual-energy X-ray absorptiometry (DXA) methods. Methods: A total of 215 AS patients (75.8% male) were enrolled from a single university hospital in Korea. Demographic and clinical information were assessed. Patients completed X-rays of the cervical and lumbar spine (L-spine), and spinal ankyloses were quantified using the modified Stoke AS Spine Score (mSASSS). Hip, anteroposterior and lateral L-spine bone mineral density (BMD) and TBS were assessed by DXA methods. Clinical characteristics and bone strength measurement results were compared between male and female AS patients. The accuracy of each bone strength evaluation method in predicting Fracture Risk Assessment Tool (FRAX) scores indicating moderate or higher fracture risk was compared by receiver operating characteristic curves in patients aged ≥ 40 years. Correlations between each bone strength measurement method and mSASSS were examined. Results: Male patients showed higher mSASSS and less prevalent peripheral joint involvement compared to female patients (p < 0.05). TBS, hip BMD, and L-spine lateral BMD showed comparably high areas under the curve (AUCs) for predicting FRAX-major osteoporotic fractures (MOF) ≥ 10% (AUC ranged 0.72 to 0.76). TBS negatively correlated with mSASSS in both male and female patients (p < 0.01). Conclusions TBS could predict the risk of MOF and is not influenced by spinal osteoproliferation in AS patients, even in those with advanced spinal changes.

A 60-year-old woman visited the authors' clinic with low back pain and arthralgia. Her symptoms had occurred 6 months previously, and she was treated with an epidural injection and a balloon dilatation procedure based on the assumption of spinal stenosis, but both treatments were ineffective. Her low back pain was aggravated, accompanied by fever and chills over a period of 4 months. As a result, she visited another referral hospital and was diagnosed with infective spondylitis associated with the invasive procedure. Her symptoms improved with antibiotics, but they recurred. When she visited our clinic, she still had continuous low back pain and febrile senses. Magnetic resonance imaging of her lumbar spine revealed interspinous bursitis, and 18 F-fluorodeoxyglucose positron emission tomography showed multifocal synovial inflammation. She was diagnosed with polymyalgia rheumatica and treatment was started on prednisolone and celecoxib. Her symptoms improved dramatically and the inflammatory markers normalized.
Anti-Bacterial Agents ; Arthralgia ; Back Pain ; Bursitis ; Celecoxib ; Chills ; Dilatation ; Female ; Fever ; Humans ; Inflammation ; Injections, Epidural ; Low Back Pain ; Magnetic Resonance Imaging ; Middle Aged ; Polymyalgia Rheumatica* ; Positron-Emission Tomography ; Prednisolone ; Referral and Consultation ; Spinal Stenosis ; Spine ; Spondylitis*

OBJECTIVE: To identify the prevalence of antiphospholipid antibodies (aPL) in systemic lupus erythematosus (SLE) patients and determine the relationship between aPL and the clinical outcomes. METHODS: SLE patients with aPL test results within 2 years of enrollment were selected from Korean lupus network study. They were classified into two groups: aPL (+) group, patients positive for at least one aPL, and aPL (−) group, patients without an aPL. The clinical characteristics of the two groups were compared and the role of aPL in the risk of chronic kidney disease (CKD) in SLE patients was examined. RESULTS: Among the 469 SLE patients, 69 (14.7%) had at least one aPL. The prevalence of cerebrovascular disease and CKD was higher in the aPL (+) group than in the aPL (−) group (10.1% vs. 1.8% and 13.8% vs. 5.1%, p < 0.05). Multivariable regression analysis showed that the aPL positivity (odds ratio=3.93, 95% confidence interval=1.48∼10.47) was associated with the risk of CKD after adjusting for age, disease duration, and lupus nephritis history. CONCLUSION: Among the 469 SLE patients, 69 (14.7%) had at least one aPL. The prevalence of cerebrovascular disease and CKD was higher in the aPL (+) group than in the aPL (−) group (10.1% vs. 1.8% and 13.8% vs. 5.1%, p < 0.05). Multivariable regression analysis showed that the aPL positivity (odds ratio=3.93, 95% confidence interval=1.48∼10.47) was associated with the risk of CKD after adjusting for age, disease duration, and lupus nephritis history.
Antibodies, Antiphospholipid* ; Cerebrovascular Disorders ; Humans ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Prevalence ; Renal Insufficiency, Chronic

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