Background: In a previous study, rhinoplasty rasp was shown an effective method for removal of button osteoma (BO) of the skull. Objective: In the present study, our experience was presented and surgical outcome using high-speed burr in surgery for BO evaluated. Methods: The register-based surgery reports of patients who underwent local excision of BO (2010∼2023) at a single institution were reviewed. Demographics, photodocumentation, radiologic examinations, pathology reports, data of scar prevention, and surgical outcome in the BO study cohort were analyzed. Results: A total of 20 BO lesions in 18 patients (14 females and four males; mean age of 52.4±14.3 years) who underwent surgery using high-speed burr were assessed. The mean size of BO was 9.3 mm (range, 5∼17 mm).Most of the BOs were located on the forehead (19/20, 95.0%), which was associated with the course of the supratrochlear (n=13) or supraorbital nerve (n=6). Minimal hematoma was complicated in three patients (16.7%).Delayed complications, recurrence, and severe scarring during the mean follow-up of 3.1±3.5 months were not reported. Conclusion The use of high-speed burr for surface smoothening may provide good surgical results in minimally invasive BO surgery.

Primary localized cutaneous amyloidosis (PLCA) is characterized by extracellular deposition of pathological fibril aggregation of proteins in the skin without systemic involvement.Macular amyloidosis, lichen (papular) amyloidosis, and nodular amyloidosis are three different subtypes of PLCA. Although the pathological mechanism of PLCA has not yet been clarified, it is assumed that a nucleus formation of amyloid fibril is formed due to repeated external stimulation, such as subcutaneous injection, which often poses diagnostic challenges. Herein, we present a 54-year-old Korean male patient with cutaneous localized amyloidosis which occurred after repeated local insulin injections, and discuss the relationship between insulin therapy in patients with diabetes mellitus and dermal amyloid deposition.

Fixed drug eruption (FDE) is a well-defined hyperpigmented patch that recurs in a fixed location each time a particular drug is taken. Common causative agents of FDE are nonsteroidal anti-inflammatory drugs, non-narcotic analgesics, sedatives, anticonvulsants, sulfonamides, and tetracycline. We report a 33-year-old male who presented with a recurrent, localized, brownish-to-erythematous macule and papules on the peri-philtrum area two hours after taking valacyclovir. Three episodes of valacyclovir ingestion for treatment of Herpes simplex virus infection provoked a similar skin rash at the same site. Histopathology results showed vacuolar degeneration in the basal layer of the epidermis, pigmentary incontinence, and perivascular inflammatory cell infiltration in the papillary dermis. Although patch test and skin prick test showed negative responses to acyclovir and valacyclovir, an intradermal test showed a positive reaction only to valacyclovir. The oral provocation test to acyclovir and valacyclovir showed a positive reaction only to valacyclovir. Through drug history, histopathological examination, patch test, intradermal test, and oral provocation test, we established a final diagnosis of FDE due to valacyclovir without cross-reactivity to acyclovir. To find alternative therapeutic drugs, we suggest diagnostic tests with not only the suspected drugs, but also other drugs in the same class.

Low-grade myofibroblastic sarcoma (LGMS) is a rare spindle cell tumor with indolent course. Due to rarity and low-grade histologic features of LGMS, accurate diagnosis is challenging. We report a 63-year-old female patient with a three-month history of a 3.1 cm×2.5 cm sized, firm, skin-colored, painless, protruding left back mass. Initial excisional biopsy was performed and the mass was diagnosed as nodular fasciitis. After 18 months after excision, the mass recurred with pain and grew larger. Considering the clinical manifestations, diagnostic impression was changed as dermatofibrosarcoma protuberans not nodular fasciitis. Second wide excision was performed and the histopathology revealed proliferative atypical spindle cells with moderate nuclear atypia and a distinctive whorling pattern, which is suggestive of low-grade sarcoma. Additional computed tomography and positron emission tomography revealed no metastasis and suspicious residual viable malignant tissue. To remove suspicious residual tumor, third wide excision were performed and the diagnosis confirmed as LGMS. A microscopically clear resection was achieved with deep and lateral safety margin 0.6 cm each. Despite of postoperative radiotherapy with 35 times, recurrence of the tumor and lung metastasis was found after 7 months later. LGMS rarely metastasizes and occurs most commonly in the head and neck region. Thus, we report a rare case of LGMS on back which repeated localized recurrence and regional lung metastasis occurred despite wide excision and adjuvant radiotherapy.

Background: Psoriasis is a chronic inflammatory autoimmune disease. Some studies have demonstrated a relationship of psoriasis with vitamin D (Vit D) deficiency or serum lipid levels. Objective: We aimed to compare serum levels of Vit D and lipids in patients with active psoriasis and control subjects. Additionally, we analyzed the relationship of disease severity with serum Vit D and lipid levels. Methods: A total of 243 patients were retrospectively analyzed. Statistical data were evaluated, and the values were considered significant at p＜0.05. Results: Statistically significant difference in Vit D levels between the psoriasis (n=117) and the control groups (n=126) was not found. In addition, an association between Vit D levels and the disease severity, using the psoriasis area and severity index (PASI) was not observed. The proportion of overweight patients (body mass index [BMI]≥ 23 kg/m2 ) was higher in the psoriasis group than in the control group, and there was a significant relationship between the increase in PASI and the serum triglycerides (TG) levels (p＜0.05). Conclusion The psoriasis and control groups did not show a statistical difference in serum Vit D levels. In the subgroup analysis of cases with normal BMI, excluding the underlying disease, no significant difference in Vit D levels between the two groups was observed. However, the association of psoriasis with factors, such as BMI and TG, was found to be significant; hence, these could be therapeutic targets in patients with psoriasis to improve their quality of life. Controlled and well-designed studies are required in the future.

Alopecia ; Classification ; Diarrhea ; Female ; Functional Food ; Hair ; Hair Follicle ; Humans ; Leuconostoc ; Male ; Pilot Projects ; Probiotics ; Scalp ; Soybeans

Purpose: Given the importance of evaluating the severity of overactive bladder (OAB) symptoms and outcomes after treatment, several questionnaires have been developed to evaluate OAB patients. However, only limited questionnaires are available in Korea for use with Korean patients. Therefore, this study aimed to develop Korean versions of OAB questionnaires through a rigorous linguistic validation process. Methods: The Indevus Urgency Severity Scale, Urgency Perception Scale, Urgency Severity Scale, and Patient Perception of Intensity of Urgency Scale underwent translation and linguistic validation. The linguistic validation procedure consisted of permission for translation, forward translations, reconciliation, back-translation, cognitive debriefing, and proofreading. Two independent bilingual translators translated the original version of each questionnaire, and a panel then discussed and reconciled the 2 initial translations. Next, a third independent bilingual translator performed a backward translation of the reconciled version into English. Five Korean patients diagnosed with OAB were interviewed for cognitive debriefing. Results: Each item of the questionnaires was translated into 2 Korean versions in the forward translation process. Terms such as ‘urgency’ and ‘wetting’ were translated into ordinary language by the translators and adjusted by the panel members to more conceptually equivalent terms in a medical context. In the back-translation process, the panel made a few changes regarding details based on a comparison of the back-translated and original versions. During the cognitive debriefing process, 5 patients provided a few pieces of feedback on the naturalness of the wording of the questionnaires, but generally agreed on the translated terms. Conclusions In this study, the panel produced a successful linguistic validation of Korean versions of multiple OAB questionnaires, which can be utilized to evaluate the severity and treatment outcomes of OAB.

PURPOSE: Urinary incontinence (UI) is associated with nursing home admission, functional decline, and risk of death among community-dwelling older adults. Little information, however, is available on sex differences in lower urinary tract symptoms (LUTS) in older Korean adults exclusively living in rural areas. This study examined sex-related differences in LUTS, factors associated with UI in older adults living in rural areas, and health-related quality of life (HRQoL) in incontinent older adults. METHODS: This was a cross-sectional study in which face-to-face interviews were conducted at 15 rural community-health centres. A total of 323 older adults aged ≥65 years from rural areas of Korea participated. LUTS prevalence was evaluated and HRQoL was measured using the King’s Health Questionnaire. The chi-square test and t -test were used to examine sex differences in characteristics, LUTS, and HRQoL. Multivariable logistic regression was used to identify risk factors associated with UI. RESULTS: Nocturia was the most prevalent symptom, affecting 87% of men and 86% of women. Women (53%) had significantly more UI of any kind than did men (35%) (P=0.007). Urgency UI was the most frequent type of UI in men, whereas stress UI was the most frequent in women. Regarding HRQoL, men had significantly higher scores in the domains of sleep/energy disturbances (P=0.032) than did women, and women reported greater effects from the severity of incontinence (P=0.001) than did men. Arthritis was the only factor associated with UI in men (odds ratio [OR], 6.88; 95% confidence interval [CI], 1.46–32.36). However, women with diabetes mellitus were less likely to have UI than those without (OR, 0.43; 95% CI, 0.23–0.82). CONCLUSIONS: LUTS were found to be highly prevalent in community-dwelling older Korean adults in rural areas. Interventions to improve sleep and to reduce UI severity are needed for incontinent men and women, respectively.
Adult* ; Arthritis ; Cross-Sectional Studies ; Diabetes Mellitus ; Female ; Humans ; Korea ; Logistic Models ; Lower Urinary Tract Symptoms* ; Male ; Nocturia ; Nursing Homes ; Prevalence* ; Quality of Life* ; Risk Factors ; Sex Characteristics* ; Urinary Incontinence