Background Alopecia areata (AA) is common non-scarring hair loss disease. Sleep distrubance has been regarded as a triggering or aggravating factor for AA. However, objective evaluation of sleep disturbance and its clinical effect on AA has not been clearly demonstrated. Objective This study investigated objective sleep evaluation tool for AA patients and their clinical correlation. Methods Patients presenting with new-onset AA or recurrences of pre-existing AA were included, and those who reported sleep disturbance in the preliminary survey were designated as the sleep disturbance group (SD group). Sleep quality was investigated for them using three self-administered questionnaires: Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleep Scale (ESS). Demographic information and clinical features of AA were analyzed according to sleep quality. Results A total of 400 participants were enrolled, and 53 were categorized into the SD group. The incidence of stressful events was significantly higher in the SD group (54.7%) than in the non-SD group (25.1%) ( p <0.001). Based on the PSQI, 77.3% of participants were objective poor sleepers (score of 5 or more), and they showed a significantly higher incidence of stressful events compared to good sleepers ( p =0.019). The proportion of poor sleepers was significantly lower in patients with mild AA (S1) than in those with moderate to severe AA (S2~S5) ( p =0.045). Conclusion This study demonstrated a positive correlation among stress, SD, and AA. The degree of SD was objectively represented by the PSQI score, showing different scores according to AA severity.

No abstract

Background: Many studies have investigated onychomycosis in various populations. However, no study has been conducted among individuals living in fishing villages, who seem to be more susceptible to onychomycosis. Objective: This study was conducted to investigate the prevalence, clinical and mycological characteristics, and risk factors of onychomycosis in individuals living in fishing villages located on two small islands. Methods: Individuals who had resided in fishing villages located on two small islands in Korea were included. Inspection and a questionnaire survey were performed, and clinical assessment and mycological identification using polymerase chain reaction were performed for those diagnosed with onychomycosis on inspection. Results: Among the 43 subjects enrolled, 32 (74.4%) were clinically diagnosed with onychomycosis. Causative organisms were identified in 23 (53.5%) subjects, and the most common identified causative strain was Trichophyton rubrum (91.3%), followed by Trichophyton species (4.3%) and Candida species (4.3%). Distal and lateral subungual onychomycosis was the most common clinical type (78.1%), followed by total dystrophic onychomycosis (12.5%). In 10 subjects (31.3%), five or more nails were affected. Among the patients who received treatment for onychomycosis (n = 19), 66.7% had used only conventional topical agents. Conclusion: Onychomycosis is more prevalent and more severe in people living in fishing villages than in the general population. These findings suggest that environmental or occupational background should be considered in managing onychomycosis.