Postoperative neck scarring is a major concern for patients who undergo thyroid surgery; however, the treatments for hypertrophic scars are generally considered by patients to provide unsatisfactory outcomes. Therefore, risk factors should be identified and prevention of these factors is considered to be critical in management. We reviewed the medical records of 96 thyroidectomy patients who were divided into two groups based on scar type: patients with hypertrophic (n = 61) and linear flat scars (n = 35). Multivariable logistic regression model was developed to identify risk factors for developing hypertrophic scar. There was no significant difference between the two groups in terms of age, gender ratio, tumor type, and type of operation. Multivariable analysis showed that hypertrophic scar development was associated with scars located within 1 cm above the sternal notch (odds ratio [OR] = 5.94, p = 0.01), prominent sternocleidomastoid muscles (OR = 12.03, p < 0.01), and a high body mass index (OR = 1.33, p = 0.01). The area under the receiver operating characteristic curve for risk factors was 0.85. Development of hypertrophic scar after thyroidectomy was found to be associated with specific preoperative factors such as incision site near the sternal notch, prominent sternocleidomastoid muscles, and high body mass index.
BackgroundMeasuring the quality of life (QOL) is important in the evaluation of nonclinical aspects of diseases, for the discovery of functional and psychological limitations, and in choosing treatment in the initial phase of the disease. Pemphigus is a potentially fatal autoimmune bullous disease caused by autoantibodies against desmogleins (cadherin family proteins in desmosomes). Thus far, there has been no published study on QOL in Korean patients with pemphigus.ObjectiveTo study the impact of pemphigus on the QOL in a large number of Korean patients.MethodsSixty-six patients enrolled at the Gangnam Severance Hospital from March 2012 to March 2013 were assessed for QOL by using the Dermatology Life Quality Index (DLQI), and for anxiety and depression by using the General Health Questionnaire (GHQ). Spearman's rank-order correlation, t-test, and ANOVA were used to identify the relations between the DLQI score and other clinical variables.ResultsPemphigus vulgaris and pemphigus foliaceus significantly reduced the QOL of patients. The average DLQI score for all patients was 10.18. The mean DLQI score was 13.45 in patients in the active state and 5.15 in the patients in the remission state. The DLQI score highly correlated with disease severity, titer of anti-desmoglein 1 in enzyme-linked immunosorbent assay, and the corticosteroid dose. However, the QOL was not affected by sex, age, subtype of pemphigus, duration of disease, or comorbidities. Forty-two percent of the patients showed a positive result in the GHQ, reflecting probable minor psychiatric nonpsychotic conditions, and the GHQ score positively correlated to the DLQI score.ConclusionPemphigus significantly impairs the QOL of patients. The QOL of Korean pemphigus patients significantly correlates with clinical severity. Therefore, considerable attention should be paid to the patients' QOL and psychological states as well as clinical status.
According to the results of the present study, sclerotherapy is a feasible alternative treatment modality for DMCs. Treatment was well tolerated with few side effects, and resulted in high cure rate. Due to its less invasive nature, high accessibility and favorable outcomes, sclerotherapy should be considered a satisfactory option for the treatment of DMC.
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