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Objective@#We aimed to investigate the oncologic outcomes of patients with endometrial cancer who underwent sentinel lymph node (SLN) biopsy without ultrastaging compared with that of those who underwent lymphadenectomy (LND). @*Methods@#Patients with endometrial cancer who underwent staging with SLN biopsy or LND during 2006 – 2021 were analyzed using propensity score matching (PSM). SLN metastasis was examined using hematoxylin and eosin staining, without ultrastaging. Progression-free survival (PFS) was compared between the two groups before and after PSM using age, histology, and stage as covariates. Clinical variables such as recurrence patterns and lymphatic complications, were assessed. @*Results@#After excluding 213 patients who underwent validation LND with SLN biopsy, 902 were identified. The demographics of the remaining patients differed according to histology, myometrial invasion depth, and stage. Lymph node metastasis was less frequent in the SLN group than in the LND group (9.4% vs. 3.8%, p=0.004). The recurrence rates within 2 years were lower in the SLN group. The SLN group exhibited significantly superior 2-year and overall PFS than the LND group. Among patients with uterus-confined disease, overall PFS was favorable for SLN biopsy. After matching, differences in PFS were no longer observed, although the lymphocele and lymphedema rates were significantly lower in the SLN group. @*Conclusion@#In patients with endometrial cancer, SLN biopsy without ultrastaging did not compromise survival outcomes and was associated with significantly reduced lymphatic complication rates compared with LND. Therefore, SLN biopsy can be recommended for patients with endometrial cancer without definitive preoperative evidence of distant metastasis.

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Background@#Avoiding causative allergens is important for controlling the clinical course of atopic dermatitis (AD). Allergen sensitization is influenced by many factors, such as the environmental factors. Although socioeconomic development, climate, and lifestyle have changed and the prevalence of allergic diseases has increased in Korea over the past few decades, there is little information about changes in common allergens over time. @*Objective@#This study aimed to identify the trends of common allergens in patients with AD over a 10-year period based on the results of the multiple allergen simultaneous test (MAST). @*Methods@#We retrospectively reviewed the medical records of 1,414 patients with AD (603 adults and 811 children) over a period of 10 years. The serum total immunoglobulin E (IgE) and specific IgE levels of 41 allergens were determined using the MAST. @*Results@#House dust and house dust mites were the most prevalent allergens in both adult and pediatric patients during the 10-year period; however, the percentage of higher-class responses has decreased in recent years. The number of patients sensitized to house dust, cats, and egg whites increased, whereas that of patients sensitized to cockroaches, storage mites, beef, and rice decreased for both adults and children. No significant changes were observed in the total number of sensitizing allergens over time. @*Conclusion@#Common allergens in patients with AD have change over time. Based on the findings of this study, physicians and patients should consider changing their disease prevention and management strategies.

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A 47-year-old man with a 25-year history of Crohn’s disease, presenting asymptomatic erythematous scaly patches (size, 1∼3 cm in diameter) on his back, left hand, right wrist, left ankle, and left sole, visited our clinic. Histopathological examination of the lesions revealed Bowen’s disease. Herein, we report a rare case of multiple Bowen’s disease in the skin, away from the anogenital region, in a patient with Crohn’s disease.

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Cosmetic facial tattoo as semi-permanent make-up for the eyebrows is gaining popularity in Korea. Consequently, the incidence of tattoo-related complications, including local skin infections, allergic reactions, and non-allergic granulomatous reactions, is also increasing. Herein, we report two cases of granulomatous reactions to semi-permanent eyebrow tattoos. Clinicians should always keep in mind that both systemic sarcoidosis and delayed complications associated with tattooing can manifest as granulomatous reactions. Therefore, every granulomatous reaction at the tattoo site should be evaluated to differentiate sarcoidosis from foreign body granuloma.

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Background@#The use of makeup is popular among Korean adolescents. With the increased use of color cosmetics, there are concerns that heavy application may cause skin problems or aggravate acne, a condition highly prevalent in this age group. Other than makeup, cosmetic products targeting acne are also easily accessible and often used. Currently, little is known about the use of these products in Korean middle school students and their understanding of its effect on the skin. @*Objective@#This study investigated the prevalence of “color cosmetics” and cosmetics targeting acne” among Korean students and their awareness of the effects of these products on their skin.Method: A questionnaire survey was conducted of 192 students from Dawon Middle School in Hwasung. The questionnaire consisted of detailed inquiries regarding the use of color cosmetics and cosmetics targeting acne and their effect on the skin. @*Results@#A total of 192 responses were analyzed. Sixty-three (32.8%) students reported experience with putting on makeup. Among these 63 students, 35 (55.5%) responded that their skin condition had worsened after applying makeup, which was associated with the frequency and extent of color cosmetic use (p＜0.05). Among the 106 (52.2%) students with acne, 63% reported having tried acne-targeting cosmetics. Approximately 14.3% of this population reported feeling very satisfied with the effect of these cosmetics on acne. @*Conclusion@#The results of our study indicated that a significant percentage of middle school adolescents are using makeup. As skin troubles may arise with the use of color cosmetics, an educational guide on minimizing application and properly removing the products should be provided to this population. Acne is highly prevalent in adolescents and cosmetics targeting acne are easily accessible. The belief that acne-targeting cosmetics can replace hospital treatment can be risky and should be thoroughly explained by dermatologists.

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Objectives@#Psychological resilience plays a significant role in many aspects of mental health. The aim of this study was to find an association between childhood attention deficit hyperactivity disorder (ADHD) features and adulthood psychological resilience in patients with mood disorders. @*Methods@#A total of 213 patients with mood disorders including major depressive disorder or bipolar I, II disorder and 909 healthy controls were included. We assessed childhood ADHD features using the Wender Utah Rating Scale (WURS), adulthood psychological resilience using the Connor-Davidson Resilience Scale (CD-RISC), and current depressive mood using the Beck Depression Inventory (BDI). Pearson’s correlation, multiple linear regression and a mediation analyses were performed to examine the relationships between three WURS factor (impulsivity, inattention, and mood instability) scores, the BDI score, and the CD-RISC score. @*Results@#The CD-RISC score was negatively correlated with the WURS childhood inattention factor score and current BDI score in patients with mood disorders. BDI score mediated the influence of the inattention factor score on CD-RISC score among patients with mood disorders. The CD-RISC score was significantly lower in patients with mood disorders than in controls even after controlling for age, WURS scores, and the BDI score. @*Conclusions@#An evaluation of psychological resilience is important for enhancing recovery and quality of life in patients with mood disorders. When assessing psychological resilience, current depression and ADHD features in childhood, particularly inattention, should be considered.

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Objectives@#Psychological resilience plays a significant role in many aspects of mental health. The aim of this study was to find an association between childhood attention deficit hyperactivity disorder (ADHD) features and adulthood psychological resilience in patients with mood disorders. @*Methods@#A total of 213 patients with mood disorders including major depressive disorder or bipolar I, II disorder and 909 healthy controls were included. We assessed childhood ADHD features using the Wender Utah Rating Scale (WURS), adulthood psychological resilience using the Connor-Davidson Resilience Scale (CD-RISC), and current depressive mood using the Beck Depression Inventory (BDI). Pearson’s correlation, multiple linear regression and a mediation analyses were performed to examine the relationships between three WURS factor (impulsivity, inattention, and mood instability) scores, the BDI score, and the CD-RISC score. @*Results@#The CD-RISC score was negatively correlated with the WURS childhood inattention factor score and current BDI score in patients with mood disorders. BDI score mediated the influence of the inattention factor score on CD-RISC score among patients with mood disorders. The CD-RISC score was significantly lower in patients with mood disorders than in controls even after controlling for age, WURS scores, and the BDI score. @*Conclusions@#An evaluation of psychological resilience is important for enhancing recovery and quality of life in patients with mood disorders. When assessing psychological resilience, current depression and ADHD features in childhood, particularly inattention, should be considered.

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BACKGROUND: Vitamin D is a hormone required by the human body. Several studies have shown that vitamin D helps improve muscle strength. The purpose of our study was to examine the relationship between vitamin D levels and muscle strength in Korean adults.METHODS: The Korea National Health and Nutrition Examination Survey was conducted in the Korean population from 2009 to 2011. We surveyed 859 men and 944 women aged between 20 and 65 years. We investigated age, blood pressure, exercise frequency, heart rate, height, body weight, waist circumference, body mass index, serum vitamin D level, and hand grip strength. We analyzed the relationship between serum vitamin D level and hand grip strength using the linear regression test.RESULTS: On statistical analysis, vitamin D levels showed a significantly positive correlation with only grip strength. However, after adjusting for all other variables, no positive correlation was observed between vitamin D levels and grip strength.CONCLUSION: No significant correlation was observed between vitamin D levels and grip strength. Further research is needed on this topic.

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BACKGROUND: Atopic dermatitis (AD) is a chronic or chronically relapsing, eczematous, severely pruritic inflammatory skin disorder. Korean red ginseng (KRG) has been shown previously to exhibit diverse biological effects including anti-inflammatory and antipruritic effects in a murine model. OBJECTIVE: We aimed to investigate the beneficial effects of KRG on AD patients, to determine whether there was improvement in disease severity, skin barrier function, pruritus and sleep disturbance relief. METHODS: An open, noncomparative clinical study that utilized KRG tablets (500 mg/tablet) was conducted. This study included 41 patients with mild to moderate AD diagnosed by the Korean atopic dermatitis guidelines. Three visits to the hospital at days 1, 28±7, and 56±7 for evaluation were made. The effects of KRG were assessed by measuring eczema area and severity index (EASI) score, transepidermal water loss (TEWL), the visual analogue scale (VAS), total amount of topical agents used in recent 8 weeks and investigator global assessment (IGA). RESULTS: Patients taking KRG tablets showed significant decreases in EASI score and TEWL, and the VAS of pruritus and sleep disturbance were significantly reduced. The amount of topical agents used was reduced but not by a statistically significant amount. IGA at the third visit showed improvement of AD compared to the second visit, but the difference was not statistically significant. CONCLUSION: KRG can be safely used as a health food to achieve clinical improvement of AD as well as improving overall quality of life, and has potential for further development.

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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.

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BACKGROUND: Topical tacrolimus is an effective anti-inflammatory therapy for acute and chronic states of atopic dermatitis (AD) in both adults and children. Topical tacrolimus has particular use at sensitive areas such as the face, anogenitals, and skin folds of neck and extremities. However, many AD patients also experience aggravated symptoms on trunk. OBJECTIVE: The aim of this study was to investigate the efficacy and safety of topical tacrolimus for AD patients with truncal lesions. METHODS: AD patients with truncal lesions who were aged ≥2 years were recruited from 20 centres in Korea. They received treatment with topical tacrolimus ointment twice daily during 4 weeks. The primary end point was change of the local eczema area and severity index (EASI) of the trunk from baseline to day 28. The secondary end points were changes in the patient global assessment (PGA) score and itch visual analogue scale (VAS) score of the trunk between baseline and day 28. RESULTS: Two hundred and ninety-one patients were recruited, and 176 patients completed the full 4-week treatment course. By the end of the treatment, the mean local EASI of the trunk (2.2±4.71) was significantly decreased from that at baseline (4.71±4.03, p < 0.001). PGA (1.71±1.15) and itch VAS score of the trunk (2.61±2.19) on day 28 were also profoundly decreased compared with the baseline (2.96±1.07 and 5.15±2.47, respectively). No serious adverse events were observed during the study period. CONCLUSION: Topical tacrolimus is an effective and safe therapy for truncal lesions in AD patients.

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OBJECTIVES: Psychological resilience is the ability to cope with stress. The genetic background behind psychological resilience is not much known. The serotonin transporter and dopamine transporter are implicated in stress related psychology and emotional processing. The aim of this study is to investigate a possible genetic role of functional polymorphisms of serotonin and dopamine transporters for psychological resilience. METHODS: A total of 951 healthy adult subjects were included. Psychological resilience was measured using Connor-Davidson Resilience Scale (CD-RISC). Genotyping was performed for serotonin transporter gene (SERT) promoter variable number tandem repeat (VNTR) and dopamine transporter gene (DAT1) 3'-untranslated region (UTR) VNTR. Genetic association analysis was conducted between genotypes and the CD-RISC score. RESULTS: No genetic association was observed for SERT promoter VNTR or DAT1 3'-UTR VNTR with CD-RISC score. No genetic interaction between SERT promoter VNTR and DAT1 3'-UTR VNTR with CD-RISC score was detected. CONCLUSIONS: Either serotonin or dopamine transporter did not seem to play a significant role for psychological resilience in this sample.

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A cutaneous sinus tract of odontogenic origin occurs when purulent by-products of dental pulp necrosis spread along the path of least resistance from the root apex to the skin on the face. Patients presenting with this condition usually visit a dermatologist first, as the lesion can mimic various dermatologic pathologies, ranging from an epidermal cyst to basal cell carcinoma. The location of the sinus in the head and neck region should lead the dermatologist to seek a dental origin in order to avoid misdiagnosis. The lesion may persist for long periods before a correct diagnosis is made and the odontogenic source is treated appropriately. Herein, we report a case of a cutaneous sinus tract of odontogenic origin.

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BACKGROUND: Skin laser treatment has improved significantly and has become an effective treatment approach for many skin diseases while also having applications for beauty treatments. However, since skin laser transfers energy directly to the skin, the misuse of such treatment may result in permanent damage to skin tissues. OBJECTIVE: This survey of Korean adults, conducted to obtain their perspectives on and their treatment experience with skin laser treatment, will be used to determine the current status of skin laser treatment and to identify necessary changes to ensure proper and safe conduct of skin laser treatment. METHODS: From April 5th to April 12th, 2016, a survey was conducted to obtain information regarding the perspectives and the treatment experience of adults aged 20~59 years. RESULTS: Approximately 50% of the participants had experience with skin laser treatment, and among these, 24.7% had not received treatment at a dermatology clinic. Compared to treatment at a dermatology clinic, the danger of side effects was 1.7 times higher at a non-dermatology clinic, 2 times higher at a skin care shop, and 5.3 times higher at an Oriental medical clinic. Among patients who received skin laser treatment, 16.1% experienced side effects, and among these, 1 out of 4 patients visited a non-dermatologist for treatment of these side effects. CONCLUSION: The results of the survey showed that in order for the public to receive safe and effective skin laser treatment based on professional diagnosis, there is a definitive need to provide correct information to the public and to implement changes to ensure proper understanding of skin laser treatment among this population.

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Korean red ginseng (KRG) and ginsenosides exhibit diverse biological effects, including anti-inflammatory and anti-allergic. We aimed to investigate the therapeutic effect of KRG in a murine model of atopic dermatitis (AD) is mediated whether by diminishing the pruritus or by suppressing the inflammation. Thirty NC/Nga mice were randomly divided to 5 groups. AD-like skin lesions were induced by percutaneous challenge with 2,4,6-trinitro-1-chrolobenzene (TNCB) on the ears and backs of NC/Nga mice. KRG extract, evening primrose oil, cyclosporine, and phosphate-buffered saline were administered orally by a gastric tube. Each study group was also divided into scratching-permitted and scratching-restricted subgroups to evaluate the impact of scratching behavior on AD. The effects of KRG and the other agents were assessed by measuring the clinical severity score, ear thickness, extent of transepidermal water loss (TEWL), number of scratching movements, total systemic immunoglobulin E (IgE) and interleukin (IL)-31 levels, histologic changes of cutaneous lesions, and mRNA expression levels of tumor necrosis factor (TNF)-α, interferon (IFN)-γ, thymic stromal lymphopoietin (TSLP), and IL-31. KRG exerts therapeutic effects against AD by inhibiting the T helper 2 (Th2) mediated inflammation as well as by diminishing the itching sensation. Moreover, restricting scratching behavior suppresses the vicious cycle of itching and scratching, thus reducing clinical and systemic inflammation in our murine model of AD.

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Interstitial granulomatous dermatitis (IGD) is a rare dermatosis, histologically characterized by an interstitial granulomatous infiltrate. It is associated with inflammatory arthritis, various medications, and autoimmune conditions. It is also associated with malignancies such as breast, endometrial, lung, and esophageal cancers as well as hematologic malignancies such as lymphoma and myelodysplastic syndrome. Herein we describe a case of IGD associated with prostate cancer, which has not been reported in the literature.

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