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Background: Wearing a face mask is one of the most effective personal protective strategies to diminish the spread of coronavirus disease 2019 (COVID-19). Several dermatological outcomes were reported because of the prolonged use of face masks, especially due to the constant mask-on policy, but the photoprotective effect of face masks has received less attention., Objective: The aim of this study was to provide guidance in the use of face masks by comparing the photoprotective effects of routinely used masks., Methods: A total of 12 frequently used face masks were tested, including certified respirators, Korea filter (KF)94, KF-anti-droplet (KF-AD), and KF80. The amount of light that penetrates each face mask was measured using a light sensor that can quantify Ultraviolet A (UVA), visible light (VL), and infrared A (IR-A) rays., Results: Black-colored KF94 masks and surgical masks reduced penetration of UVA, VL, and IR-A by approximately 100%. The UVA penetration decreased on average by 95.51%, 90.97%, 85.06%, and 86.41% with white-colored KF94, KF-AD, KF80, and surgical masks, respectively. The VL and IR-A were blocked by approximately 75.58%, 66.16%, 59.18%, and 64.48% with white-colored KF94, KF-AD, KF80, and surgical masks, respectively., Conclusion: In conclusion, the different photoprotective effectiveness of face masks was mainly determined by colors, and therefore, black-colored, multi-layered respirators can be recommended in terms of photoprotection in the COVID-19 pandemic. The quantified comparative results will be helpful to the person with pre-existing photo-aggravated dermatosis, especially in the season of the high intensity of sunlight., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: Recent studies indicated that the autoimmunity of vitiligo exerts effects on cells other than melanocytes, which confer reduced risks of both melanoma and nonmelanoma skin cancers in patients with vitiligo. However, the risk of internal malignancy in patients with vitiligo has not been elucidated., Patients and Methods: We conducted a population-based retrospective cohort study using data from the Korean National Health Insurance claims database obtained from January 2007 to December 2016. All patients age 20 years or older with vitiligo who had at least two contacts with a physician from 2009 to 2016, during which a principal diagnosis was made, were identified (vitiligo group). Controls were randomly selected (two per patient with vitiligo) after frequency matching with the vitiligo group for age and sex during the same period (control group)., Results: A total of 101,078 patients with vitiligo and 202,156 controls without vitiligo were included. The incidence rates of internal malignancies were 612.9 and 708.9 per 100,000 person-years in the vitiligo and control groups, respectively. Patients with vitiligo showed a significantly reduced risk of overall internal malignancies (hazard ratio [HR], 0.86; 95% CI, 0.82 to 0.89; P < .001) compared with controls without vitiligo after adjustments for age, sex, and comorbidities. With regard to organ-specific malignancies, patients with vitiligo showed a remarkably decreased risk of cancer in the colon and rectum (HR, 0.62; 95% CI, 0.55 to 0.69; P < .001), ovary (HR, 0.62; 95% CI, 0.46 to 0.83; P < .001), and lung (HR, 0.75; 95% CI, 0.65 to 0.86; P < .001)., Conclusion: Vitiligo was associated with a reduced risk of overall internal malignancies. These findings suggest that autoimmune diseases, including vitiligo, may provide immune surveillance for the development of cancer beyond the targeted organ.

Skin biopsy for AK diagnosis is usually performed on only a limited part of the whole lesion. Therefore, a clinical diagnosis is important. According to a study, there is no significant correlation between histopathological and clinical classification system. We examined the correlation between microscopic information and dermoscopic findings to deduce if dermoscopic information reflects histopathologic grade severity. Forty seven patients with histologically confirmed AK were enrolled and positive ratio of red pseudonetwork, rosette, red background and targetoid signs, white-to-yellow scale, white structureless area, and pigmentation from dermoscopic findings were investigated. Furthermore, viable epidermal thickness, vessel lumen dimensions, existence and thickness of ortho- and parakeratosis, degree of sola elastosis, flag sign existence, and Roewert-Huber classification were measured as histologic findings. Red background did not show a significant correlation with vascular dimension or viable epidermal thickness. When targetoid sign was present, vascular dimension was significantly larger but showed no correlation with viable epidermal thickness, parakeratosis or orthokeratosis. Solar elastosis level was significantly higher when white-to-yellow scale was present. According to Spearman's correlation analysis, ortho/parakeratotic thickness showed correlations with each other. The negative correlation between viable epidermal thickness and vascular dimension was also shown. Roewert-Huber histologic AK classification showed no correlation with any factors we checked. Factors considered to be characteristic features of AK in dermoscopy seemed unassociated with histologic AK classification and additional research is needed to determine degree of dysplasia of AK lesions using dermoscopy., (© 2018 Wiley Periodicals, Inc.)

Background: Melasma is a common acquired facial pigmentary disorder that is resistant to various modalities of treatment. Recently, the low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser (QSNY) has emerged as the new gold standard of melasma treatment in Asia., Objective: To evaluate the efficacy and safety of low-fluence 1064-nm QSNY in Asian patients with melasma., Methods: Data of patients with melasma treated with low-fluence QSNY in the department of dermatology at the Korea University Anam Hospital were reviewed retrospectively. A 1064-nm QSNY with 8 mm spot size and fluence of 1.2-2.0 J/cm 2 at 10 Hz was used. The results were evaluated using the modified Melasma Area and Severity Index (mMASI) score and the physician's global assessment (PGA)., Results: A total of 40 Korean patients with Fitzpatrick skin type III to IV were included. Patients were treated for a median of 10 sessions at a median of 1-week intervals. The mean mMASI score decreased by 54.23% from a baseline of 3.19 ± 2.64 to 1.46 ± 1.06 after treatment. On PGA, 1 out of 40 patients (2.5%) showed excellent improvement, 14 (35%) good, 15 (37.5%) fair, 6 (15%) poor, and 4 (10%) no improvement. However, two patients showed mottled hypopigmentation and rebound hyperpigmentation., Conclusion: Low-fluence 1064-nm QSNY appears to be a safe and effective treatment for Asian patients with melasma., (© 2018 Wiley Periodicals, Inc.)

Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin disorder. Although several epidemiological studies have been conducted in Western countries, such data regarding Asian populations are scarce. In this study, we sought to investigate the demographic and clinical features of HS in Korea. A total of 438 patients, diagnosed with HS from May 2007 to April 2017, were enrolled and the electronic medical record of each patient was reviewed. Male patients were predominant with a male : female ratio of 2.5:1. Mean age of disease onset was 23.9 years and most patients had no family history. The most frequently affected area was the buttocks, followed by axillae and groin. Acne and diabetes mellitus were the most prevalent associated diseases and no patients with inflammatory bowel diseases were observed. In the univariable analysis, male patients had severe diseases compared with females with an odds ratio (OR) of 1.790. Two or more affected body regions were associated with HS severity with an OR of 1.693. While involvement of the perineum (OR, 4.067) and buttocks (OR, 1.471) tended to be associated with increased severity of the disease, the inguinal area (OR, 0.620) showed a tendency to be inversely associated with the severity. In multivariable analysis, identified risk factors were the involvement of the perineum (OR, 3.819) and buttocks (OR, 2.288). Smoking status and high body mass index seemed to be associated with more severe diseases. Our results will provide clinical characteristics of HS patients in Asia and help to broaden understanding of HS., (© 2018 Japanese Dermatological Association.)

Aged skin is reported to be associated with unattractive skin color changes and solar elastosis. However, comparative studies have not documented the possible correlation between the two factors. This study investigated the plausible relationship between the facial skin color of elderly Asians and solar elastosis. A total of 22 skin specimens were collected from 22 Korean patients who underwent cheek skin biopsies. Skin color was quantitatively measured using colorimetric photography techniques to produce CIE L*a*b* values; the degree of solar elastosis was quantifiably assessed using a histologic grading scale. These values were used to investigate a correlation between the CIE L*a*b* coordinates and solar elastosis grade. The solar elastosis grade increased according to patient age (r = 0.67, p = .0006). However, the extent of solar elastosis was not statistically correlated with the CIE L*a*b* values, including L*, a*, and b* (r = 0.02, p = .95; r = 0.15, p = 0.50; r = -0.07, p = 0.76, respectively). The results showed that the solar elastosis grade increased, according to patient age, because of cumulative actinic damage. However, colorimetric skin color data did not correlate with the degree of solar elastosis. Therefore, cutaneous color changes and solar elastosis are separate, age-related phenomena. Physicians should be aware of the possible histologic changes in actinically damaged facial skin, regardless of the skin color., (© 2017 Wiley Periodicals, Inc.)

A skin biopsy is one of the most frequently performed procedures in the dermatology outpatient clinic, but doctors often do not consider the cognitive impact of the biopsy procedure. Based on "terror management theory," we reasoned that a skin biopsy increases patient compliance by unconsciously stimulating mortality salience. To study this hypothesis, trust toward doctors, authoritarian personality, mood, attitude toward recommendations, and intention to accept recommendations were compared be-tween skin biopsy and non-skin biopsy groups of patients. Eighty-three patients participated in the study, and 78 responses were used for the analysis. The results showed that patients who had a skin biopsy had a more positive attitude toward doctors' recommendations and a higher intention to follow the recommendations. These effects were not moderated by the patient's own personality (patient trust and authoritarian personality). The outcome of this study implies that performing a procedure itself can subliminally influence a patient's attitude toward a doctor's recommendations.