Purpose: To report a case of upper eyelid keratoacanthoma with a cutaneous horn.Case summary: A 59-year-old female presented to our clinic with a rapidly growing, painless mass in the center of the right upper eyelid. A 2 × 2 × 5 mm dark brown conical hyperkeratotic mass and a 7 × 4 mm nodular, nontender mass were palpable on the right upper eyelid. The lesion was isolated from the surrounding tissues and excised completely. Histopathologically, the excised masses showed parakeratosis along with hyperkeratosis of the conical mass and the keratin plug, keratin pearls, and epithelial proliferation in the nodular mass. These findings led to a diagnosis of eyelid keratoacanthoma with a cutaneous horn. Conclusions Eyelid keratoacanthomas may be accompanied by cutaneous horns and confused with squamous cell carcinomas. The treatment is complete excision, which should be followed by histopathological analysis

Given that tooth loss is a degenerative change, the number of residual teeth may be used to specify a particular age range as a marker for age estimation. This study examined changes in the number of teeth with age using a nationwide oral survey database and derived the age distribution of the Korean population according to the number of teeth. Data on the number of teeth and age were extracted from the oral examination data of the Korean National Health and Nutrition Examination Survey (KNHANES) from 2016 to 2018. Statistical analyses of a complex sample survey were performed using weighted values. The distribution range of the number of teeth by age was broad. The proportion of young people decreased progressively as the number of remaining teeth decreased. In contrast, the proportion of those from the older age group decreased slightly as the number of teeth increased. The number of teeth was subdivided into groups of four, age was categorized into 5-year intervals, and the distribution of age groups by the number of teeth was analyzed. We attempted to determine the age group threshold at approximately 95th percentile for age. In summary, we found that if there were ≤4, 5-12, and 13-20 residual teeth, the estimated age was ≥60, ≥55, and ≥50 years, respectively, with an approximately 95% probability. When many teeth are lost and it is difficult to apply conventional dental age estimation methods, our method may assist in narrowing the age range, although it is not an accurate age determination method.

Purpose: The purpose of this study was to compare the efficacy of intralesional triamcinolone acetonide injection in the treatment of chalazion according to age and size of the lesion. Methods: We performed a retrospective chart review of 108 patients (108 lesions) who underwent intralesional triamcinolone acetonide injections between January 2017 and February 2018. Patients were divided into three groups according to their age and size of the lesion and evaluated with respect to the treatment success and complications. Results: Cumulative treatment success of intralesional triamcinolone acetonide injection was 69.4% with the first injection and 80.6% with the second injection in 108 lesions. With respect to age, 30 lesions were observed in patients under the age of 7 years, 22 lesions were found in patients aged 7 to 16 years, and 56 lesions were observed in patients who were 17 years or older; cumulative treatment success percentages with second injections were 86.7%, 81.8%, and 76.8% respectively. Twenty-seven lesions were under 10 mm in size, 70 lesions ranged from 10 to 15 mm, and 11 lesions were sized 16 to 20 mm; cumulative treatment success percentages were 85.2%, 80%, and 72.7% respectively. Although the results were not statistically significant. Conclusions Intralesional triamcinolone acetonide injection in chalazion is more effective for smaller lesions and younger pediatric patients.

Purpose: To report a rare case of lower eyelid desmoplastic trichoepithelioma.Case summary: A 56-year-old woman presented to our clinic with a slow-growing, painless, recurrent mass located in the temporal area of the left lower eyelid margin. Surgical incision had been performed on a similar mass 4 years before. On examination, a 7 × 2-mm firm, nodular, nontender mass was palpable in the left lower eyelid. The lesion was isolated from the surrounding tissues and completely excised. Histopathologically, the excised mass showed small strands of basaloid cells, keratinous cysts, and focal calcification. These findings supported a diagnosis of eyelid desmoplastic trichoepithelioma. Conclusions Because of its rarity and solitary features, eyelid desmoplastic trichoepithelioma can be confused with sclerosing basal cell carcinoma. Thus, the goal of surgical therapy should be complete excision; histopathological analysis should be also performed.

PURPOSE: This descriptive study was aimed to examine trends in the incidence of melanoma and nonmelanoma in South Korea. MATERIALS AND METHODS: The nationwide incidence data for melanoma and non-melanoma skin cancer was obtained from the Korea Central Cancer Registry. Age-standardized rates were calculated and analyzed, using a Joinpoint regression model. RESULTS: The incidence of basal cell carcinoma has increased dramatically both in men (average annual percentage change [AAPC], 8.0 [95% confidence interval (CI), 6.0 to 10.1]) and women (AAPC, 9.0 [95% CI, 7.5 to 10.4]). Squamous cell carcinoma has also steadily increased both in men (AAPC, 3.3 [95% CI, 2.6 to 4.0]) and women (AAPC, 6.8 [95% CI, 5.3 to 8.4]). Cutaneous melanoma increased continuously from 1999 to 2014 inwomen (AAPC, 3.5 [95% CI, 2.4 to 4.6]), whilst rapidly increasing in men until 2005 (APC, 7.9 [95% CI, 2.4 to 13.7]) after which no increase has been observed (APC, -0.2 [95% CI, -2.3 to 2.0]). CONCLUSION: The incidence rates of melanoma and non-melanoma skin cancer have increased over the past years, with the exception of melanoma in men. Further studies are required to investigate the reasons for the increased incidence of these skin cancers in South Korea.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Female ; Humans ; Incidence* ; Korea* ; Male ; Melanoma* ; Skin Neoplasms* ; Skin*

BACKGROUND AND OBJECTIVES: The present study evaluated the results of skin prick test using 55 allergens at 20 centers in the Republic of Korea in 2006, 2010, and 2014–2015. The aim was to assess changes in the positive rate of allergens according to temporal, regional, and environmental factors. MATERIALS AND METHODS: In total, 20 hospitals were selected based on the population distribution in the Republic of Korea. A skin prick test panel comprising 55 aeroallergens was distributed to 18 hospitals for this prospective study. The 2006 and 2010 skin prick test results were collected and analyzed retrospectively from 20 hospitals, while the 2014/2015 skin prick test results (from June 2014 to May 2015) were collected prospectively from 18 hospitals. RESULTS: A total of 14,897 SPT test results were analyzed: 4,319 in 2006, 7,431 in 2010, and 1,852 in 2014/2015. The overall rate of skin prick test positivity to more than two allergens was significantly higher in males than females. The positive rates of alder pollens and birch, oak and ragweed pollen positivity were increased in older patients. Several positive rates were increased according to the temperature in spring. The positive rates for beech pollen, birch pollen, hazel pollen, oak pollen, Tyrophagus putrescentiae, mugwort, cat, Acarus siro, Lepidoglyphus destructor and Tyrophagus putrescentiae were significantly increased, while those of Cult rye pollen and dandelion were significantly decreased over the three test periods. The overall positive rate for allergens in Jeju province varied significantly from Seoul and other cities. CONCLUSION: Change in the positive rate of multiple aeroallergens was evaluated in the Republic of Korea over time. Our findings can be used to recommend aeroallergens suitable for inclusion in skin prick test panels in the Republic of Korea and will facilitate further investigation of changes in the patterns of allergic diseases.
Allergens* ; Alnus ; Ambrosia ; Animals ; Artemisia ; Betula ; Cats ; Demography ; Fagus ; Female ; Humans ; Korea* ; Male ; Mites ; Pollen ; Prospective Studies ; Republic of Korea ; Retrospective Studies ; Secale ; Seoul ; Skin* ; Taraxacum

PURPOSE: To report a rare case of upper eyelid schwannoma presenting as a chalazion. CASE SUMMARY: A 54-year-old male presented to our clinic with a slowly growing, painless recurred mass located in the middle area of the right upper eyelid margin. Surgical incision had been performed on a similar mass two year previous, although no histological analysis had been performed. On examination, a 4 × 3-mm-sized, firm, nonpigmented mass was palpable in the right upper eyelid, and no signs of neurofibromatosis were present elsewhere. The lesion was initially thought to be an eyelid mass, so we performed an excisional biopsy under local anesthesia. The lesion was easily isolated from the surrounding tissue and was excised completely. Histopathologically, the excised mass showed a compact arrangement of spindle cells forming palisades with Verocay bodies (Antoni A patterns). Immunohistochemistry revealed diffuse and strong S-100 protein positivity. These findings resulted in the diagnosis of eyelid schwannoma. CONCLUSIONS: Because of its rarity and solitary feature, eyelid schwannoma can be confused with chalazion. Thus, ophthalmologists should consider schwannoma in the differential diagnosis of a slowly growing, painless recurred mass or a lesion with malignant transformation after incomplete excision.
Anesthesia, Local ; Biopsy ; Chalazion ; Diagnosis ; Diagnosis, Differential ; Eyelids* ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neurilemmoma* ; Neurofibromatoses ; S100 Proteins

PURPOSE: To evaluate the causes of failed dacryocystorhinostomy (DCR) and the effects of transcanalicular diode laser-assisted endonasal revision surgery according to the number of silicone tubes. METHODS: Sixty-seven patients (70 eyes) who underwent revision surgery using transcanalicular diode laser for failed primary endonasal DCR at Sungmo Eye Hospital between March 2007 and December 2012 were studied retrospectively. The causes of failed DCR and the time of recurrence were evaluated. The revision surgeries were endoscopic removal of granuloma and membrane and synechiolysis with intubation of 1 or 2 silicone tubes. We compared the results of revision surgery with 1 silicone tube and 2 silicone tube intubations. RESULTS: Recurrence occurred after a mean duration of 4.6 months following the first DCR. The causes of surgical failure were granuloma (35 eyes), membranous obstruction (23 eyes), synechia (7 eyes), and functional obstruction (5 eyes). We performed revision surgery with 1 silicone tube intubation in 45 eyes (group A) and 2 silicone tube intubations in 25 eyes (group B). The final success rates in groups A and B were 75.6% (34/45) and 84% (21/25), respectively (chi-square test, p = 0.828). CONCLUSIONS: Transcanalicular diode laser-assisted endonasal revision surgery with 2 silicone tubes is not recommended.
Dacryocystorhinostomy ; Granuloma ; Humans ; Intubation ; Lasers, Semiconductor ; Membranes ; Recurrence ; Retrospective Studies ; Silicones*

PURPOSE: To report on the clinical manifestations, species and treatments of patients with chronic canaliculitis. METHODS: From August 2003 to February 2012, 77 eyes of 77 patients who were diagnosed with chronic canaliculitis at our hospital were retrospectively analyzed. RESULTS: The mean period from the onset of symptoms to diagnosis was 4.7 months. The most common systemic disease associated with chronic canaliculitis was diabetes (18 eyes, 23%), and 13 eyes (17%) were related to punctual plug insertion. Main symptoms consisted of epiphora with discharge and pouting punctum. In the culture results of 55 eyes, streptococci, staphylococci, and actinomyces among other bacteria were identified. Seventy-two eyes (94%) were cured with one-snip punctoplasty with curettage. CONCLUSIONS: Chronic canaliculitis is rare, and the clinical aspect can be obscured by chronic conjunctivitis, thus the diagnosis is often delayed. In patients who have systemic diseases such as diabetes or past history of punctual plug insertion, chronic canaliculitis should be differentiated by observing the punctum more closely. If the diagnosis is accurate at the time, chronic canaliculitis could be easily cured by a relatively simple procedure such as one-snip punctoplasty with curettage.
Actinomyces ; Bacteria ; Conjunctivitis ; Corneal Ulcer ; Curettage ; Dacryocystitis ; Eye ; Humans ; Lacrimal Apparatus Diseases ; Retrospective Studies ; Canaliculitis

We report here the cases of two females with Graves' disease who developed insulin autoimmune syndrome after treatment with methimazole. The patients exhibited a sudden altered mental state after treatment with methimazole for approximately 4 weeks. Patients had hypoglycemia with serum glucose below 70 mg/dL, and laboratory findings showed both high levels of serum insulin and high titers of insulin autoantibodies. The two women had never been exposed to insulin or oral antidiabetic agents, and there was no evidence of insulinoma in imaging studies. After glucose loading, serum glucose, and total insulin levels increased abnormally. One of the patient was found to have HLA-DRB1*0406, which is known to be strongly associated with methimazole-induced insulin autoimmune syndrome. After discontinuation of methimazole, hypoglycemic events disappeared within 1 month. Insulin autoantibody titer and insulin levels decreased within 5 months and there was no further development of hypoglycemic events. We present these cases with a review of the relevant literature.
Autoantibodies ; Female ; Glucose ; Graves Disease ; HLA-DRB1 Chains ; Humans ; Hypoglycemia ; Hypoglycemic Agents ; Insulin ; Insulinoma ; Methimazole