Sang Woong Youn

Long-term ketotifen use was associated with a significantly lower incidence of recorded diagnoses of benign cutaneous tumours among patients with neurofibromatosis type 1. No statistically significant association was observed for neural tumours. These findings suggest that ketotifen may be a potentially accessible adjunctive option in the management of benign cutaneous tumours in neurofibromatosis type 1.

Palmoplantar pustulosis (PPP) is a chronic relapsing inflammatory skin disorder predominantly affecting the palms and soles. Despite the continued use of oral systemic agents, real‐world data on their durability and treatment patterns in PPP remain limited. To investigate the treatment patterns, drug survival, and clinical factors associated with treatment persistence in patients with PPP receiving oral systemic therapies. We conducted a retrospective cohort study of patients diagnosed with PPP at a tertiary care referral center in Korea between January 2010 and August 2023. Patients were categorized according to the initial oral agent prescribed—cyclosporine, acitretin, or methotrexate. Treatment trajectories were assessed using predefined criteria, and 12‐month drug survival was evaluated. Clinical predictors of treatment non‐persistence were identified using Cox proportional hazards regression analysis. Among 374 patients, 192 received oral systemic therapy (cyclosporine, n = 110; acitretin, n = 72; methotrexate, n = 8). Cyclosporine was the most commonly prescribed first‐line agent. Median drug survival was the longest for cyclosporine, followed by methotrexate and acitretin ( p = 0.15). Nail involvement was associated with greater persistence (HR = 0.617; 95% CI: 0.444–0.857; p = 0.004), whereas baseline hypertension increased discontinuation risk (HR = 1.492; 95% CI: 1.015–2.195; p = 0.042). Discontinuation patterns differed by agent: cyclosporine was often stopped early due to adverse events but remained durable in patients who tolerated it; acitretin was associated with early and persistent adverse events, with well‐controlled disease emerging as a later reason for cessation; and methotrexate showed sustained use beyond 6 months, with most discontinuations attributed to well‐controlled disease. This study highlights the heterogeneous treatment trajectories and variable drug survival among oral agents for PPP. Nail involvement and hypertension may be key clinical predictors of persistence. These findings support individualized treatment approaches to improve long‐term management of PPP.

Objective: Given that the therapeutic evidence for doxycycline in rosacea has predominantly been derived from studies on papulopustular rosacea (PPR), this study aimed to evaluate the efficacy and safety of combined oral doxycycline, topical calcineurin inhibitor (TCI), and pulsed dye laser (PDL) therapy in erythematotelangiectatic rosacea (ETR) and to identify clinical predictors of treatment response. Materials and Methods: Medical photographs of patients with ETR treated with oral doxycycline, TCI, and two subsequent PDL sessions were retrospectively reviewed. Erythema on the right cheek was quantitatively measured using computer‐aided image analysis. Results: Of the 79 included patients, 47 had the ETR subtype and 32 had the mixed ETR/PPR subtype. Erythema significantly improved after oral doxycycline and TCI treatment ( p < 0.001) and further PDL treatment ( p < 0.001). Particularly, in patients with moderate‐to‐severe ETR, background erythema improved to a level comparable to that observed in patients with mild ETR after treatment ( p = 0.307). Post‐treatment erythema did not differ by age ( p = 0.963) or Fitzpatrick skin type ( p = 0.277); however, it was significantly lower among males ( p = 0.008) and in patients without prior steroid treatment ( p = 0.046). No serious adverse events, including photosensitivity, were observed. Conclusion: Combined oral doxycycline, TCI, and PDL therapy is effective and safe for ETR, especially in patients with higher severity. Prompt diagnosis and avoidance of steroid misuse may improve treatment responses.

Background: This study aimed to identify the baseline characteristics predictive of Psoriasis Area and Sensitivity Index (PASI) 90 response to guselkumab and assess treatment effectiveness outcomes for PASI 90 responders and PASI 90 non-responders. Methods: This post hoc analysis used data from a prospective, multicenter, observational study of guselkumab in Korean patients with moderate-to-severe psoriasis conducted between February 2019 and March 2022. Stepwise logistic regression analysis was used to identify baseline characteristics predictive of PASI 90 response. Results: Of 339 patients, 245 (72.3%) week-28 PASI 90 responders and 94 (27.7%) non-responders were identified. Baseline characteristics significantly predictive of PASI 90 response in multivariate logistic regression were absence of family history of psoriasis (odds ratio [OR]: 0.35; p = 0.0266), higher PASI score (OR: 1.22; p = 0.0006), higher body surface area of psoriasis involvement (OR: 0.95; p = 0.0127), prior phototherapy use (OR: 2.44; p = 0.0108), and reduced concomitant topical agent use (OR: 0.41; p = 0.0044). More PASI 90 responders versus non-responders achieved absolute PASI score ≤ 2 by week 44 (95.8% vs. 67.5%) and Dermatology Life Quality Index scores of 0 or 1 by week 28 (72.2% vs. 34.0%). Conclusions: Guselkumab PASI 90 responders had unique baseline characteristics that may predict positive treatment outcomes.

Several dermatological comorbidities, including juvenile xanthogranuloma, cutaneous mastocytosis, trichotillomania, xanthelasma palpebrarum, lipoma and malignant melanoma, have been frequently observed in patients with neurofibromatosis type 1 in different age groups. Dermatologists, who are crucial in diagnosing and managing this disorder throughout a patient’s life, should be aware of these comorbidities.

Neurofibromatosis type 1 (NF1) affects multiple organs progressively, leading to a shortened life expectancy. This study aimed to identify the complications that are prominent in each age group by comparing 28,082 patients with NF1 and 84,246 matched controls. Benign and malignant neoplasms along with neurological complications were the primary contributors to hospital use across most age groups. Respiratory and circulatory disorders were a common cause of hospital use in children and older adults, respectively. Except for soft tissue and central nervous system-originated malignancies, which are well-established NF1-related tumours, the highest rate ratios (RR) of malignancies with statistical significance was observed in the adrenal gland (0–9 years, RR 50.67, 95% CI 6.74–380.76); female genital organs (10–14 years, RR 12.06, 95% CI 1.35–107.93); respiratory and intrathoracic organs (15–19 years, RR 15.10, 95% CI 1.76–129.22; 20–29 years, RR 7.59, 95% CI 2.94–19.56; ≥ 60 years, RR 1.38, 95% CI 1.18–1.61); lip, oral cavity, and pharynx (30–39 years, RR 6.11, 95% CI 1.53–24.42); and bone and articular cartilage (40–49 years, RR 3.06, 95% CI 1.37–6.81; 50–59 years, RR 4.73, 95% CI 2.35–9.50). Comorbidities and malignancies that predominantly affect patients vary by age group; physicians should be aware of the appropriate management strategies throughout their lifespan.

Bo Mi Kang, Eunyoung Seo, Jung Min Ahn, Bo Ri Kim, Gwanyoung Kim, Kyungmin Lee, Seunghyun Choi, Taeheon Kim, Yunjee Lee, Wonwoo Choi, Chong Won Choi, and Sang Woong Youn. Biomolecules & Therapeutics -0001;0:. https://doi.org/10.4062/biomolther.2024.210

Clinical trials have demonstrated the efficacy and safety of guselkumab in patients with moderate‐to‐severe plaque psoriasis. Real‐world evidence for guselkumab in Korea is needed to establish drug safety and effectiveness under real‐world practice in this population. This study assessed the effectiveness, safety, and drug survival of guselkumab in Korean patients with moderate‐to‐severe plaque psoriasis in a real‐world clinical setting. In this prospective, non‐interventional observational study conducted at 44 clinical centers in South Korea, adult patients with moderate‐to‐severe plaque psoriasis who would receive guselkumab per the product label were enrolled. Disease assessment was performed at visits 1 (baseline, week 0), 2 (approximately week 4), and 3–7 (approximately every 8 weeks after week 4, weeks 12–44). Between February 25, 2019 and March 25, 2022, 707 patients were enrolled and 562 (79.5%) had completed the 56‐week observation period. The proportions of patients with an absolute Psoriasis Area and Severity Index (PASI) score of ≤ 3, ≤ 2, or ≤ 1 reached maximums of 96.0%, 86.7%, and 59.0%, respectively, at visit 7. A significantly greater proportion of biologic‐naïve (vs. biologic‐experienced) patients achieved absolute PASI ≤ 3 by visits 5–7 (p = 0.001 at visit 7) and absolute PASI ≤ 2 by visits 6–7 (p = 0.0014 at visit 7). Dermatology Life Quality Index (DLQI) scores decreased over time, with 64.1% of patients achieving DLQI 0/1 by visit 7; results were similar regardless of prior biologic therapy. The estimated drug‐survival rate at 1 year was 92.7%. Adverse events (AEs) occurred in 22.5% of patients, with an incidence rate of 42.1 per 100 patient years (PY); 14 serious AEs occurred in 13 (1.8%) patients, with an incidence rate (95% confidence interval) of 2.4 (1.2–3.7) per 100 PY. Guselkumab administered under approved label conditions was effective and well‐tolerated in Korean patients with moderate‐to‐severe plaque psoriasis in a real‐world clinical setting.

We developed a dataset of 4133 cropped vitiligo patch images from 296 patients. Using this dataset, we trained a pre-trained Xception model to assess morphological characteristics of active or stable vitiligo. The deep learning algorithm (DLA) achieved an area under the receiver operating characteristic curve value of 0.96, an accuracy of 94%, a sensitivity of 92.63% and a specificity of 94.60%. The DLA demonstrated excellent performance in distinguishing lesions with morphological characteristics suggestive of active vitiligo from those indicative of a stable state.