Rheumatoid neutrophilic dermatitis (RND) is a rare extra-articular skin lesion associated with rheumatoid arthritis (RA). Lesions typically occur symmetrically on the extensor surfaces of the extremities and present with variable clinical features. A 78-year-old female with a 2-month history of skin rash on the right forearm and left lower leg, with no other systemic symptoms, visited the dermatology department of our hospital. She had been diagnosed with seropositive RA approximately 20 years ago. The skin rash was asymmetrically distributed and presented with localized pustules, purpura, and edema. The biopsy specimen showed dermal infiltration by neutrophils, leukocytoclasia without vasculitis, and a neutrophilic dermal abscess. No fungi or bacteria were detected on any of the stains. The patient was diagnosed with RND. Clinical improvement was noted after treatment with dapsone, followed by colchicine and methylprednisolone. In this case report, we described the case of a female patient with atypically presented RND and conducted a literature review.

Background: This study compared the costs associated with transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in Korea by utilizing the National Health Insurance Service database. Methods: Between June 2015 and May 2019, 1,468 patients underwent primary isolated transfemoral TAVI, while 2,835 patients received primary isolated SAVR with a bioprosthesis. We assessed the costs of index hospitalization and subsequent healthcare utilization, categorizing the cohort into 6 age subgroups: <70, 70–74, 75–79, 80–84, 85–89, and ≥90 years. The median follow-up periods were 2.5 and 3.0 years in the TAVI and SAVR groups, respectively. Results: The index hospitalization costs were 41.0 million Korean won (KRW) (interquartile range [IQR], 39.1–44.7) for the TAVI group and 24.6 million KRW (IQR, 21.3–30.2) for the SAVR group (p<0.001). The TAVI group exhibited relatively constant index hospitalization costs across different age subgroups. In contrast, the SAVR group showed increasing index hospitalization costs with advancing age. The healthcare utilization costs were 5.7 million KRW per year (IQR, 3.3–14.2) for the TAVI group and 4.0 million KRW per year (IQR, 2.2–9.0) for the SAVR group (p<0.001). Healthcare utilization costs were higher in the TAVI group than in the SAVR group for the age subgroups of <70, 70–74, and 75–79 years, and were comparable in the age subgroups of 80–84, 85–89, and ≥90 years. Conclusion TAVI had much higher index hospitalization costs than SAVR. Additionally, the overall healthcare utilization costs post-discharge for TAVI were also marginally higher than those for SAVR in younger age subgroups.

Background: This study compared the costs associated with transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in Korea by utilizing the National Health Insurance Service database. Methods: Between June 2015 and May 2019, 1,468 patients underwent primary isolated transfemoral TAVI, while 2,835 patients received primary isolated SAVR with a bioprosthesis. We assessed the costs of index hospitalization and subsequent healthcare utilization, categorizing the cohort into 6 age subgroups: <70, 70–74, 75–79, 80–84, 85–89, and ≥90 years. The median follow-up periods were 2.5 and 3.0 years in the TAVI and SAVR groups, respectively. Results: The index hospitalization costs were 41.0 million Korean won (KRW) (interquartile range [IQR], 39.1–44.7) for the TAVI group and 24.6 million KRW (IQR, 21.3–30.2) for the SAVR group (p<0.001). The TAVI group exhibited relatively constant index hospitalization costs across different age subgroups. In contrast, the SAVR group showed increasing index hospitalization costs with advancing age. The healthcare utilization costs were 5.7 million KRW per year (IQR, 3.3–14.2) for the TAVI group and 4.0 million KRW per year (IQR, 2.2–9.0) for the SAVR group (p<0.001). Healthcare utilization costs were higher in the TAVI group than in the SAVR group for the age subgroups of <70, 70–74, and 75–79 years, and were comparable in the age subgroups of 80–84, 85–89, and ≥90 years. Conclusion TAVI had much higher index hospitalization costs than SAVR. Additionally, the overall healthcare utilization costs post-discharge for TAVI were also marginally higher than those for SAVR in younger age subgroups.

Background: This study compared the costs associated with transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in Korea by utilizing the National Health Insurance Service database. Methods: Between June 2015 and May 2019, 1,468 patients underwent primary isolated transfemoral TAVI, while 2,835 patients received primary isolated SAVR with a bioprosthesis. We assessed the costs of index hospitalization and subsequent healthcare utilization, categorizing the cohort into 6 age subgroups: <70, 70–74, 75–79, 80–84, 85–89, and ≥90 years. The median follow-up periods were 2.5 and 3.0 years in the TAVI and SAVR groups, respectively. Results: The index hospitalization costs were 41.0 million Korean won (KRW) (interquartile range [IQR], 39.1–44.7) for the TAVI group and 24.6 million KRW (IQR, 21.3–30.2) for the SAVR group (p<0.001). The TAVI group exhibited relatively constant index hospitalization costs across different age subgroups. In contrast, the SAVR group showed increasing index hospitalization costs with advancing age. The healthcare utilization costs were 5.7 million KRW per year (IQR, 3.3–14.2) for the TAVI group and 4.0 million KRW per year (IQR, 2.2–9.0) for the SAVR group (p<0.001). Healthcare utilization costs were higher in the TAVI group than in the SAVR group for the age subgroups of <70, 70–74, and 75–79 years, and were comparable in the age subgroups of 80–84, 85–89, and ≥90 years. Conclusion TAVI had much higher index hospitalization costs than SAVR. Additionally, the overall healthcare utilization costs post-discharge for TAVI were also marginally higher than those for SAVR in younger age subgroups.

Interstitial granulomatous dermatitis (IGD) is a rare skin condition commonly associated with autoimmune diseases.Lesions typically occur bilaterally on the lateral trunk and proximal extremities and present as variable cutaneous lesions. A 63-year-old female with a 1-year history of a skin rash on her face visited the dermatology department of our hospital. The patient had received a dermal filler injection with unidentified gradients on the face of an unlicensed practitioner 20 years before. The lesions on the left cheek were tender, violaceous, coalescing, and annular. A violaceous round nodule with tenderness was observed on the left chin and glabella. She denied having any systemic complaints. The biopsy specimen showed diffuse interstitial CD68＋ histiocytic infiltration involving the reticular dermis around the degenerative collagen bundles. The patient was diagnosed with IGD. The patient was treated with systemic steroids and showed clinical improvement. Herein, we report a case of IGD after an unknown dermal filler injection, along with a literature review.

Background: Chronic scalp pruritus is a common symptom in dermatology patients. However, few studies have investigated its causes and clinical characteristics. Objective: We aimed to evaluate in this study the causes of chronic scalp pruritus, classify itching, and the clinical manifestations associated with different causes and classifications. Methods: A cross-sectional study was conducted involving 179 patients with chronic scalp pruritus recruited from the Department of Dermatology at Konyang University Hospital between August 2023 to February 2024. Age, sex, clinical features, Itch Numeric Rating Scale (NRS), Dermatology Life Quality Index (DLQI), and treatment response were evaluated using a questionnaire. Results: The most common cause of chronic scalp pruritus was a dermatologic condition (n=135, 75.4%). Systemic scalp pruritus (n=15, 8.4%) was the second most common cause, followed by neuropathic pruritus (n=14, 7.8%), psychogenic scalp pruritus (n=9, 5.0%), and scalp pruritus of unknown origin (n=6, 3.4%). Patients with systemic pruritus had higher itch NRS scores compared to those with neuropathic pruritus (p=0.033). In addition, patients with dermatological pruritus experienced longer itch duration and treatment courses than patients with neuropathic pruritus (p=0.001 and p=0.005, respectively). Moreover, patients with higher itch NRS scores had higher DLQI scores among patients with dermatological pruritus (p＜0.001). Conclusion In this study, we classified the causes of scalp pruritus and identified the itch severity and clinical manifestations. The severity of itching, pruritus duration, treatment duration, and aggravating factors differed for each scalp pruritus classification. Understanding the classification and clinical characteristics of scalp pruritus can facilitate the development of more effective treatments.

Background: Daily usage of facial masks during coronavirus disease 2019 pandemic influenced on facial dermatoses. Objective: This study investigated the impact of mask-wearing habits on facial dermatoses. Methods: A nationwide, observational, questionnaire-based survey was conducted from July through August 2021, involving 20 hospitals in Korea. Results: Among 1,958 facial dermatoses, 75.9% of patients experienced aggravation or development of new-onset facial dermatoses after wearing masks. In aggravated or newly developed acne patients (543 out of 743), associated factors were healthcare provider, female gender, and a long duration of mask-wearing. Irritating symptoms, xerosis, and hyperpigmentation were more frequently observed in this group. Aggravated or newly developed rosacea patients (515 out of 660) were likely to be female, young, and have a long duration of mask-wearing per day. Seborrheic dermatitis patients who experienced aggravation or de novo development (132 out of 184) were younger, and they more frequently involved the chin and jaw in addition to the nasolabial folds and both cheeks. Contact dermatitis patients (132 out of 147) with aggravation or de novo development tended to be female, involve both cheeks, and complain of pruritus. Aggravated or newly developed atopic dermatitis patients (165 out of 224) were more likely to be female, and had a higher baseline investigator global assessment score before mask-wearing. Conclusion Clinical features and factors related to aggravation were different according to the types of facial dermatoses.

Background: More than half of acne patients have truncal acne on their chest, back, and shoulders. However, since most studies on acne have focused on the face, data on clinical characteristics and proper management for truncal acne are insufficient. Objective: To establish a Korean Acne Rosacea Society (KARS) consensus for experts’ perception and treatment patterns of truncal acne. Methods: We conducted two rounds of the Dephi technique to gather expert opinion and reach a consensus on truncal acne. The first round comprised 48 questionnaires focusing on various aspects such as epidemiology, clinical features, diagnosis, treatment, prognosis and more, while second rounds consisted of 26 questionnaires. Results: A total of 36 dermatologists (36/38 KARS members, 94.7%) completed this survey. In the first-round survey, consensus was reached on 20 out of the 48 questions (41.7%). In the secondround questionnaire, consensus was achieved on 9 of the 26 questions (34.6%). The most unresponsive lesion to truncal acne treatment was scars (atrophic/hypertrophic). The most commonly used treatments for each non-inflammatory and inflammatory truncal acne lesions were selected to use topical retinoids (78.1% of the responders) and oral antibiotics (93.8% of the responders). Conclusion Our study has yielded valuable insights into the epidemiology, clinical manifestations, diagnosis, treatment, and quality of life of patients with truncal acne. We anticipate that this study will inspire further comprehensive research for individuals with truncal acne.

Background: Prurigo nodularis (PN) is a severely pruritic chronic skin disease, and its management is challenging.Although some studies have described the natural course and demographics of PN, there are few studies on the quality of life (QOL) or psychological problems in patients with PN. Objective: This study aimed to evaluate the QOL and psychological problems of PN patients and identify the factors which effect on the QOL and psychological problems of these patients. Methods: We performed a cross-sectional study of 41 patients with PN who visited the Department of Dermatology at Konyang University Hospital between November 2022 and March 2023. Age, sex, clinical features, itch Numeric Rating Scale (NRS), Dermatology Life Quality Index (DLQI), Beck Depression Inventory (BDI), Insomnia Severity Index (ISI), and Beck Anxiety Inventory (BAI) were evaluated through the questionnaire. Results: PN patients had mean DLQI, BDI, ISI, and BAI scores of 13.9, 15.0, 8.9, and 13.0, respectively. There were no significant differences in the DLQI, BDI, ISI, or BAI scores with respect to sex, smoking, alcohol, drug history, disease duration, or treatment duration. Patients with systemic diseases or other dermatologic diseases were more likely to have higher DLQI scores than those without any associated disease (p=0.043 and p=0.015). Moreover, patients with higher itch NRS scores had higher DLQI and ISI scores (p=0.002 and p=0.030). Conclusion We found that PN had a large impact on QOL and mental health. Therefore, we recommend that dermatologists pay close attention to the psychological aspects when treating and educating patients with PN.