Background: Rosacea is a chronic inflammatory skin disorder characterized by erythema, papules, ocular symptoms, and heightened sensitivity. Patients with neurogenic symptoms such as burning or stinging remain particularly difficult to manage. Current guidelines often underrepresent energy-based devices (EBDs), pigmentary sequelae, psychosocial burden, and ocular comorbidities. Objective: To examine Korean dermatologists’ expert perspectives on rosacea management, focusing on skin sensitivity, neurogenic symptoms, pigmentary changes, psychosocial impact, ocular involvement, and EBD use. Methods: A web-based, 29-item survey was administered to 25 board-certified Korean dermatologists (May–June 2025). Quantitative and qualitative responses were analyzed. Results: Erythematotelangiectatic and papulopustular phenotypes with sensitivity skin predominated. EBDs (pulsed dye laser, intense pulsed light) were frequently used but limited by cost and sensitivity issues. Neurogenic symptoms were recognized but rarely treated with neuromodulators. Post-inflammatory hyperpigmentation was infrequent, yet monitoring was inconsistent.Psychosocial and ocular aspects were acknowledged but seldomly systematically addressed.Respondents expressed interest in emerging adjunctive treatments such as cold plasma, skin boosters, and holistic care approaches. Conclusion Korean dermatologists adopt individualized strategies for rosacea, yet practice gaps remain regarding neurogenic symptoms, pigmentary complications, and psychosocial and ocular comorbidities. Findings support the need for updated multidisciplinary, phenotype-driven guidelines aligned with real-world practice.

Objective: This study aimed to assess the association between exposure to gadolinium-based contrast agents (GBCAs) and the risk of parkinsonism according to the GBCA type. Materials and Methods: Individuals aged ≥40 years who underwent first-ever magnetic resonance imaging (MRI) examinations between 2011 and 2014 were identified from the Korean nationwide population-based health insurance claims database and followed up until 2022. Individuals were divided into those who underwent at least one GBCA-enhanced MRI, and those who underwent only non-enhanced MRI. GBCA-exposed individuals were further categorized into those exposed only to linear or macrocyclic GBCAs, after excluding those exposed to both types. The primary event of interest was allcause parkinsonism. Secondary events included all-cause parkinsonism requiring medication, Parkinson’s disease (PD), atypical parkinsonism, and secondary parkinsonism. Hazard ratios (HRs) were estimated using multivariable Cox proportional hazard regression models for exposure to linear and macrocyclic GBCAs, with the non-enhanced MRI group serving as a reference. The models were adjusted for age, sex, smoking status, alcohol consumption, regular exercise, body mass index, estimated glomerular filtration rate, and comorbidities. Subgroup analyses were performed according to age, sex, renal function, and history of cancer. Results: A total of 222,977 individuals were included in this study. Among them, 92,230, 48,335, and 82,412 individuals underwent non-enhanced, linear GBCA-enhanced, and macrocyclic GBCA-enhanced MRI, respectively. Exposure to linear GBCAs slightly increased the risk of all-cause parkinsonism (adjusted HR, 1.13 [97.5% confidence interval, 1.08–1.19]), while exposure to macrocyclic GBCAs did not increase the risk (adjusted HR, 1.00 [97.5% confidence interval, 0.95–1.05]).The results were similar for all-cause parkinsonism requiring medication, PD, and secondary parkinsonism, whereas no significant association was observed for atypical parkinsonism. Conclusion Exposure to linear GBCAs may slightly increase the risk of parkinsonism in adults, whereas exposure to macrocyclic GBCAs may not. Caution should be exercised when using linear GBCAs until further evidence emerges.

Pharmacogenomic variations may significantly influence responses to commonly prescribed stroke medications. Despite accumulating evidence, genetic testing has not yet been widely integrated into stroke care. This review summarizes current evidence and provides practical guidance for clinical implementation. Pharmacogenomic studies and clinical guidelines related to antiplatelet agents, anticoagulants, and statins were reviewed, with particular emphasis on East Asian populations. Substantial evidence supports genotype-guided use of clopidogrel (CYP2C19), warfarin (CYP2C9, VKORC1, CYP4F2), and statins (SLCO1B1, ABCG2). For aspirin, PTGS1/2 and PEAR1 variants have been investigated; however, current data remain insufficient for clinical application. Regarding direct oral anticoagulants (DOACs), candidate genes such as ABCB1 and CES1 demonstrate pharmacokinetic associations, though robust clinical outcome data are lacking. Distinct allele frequencies in East Asians—such as higher prevalence of CYP2C19 and ABCG2 variants—underscore the need for population-specific strategies. Beyond single-gene approaches, polygenic risk scores, pharmacogenomic panels, and integration with multi-omics data and artificial intelligence represent promising directions for personalized therapy. Pharmacogenomic testing can enhance stroke pharmacotherapy, particularly in populations with high frequencies of actionable variants. Broader implementation requires rapid testing platforms, clinician education, tailored clinical guidelines, and real-world validation of aspirin, DOACs, and multi-gene approaches. Future research should expand population-specific studies and integrate pharmacogenomics within the broader framework of precision medicine to ensure equitable clinical benefit.

Purpose: To develop the 2025 update to the Korean colorectal cancer (CRC) screening guidelines by systematically evaluating recent evidence, integrating domestic data, and addressing changes since the 2015 guideline revision, thereby providing an evidence-based standard for clinicians and policymakers. Methods: A multidisciplinary committee developed the guidelines using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The process included formulation of three key questions addressing screening efficacy, diagnostic accuracy, and optimal screening age and interval. A systematic review of international guidelines and primary literature was conducted, yielding 327 eligible studies. In addition, a utility-based analysis using a Markov model was performed to determine optimal screening ages and intervals. Results: The evidence synthesis identified high-certainty evidence supporting the use of the fecal immunochemical test (FIT) for reducing CRC mortality and moderate-certainty evidence for colonoscopy. Evidence for computed tomographic colonography (CTC) and stool DNA testing was rated as very low certainty. Based on the evidence review and cost-utility analysis, the committee conditionally recommends CRC screening for asymptomatic, average-risk adults aged 45–74 years using either colonoscopy every 10 years or FIT every 1–2 years. CTC and stool DNA testing were not recommended owing to insufficient evidence. Conclusion The 2025 Korean Guidelines for Colorectal Cancer Screening present updated, evidence-based recommendations tailored to the domestic healthcare context. By conditionally endorsing both colonoscopy and FIT for individuals aged 45–74 years, these guidelines aim to improve population-level screening effectiveness and reduce the burden of CRC in South Korea.

Background: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced malignant melanoma. This study examined the real-world efficacy of dacarbazine (dimethyl triazeno imidazole carboxamide, DTIC) in patients who had previously received pembrolizumab, based on the hypothesis that prior ICI treatment enhances the therapeutic response to subsequent chemotherapy. Methods: This retrospective study included 71 patients with histologically confirmed malignant melanoma treated at Kyungpook National University Chilgok Hospital (Daegu, Korea) between 2011 and 2023. The patients received DTIC for unresectable stage IIIC, IIID, or IV melanoma (American Joint Committee on Cancer, 8th edition). Results: Among the 71 patients, the median patient age was 64 years (range, 25–89 years). When categorized by melanoma subtype, 18 patients (25.4%) had acral melanoma, 40 (56.3%) had cutaneous melanoma, and 13 (18.3%) had mucosal melanoma. Sixteen of the DTIC-treated patients had not received pembrolizumab previously (DTIC-only group), while 55 had (pem-DTIC group). The median progression-free survival was 2.3 months in the DTIC-only group and 3.9 months in the pem-DTIC group (hazard ratio [HR], 0.246; 95% confidence interval [CI], 0.106–0.576; p=0.001). The median overall survival was 6.8 months in the DTIC-only group and 19.0 months in the pem-DTIC group (HR, 0.198; 95% CI, 0.068–0.574; p=0.003). The duration of response (DoR) was 4.64 months in the DTIC group and 8.11 months in the pem-DTIC group. Conclusion This study demonstrated that the DoR to DTIC was prolonged following ICI therapy (4.64 months vs. 8.11 months). This indicates that prior ICI treatment may enhance tumor sensitivity to chemotherapy, making DTIC a viable option for treating refractory, relapsed, or progressive melanoma.

Janus kinase (JAK) inhibitors are an important treatment option for ulcerative colitis, providing rapid onset of action, oral administration, and efficacy even after biologic failure. The 3 approved agents—tofacitinib, filgotinib, and upadacitinib—differ in JAK isoform selectivity, leading to clinically meaningful differences in efficacy and safety. Evidence from network meta-analyses, clinical trials, and real-world studies consistently shows that upadacitinib provides the highest efficacy for induction and maintenance of remission, whereas filgotinib demonstrates the most favorable safety profile. The strong efficacy of upadacitinib and tofacitinib is particularly relevant in patients with severe disease, including acute severe ulcerative colitis, and upadacitinib maintains high efficacy regardless of prior advanced therapy exposure. JAK inhibitors also benefit extraintestinal manifestations. Although risks such as herpes zoster, serious infection, thromboembolism, and major cardiovascular events differ among agents, long-term data suggest generally acceptable safety when used appropriately. Intraclass JAK-to-JAK cycling is feasible, with about half of patients achieving steroid-free clinical remission in retrospective cohorts. Based on mechanistic, clinical, and real-world evidence, filgotinib may be a first-line option for patients with lower disease activity or when safety is a priority, whereas upadacitinib or tofacitinib may be preferred in higher disease activity. Strategically selecting agents may improve durability and outcomes.

Colorectal cancer (CRC) is one of the most common malignancies worldwide and the second leading cause of cancer-related death.In South Korea, the incidence of CRC has increased alongside rapid socioeconomic development and westernized lifestyles, but it has recently shown a gradual decline, largely due to the National Cancer Screening Program (NCSP). The NCSP, first launched in 1999 and expanded in 2004 to include CRC screening, has reduced the incidence and mortality of colorectal cancer significantly, while improving the five-year relative survival rate. The Korean Colonoscopy Screening Pilot Study (K-COSPI) reported the feasibility, safety, and high acceptability of colonoscopy as a primary screening tool, suggesting the potential to transition to colonoscopy-based national screening. Nevertheless, challenges persist in increasing participation and maintaining high-quality performance because the adenoma detection rate remains a critical indicator of screening effectiveness. Continuous efforts to strengthen public awareness, enhance the quality control of colonoscopy, and develop evidence-based, risk-stratified screening strategies will be essential for sustaining and advancing this exemplary public health achievement.

Background: Pregnant women are particularly vulnerable to oral diseases due to hormonal and behavioral changes, yet disparitiesin healthcare resources and limited access to structured oral health education persist. Plaque visualization technologies may improve self-awareness and encourage behavioral changes. Although digital education media are increasingly utilized, comparative evidence on their effectiveness and acceptability across modalities remains limited. This study aimed to compare the perceived effectiveness and preferences for plaque visualization-based digital oral health education media among pregnant women in Vietnam. Methods: In total, 497 pregnant women were recruited from obstetric and maternal health facilities in Vietnam. Participants useda mobile application with artificial intelligence-based dental plaque visualization and feedback once and viewed pregnancytailored infographics and video educational materials once. After exposure, they completed a structured post-intervention questionnaire assessing sociodemographic characteristics, self-reported periodontal symptoms, oral health behaviors, perceived effectiveness, satisfaction with each medium, and media preferences. Descriptive statistics were calculated, and t-tests were used to compare evaluation scores across media and preferences according to participant characteristics. Results: Overall, 85.1% of participants reported gingival problems during pregnancy. Media preference was highest for video-basededucation, followed by mobile applications and infographics. However, mobile applications received the highest scores for educational effectiveness. Internal consistency was acceptable to high across media (video α=0.81, infographic α=0.84, mobile application α=0.91), with the mobile application demonstrating the highest reliability. Preference for mobile applications was significantly higher among women aged 28∼34 years and those employed in the service and tourism sectors. Conclusion Perceived educational values and preferences varied by digital oral health education medium. Although video-basededucation was preferred for accessibility and initial understanding, plaque visualization-based mobile application education received higher ratings for supporting self-management and feedback. These findings suggest that a multimedia strategy integrating visual feedback technology with educational content may be effective for oral health promotion among pregnant women.