Background/Aims: The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; therefore, widespread HCV screening is required. The WHO recommends HCV self-testing (HCVST) as a new approach. We aimed to evaluate disease burden reduction using the HCVST screening strategy and identify the most cost-effective approach. Methods: We developed a dynamic open-cohort Markov model to assess the long-term effects and costeffectiveness of HCVST in the Republic of Korea from 2024 to 2030. Strategies for comparison included universal, birth cohort, high-risk group screening, and no screening, focusing on the following: (1) incremental costeffectiveness ratio (ICER) per disability-adjusted life-year (DALY) saved; (2) severe liver disease cases; and (3) liverrelated death reduction. Results: Universal HCVST screening is the most effective strategy for achieving the WHO goal by 2030, substantially lowering the incidence of severe liver disease by 71% and preventing liver-related deaths by 69%, thereby averting 267,942 DALYs. Moreover, with an ICER of US$8,078 per DALY and high cost-effectiveness, the sensitivity results prove that cost-effectiveness is robust. Although high-risk group screening offers the lowest cost compared with other strategies, its effectiveness in preventing severe liver disease is minimal, falling short of the current WHO goal. Conclusions Our study confirms that universal HCVST screening is a cost-effective strategy aligned with the WHO goal to eliminate HCV by 2030. Despite its higher costs compared to risk-based screening, the disease burden can be significantly reduced by providing effective HCVST access to individuals who might otherwise not be tested.

Background/Aims: The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; therefore, widespread HCV screening is required. The WHO recommends HCV self-testing (HCVST) as a new approach. We aimed to evaluate disease burden reduction using the HCVST screening strategy and identify the most cost-effective approach. Methods: We developed a dynamic open-cohort Markov model to assess the long-term effects and costeffectiveness of HCVST in the Republic of Korea from 2024 to 2030. Strategies for comparison included universal, birth cohort, high-risk group screening, and no screening, focusing on the following: (1) incremental costeffectiveness ratio (ICER) per disability-adjusted life-year (DALY) saved; (2) severe liver disease cases; and (3) liverrelated death reduction. Results: Universal HCVST screening is the most effective strategy for achieving the WHO goal by 2030, substantially lowering the incidence of severe liver disease by 71% and preventing liver-related deaths by 69%, thereby averting 267,942 DALYs. Moreover, with an ICER of US$8,078 per DALY and high cost-effectiveness, the sensitivity results prove that cost-effectiveness is robust. Although high-risk group screening offers the lowest cost compared with other strategies, its effectiveness in preventing severe liver disease is minimal, falling short of the current WHO goal. Conclusions Our study confirms that universal HCVST screening is a cost-effective strategy aligned with the WHO goal to eliminate HCV by 2030. Despite its higher costs compared to risk-based screening, the disease burden can be significantly reduced by providing effective HCVST access to individuals who might otherwise not be tested.

Background/Aims: The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; therefore, widespread HCV screening is required. The WHO recommends HCV self-testing (HCVST) as a new approach. We aimed to evaluate disease burden reduction using the HCVST screening strategy and identify the most cost-effective approach. Methods: We developed a dynamic open-cohort Markov model to assess the long-term effects and costeffectiveness of HCVST in the Republic of Korea from 2024 to 2030. Strategies for comparison included universal, birth cohort, high-risk group screening, and no screening, focusing on the following: (1) incremental costeffectiveness ratio (ICER) per disability-adjusted life-year (DALY) saved; (2) severe liver disease cases; and (3) liverrelated death reduction. Results: Universal HCVST screening is the most effective strategy for achieving the WHO goal by 2030, substantially lowering the incidence of severe liver disease by 71% and preventing liver-related deaths by 69%, thereby averting 267,942 DALYs. Moreover, with an ICER of US$8,078 per DALY and high cost-effectiveness, the sensitivity results prove that cost-effectiveness is robust. Although high-risk group screening offers the lowest cost compared with other strategies, its effectiveness in preventing severe liver disease is minimal, falling short of the current WHO goal. Conclusions Our study confirms that universal HCVST screening is a cost-effective strategy aligned with the WHO goal to eliminate HCV by 2030. Despite its higher costs compared to risk-based screening, the disease burden can be significantly reduced by providing effective HCVST access to individuals who might otherwise not be tested.

Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.

Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.

When aneurysmal subarachnoid hemorrhage due to multiple aneurysms is suspected, identifying the rupture site is essential to determine the exact surgical site, but it may not be easy. Even if embolization is adequately performed, complications may remain. Typical complications include rebleeding and hydrocephalus in the early phase and delayed cerebral ischemia in the delayed phase. Herein, we describe a case of rupture of an intracranial aneurysm after performing embolization for a different ruptured intracranial aneurysm in a patient with multiple intracranial aneurysms. Patients with multiple intracranial aneurysms need to be considered for closer observation than those with a single ruptured intracranial aneurysm, even if the patient’s prognosis is good.

Coronavirus disease 2019 (COVID-19), a multi-organ disease impacting the respiratory system and various organs, has recently been linked to diverse cutaneous manifestations. COVID toes, a cutaneous sign of COVID-19 infection, is relatively common in children and young adults, although its clear association with COVID-19 has not been widely reported. This report presents the case of a 1-year-old infant with COVID toes. The patient exhibited violaceous discoloration in the distal toes. Further, the patient exhibited no symptoms of COVID-19 infection and the enzyme-linked immunosorbent assay was negative for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2); therefore, the patient was initially diagnosed with frostbite. However, the infant’s condition deteriorated despite treatment with nonsteroidal anti-inflammatory drugs and a warm-water bath. After a skin biopsy and serum SARS-CoV-2 test, the patient was diagnosed with COVID toes and treated with systemic steroids, photobiomodulation therapy, and dressing. This case underscores the importance of recognizing chilblain-like lesions in pediatric patients during the COVID-19 pandemic, emphasizing the need for awareness of COVID toes among healthcare professionals.