Background: Primary cicatricial alopecia (PCA) is a rare disease that causes irreversible destruction of hair follicles and affects the quality of life (QOL). Objective: We aimed to investigate the disease awareness, medical use behavior, QOL, and real-world diagnosis and treatment status of patients with PCA. Methods: A self-administered questionnaire was administered to patients with PCA and their dermatologists. Patients aged between 19 and 75 years who visited one of 27 dermatology departments between September 2021 and September 2022 were included. Results: In total, 274 patients were included. The male-to-female ratio was 1:1.47, with a mean age of 45.7 years. Patients with neutrophilic and mixed PCA were predominantly male and younger than those with lymphocytic PCA. Among patients with lymphocytic PCA, lichen planopilaris was the most common type, and among those with neutrophilic PCA, folliculitis decalvans was the most common type. Among the total patients, 28.8% were previously diagnosed with PCA, 47.0% were diagnosed with PCA at least 6 months after their first hospital visit, 20.0% received early treatment within 3 months of disease onset, and 54.4% received steady treatment. More than half of the patients had a moderate to severe impairment in QOL. Topical/intralesional steroid injections were the most common treatment. Systemic immunosuppressants were frequently prescribed to patients with lymphocytic PCA, and antibiotics were mostly prescribed to patients with neutrophilic PCA. Conclusion This study provides information on the disease awareness, medical use behavior, QOL, diagnosis, and treatment status of Korean patients with PCA. This can help dermatologists educate patients with PCA to understand the necessity for early diagnosis and steady treatment.

Background: Pediatric alopecia areata (AA) can affect the quality of life (QoL) of patients and their family members. Research on the QoL and burden on family members in pediatric AA is limited. Objective: This nationwide multicenter questionnaire study described the QoL and burden of the family members of patients with pediatric AA. Methods: This nationwide multicenter questionnaire study enrolled AA patients between the ages of 5 and 18 years from March 1, 2017 to February 28, 2018. Enrolled patients and their parents completed the modified Children’s Dermatology Life Quality Index (CDLQI) and the modified Dermatitis Family Impact (mDFI). The disease severity was measured using the Severity of Alopecia Tool (SALT) survey scores. Results: A total of 268 patients with AA from 22 hospitals participated in this study. Our study found that the efficacy and satisfaction of previous treatments of AA decreased as the severity of the disease increased. The use of home-based therapies and traditional medicines increased with the increasing severity of the disease, but the efficacy felt by patients was limited. CDLQI and mDFI scores were higher in patients with extensive AA than those with mild to moderate AA. The economic and time burden of the family members also increased as the severity of the disease increased. Conclusion The severity of the AA is indirectly proportional to the QoL of patients and their family members and directly proportional to the burden. Physicians need to understand these characteristics of pediatric AA and provide appropriate intervention to patients and their family members.

BACKGROUND: Healthy skin is an important determinant of the quality of life and physical and mental well-being. The demand for dermatological information is increasing not only in patients with skin diseases, but also in the general population with normal/healthy skin. However, public perception and behavior with regard to skin health among Koreans are not known. OBJECTIVE: To examine public perception and behaviors with regard to skin health in Koreans visiting the Skin Health Expo 2017. METHODS: A total of 597 participants completed a questionnaire that assessed demographics, status, and behavior for skin health and Expo satisfaction. RESULTS: Respondents with higher stress levels and a history of skin diseases showed lower satisfaction with self-skin health. Most participants considered adequate sleep and water intake to be important factors associated with healthy skin. One-on-one consultation with dermatologists was the most satisfactory among participants at the Expo. CONCLUSION: Educational tools using mass media and informative activities such as the Expo planned by dermatologists and the government are necessary to spread awareness and provide proper information to improve skin health in the general population and to emphasize the key role of dermatologists in skin disorders with a social burden.
Demography ; Drinking ; Humans ; Korea* ; Mass Media ; Quality of Life ; Research Report* ; Skin Diseases ; Skin* ; Surveys and Questionnaires

PURPOSE: To evaluate the efficacy of intravitreal aflibercept monotherapy in submacular hemorrhage (SMH) secondary to wet age-related macular degeneration (AMD). METHODS: This study included 25 eyes in 25 patients with SMH involving the fovea secondary to wet-AMD. All patients were treated with three consecutive monthly intravitreal aflibercept (2.0 mg/0.05 mL) injections, followed by as-needed reinjection. They were followed for at least 6 months. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), and area of SMH were measured at diagnosis, as well as at 3 and 6 months after treatment initiation. RESULTS: The BCVA significantly improved from 0.79 ± 0.41 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.54 ± 0.41 logMAR at 6 months (p < 0.001). BCVA ≥3 lines and stable vision were observed in 96% of the eyes. The CFT significantly decreased from 560.8 ± 215.3 µm at baseline to 299.8 ± 160.2 µm at 6 months (p < 0.001). The area of SMH significantly decreased from 10.5 ± 7.1 mm² at baseline to 1.8 ± 6.5 mm² at 6 months (p < 0.001). The BCVA, CFT, and area of SMH at baseline, as well as duration of symptoms, all correlated with BCVA at the 6-month follow-up. CONCLUSIONS: Intravitreal injection of aflibercept is an effective treatment option for patients with SMH secondary to wet-AMD; however, there may be limited efficacy in eyes with large SMH area and cases in which treatment is delayed.
Choroid Hemorrhage ; Diagnosis ; Follow-Up Studies ; Hemorrhage* ; Humans ; Intravitreal Injections ; Macular Degeneration* ; Retinal Hemorrhage ; Visual Acuity

OBJECTIVES: We conducted a study to investigate the normal range for TSH and within-individual variations of TSH according to temperature and aging. PATIENTS AND METHODS: We enrolled patients who underwent periodic medical examinations five times over a six year period (2007.8~2013.6). Anthropometric data and thyroid ultrasonography were evaluated, and serum TSH, T3, and T4 were assayed. RESULTS: Subjects were 19-64 years old, 120 were female, and 208 were male. Reference ranges for TSH were 0.53-4.94 mIU/L in the first test, 0.49-5.61 mIU/L in the second test, 0.46-6.06 mIU/L in the third test, 0.48-5.99 mIU/L in the fourth test, and 0.52-6.3 mIU/L in the fifth test. When the TSH level was analyzed according to temperature and sex, mean TSH was higher in months in which the average monthly temperatures were below 10degrees C in Jinju, Gyeongnam and female. The aging and low temperatures are associated with increased serum TSH concentrations in the within-individual. CONCLUSIONS: This study showed that aging is associated with increased serum TSH concentrations in the within-individual and serum TSH concentrations are different in the within-individual according to the temperature.
Aging* ; Female ; Gyeongsangnam-do ; Humans ; Male ; Reference Values ; Thyroid Gland ; Thyrotropin* ; Ultrasonography

Liver cirrhosis is commonly associated with bleeding complications due to portal hypertension or coagulopathy. Spontaneous muscle hematoma is a rare but potentially lethal complication of liver cirrhosis. Here we report three cases of spontaneous muscle hematoma diagnosed in patients with alcoholic liver cirrhosis. All three patients died due to recurrent bleeding and liver failure although they had undergone repeated transcatheter arterial embolization of the actively bleeding vessels. We reviewed 14 cases of spontaneous muscle hematoma that were associated with liver cirrhosis, including our cases, and found that the mortality rate was 86%, despite early diagnosis and treatment. Cirrhosis-associated spontaneous muscle hematoma occurred more frequently in patients with alcoholic liver cirrhosis, who accounted for -93% of cases. Thus, spontaneous muscle hematoma should be considered a life-threatening complication in patients with alcoholic liver cirrhosis, and abstinence from alcohol may help to prevent the occurrence of this deadly condition.
Alcoholics* ; Early Diagnosis ; Fibrosis ; Hematoma* ; Hemorrhage ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic* ; Liver Failure ; Mortality

Transcatheter arterial chemoembolization (TACE) has become an effective alternative treatment strategy for patients with inoperable hepatocellular carcinoma (HCC). Although TACE is relatively safe, acute respiratory distress syndrome associated with pulmonary lipiodol embolism is a rare and potentially fatal complication. We report a rare case of acute respiratory distress syndrome after TACE for inoperable HCC. A 75-year-old man, with huge HCC in right lobe, was treated by TACE for the first time. Seven hours after uneventful TACE procedure, he felt dyspneic and his oxygen saturation recorded by pulse oximetry (SpO2) fell to 80% despite of applying non-rebreathing mask. He underwent mechanical ventilation with a protective ventilatory strategy. We experienced a case of acute respiratory distress syndrome after TACE for HCC.
Carcinoma, Hepatocellular ; Embolism ; Ethiodized Oil ; Humans ; Masks ; Oximetry ; Oxygen ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult

BACKGROUND/AIMS: Several studies reported a subgroup of gastric cancer patients showing elevated serum alpha-fetoprotein (AFP) at the time of diagnosis. We investigated the clinicopathological characteristics and prognostic factors of AFP producing gastric cancer (AFPPGC) by comparing with AFP non-producing gastric cancer (AFPNPGC). METHODS: A total of 909 patients were diagnosed with gastric cancer from January 2005 to March 2013 at Gyeongsang National University Hospital and their AFP levels were measured at the time of diagnosis. After excluding 138 patients with underlying liver diseases, 34 patients with elevated serum AFP level over 10 mg/mL were assigned to AFPPGC group and the remaining 737 patients with serum level of AFP below 10 ng/mL were assigned to AFPNPGC group. RESULTS: The median survival length was shorter in AFPPGC group than AFPNPGC group (18.3+/-25.5 months vs. 30.0+/-22.0 months, p=0.004). The incidence of liver metastasis (47.1% vs. 3.3%, p<0.001) and lymph node metastasis (91.2% vs. 31.6%, p<0.001) was significantly higher in AFPPGC group. The probability of encountering metachronous liver metastasis after the operation was higher in AFPPGC group (44.4% vs. 2.0%, p<0.001). Multivariate analysis revealed that patients in the AFPPGC group who received chemotherapy (p=0.037) or underwent operation (p=0.001) had a better survival rate. CONCLUSIONS: AFPPGC behaves more aggressively and shows a worse prognosis. Therefore, serum AFP level should be routinely checked in all patients diagnosed with gastric cancer.
Aged ; Aged, 80 and over ; Female ; Humans ; Liver Neoplasms/secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Smoking ; Stomach Neoplasms/*diagnosis/mortality/pathology ; Survival Rate ; Treatment Outcome ; alpha-Fetoproteins/*metabolism

BACKGROUND/AIMS: Several studies reported a subgroup of gastric cancer patients showing elevated serum alpha-fetoprotein (AFP) at the time of diagnosis. We investigated the clinicopathological characteristics and prognostic factors of AFP producing gastric cancer (AFPPGC) by comparing with AFP non-producing gastric cancer (AFPNPGC). METHODS: A total of 909 patients were diagnosed with gastric cancer from January 2005 to March 2013 at Gyeongsang National University Hospital and their AFP levels were measured at the time of diagnosis. After excluding 138 patients with underlying liver diseases, 34 patients with elevated serum AFP level over 10 mg/mL were assigned to AFPPGC group and the remaining 737 patients with serum level of AFP below 10 ng/mL were assigned to AFPNPGC group. RESULTS: The median survival length was shorter in AFPPGC group than AFPNPGC group (18.3+/-25.5 months vs. 30.0+/-22.0 months, p=0.004). The incidence of liver metastasis (47.1% vs. 3.3%, p<0.001) and lymph node metastasis (91.2% vs. 31.6%, p<0.001) was significantly higher in AFPPGC group. The probability of encountering metachronous liver metastasis after the operation was higher in AFPPGC group (44.4% vs. 2.0%, p<0.001). Multivariate analysis revealed that patients in the AFPPGC group who received chemotherapy (p=0.037) or underwent operation (p=0.001) had a better survival rate. CONCLUSIONS: AFPPGC behaves more aggressively and shows a worse prognosis. Therefore, serum AFP level should be routinely checked in all patients diagnosed with gastric cancer.
Aged ; Aged, 80 and over ; Female ; Humans ; Liver Neoplasms/secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Smoking ; Stomach Neoplasms/*diagnosis/mortality/pathology ; Survival Rate ; Treatment Outcome ; alpha-Fetoproteins/*metabolism

OBJECTIVE: To examine the relationship between Fas gene polymorphisms, and bone mineral density (BMD). METHODS: Restriction fragment length polymorphisms at the Fas A670G, G1377A gene site, and BMD at the lumbar spine and proximal femur were analyzed in 229 postmenopausal Korean women (81 normal, 111 osteopenic and 37 osteoporotic patients). BMDs were measured by DEXA. RESULTS: The distribution of A670G and G1377C polymorphisms in all postmenopausal women was as follows: AA 18.3%, AG 46.3%, GG 35.4%; GG 38.0%, GA 39.7%, AA 22.3%, respectively. After adjusting for potential confounding factors such as age, BMI, and menopause duration, A670G polymorphism was significantly associated with BMD at the lumbar spine, the femur neck and trochanter in osteopenic and osteoporotic patients, and G1377A polymorphism was significantly associated with BMD at lumbar spine and the femur neck in osteopenic patients. CONCLUSION: These findings suggest that Fas gene polymorphisms may be an important contributor to the variation of BMD among postmenopausal Korean women.
Bone Density* ; Female ; Femur ; Femur Neck ; Humans ; Menopause ; Osteoporosis ; Polymorphism, Restriction Fragment Length ; Spine