exudates and Skin-Diseases

Topics: Dermatitis; Dermatology; Eczema; Humans; Indonesia; Malaysia; Sexually Transmitted Diseases; Singapore; Skin Diseases; Skin Diseases, Infectious

Ultraviolet phototherapies are important treatment modalities for a wide range of dermatological conditions. We aim to describe the utilization of phototherapy in the Department of Dermatology Hospital Kuala Lumpur.. This is a 5-year retrospective audit on patients who underwent phototherapy between 2011 and 2015.. There were 892 patients, M:F=1.08:1, aged from 4- 88 years, with a median age of 38.8 years who underwent phototherapy. Majority (58.9%) had skin phototype IV, followed by type III (37.7%) and type II (0.7%). There were 697(78.1%) who underwent NBUVB, 136 (15.2%) had topical PUVA, 22(2.5%) had oral PUVA, 12(1.4%) had UVA1 and 23(2.6%) had NBUVB with topical or oral PUVA/UVA1 at different time periods. The indications were psoriasis (46.6%), vitiligo (26.7%), atopic eczema (9.8%), pityriasis lichenoides chronica (5.3%), mycosis fungoides (3.9%), lichen planus (2.5%), nodular prurigo (2.2%), scleroderma (1.2%), alopecia areata (0.7%) and others. The median number of session received were 27 (range 1-252) for NBUVB, 30 (range 1-330) for topical PUVA, 30 (range 3-190) for oral PUVA and 24.5 (range 2-161) for UVA1. The acute adverse effects experienced by patients were erythema (18%), pruritus (16.3%), warmth (3.3%), blister formation (3.1%), cutaneous pain (2.4%), and xerosis (0.8%), skin swelling (0.7%) and phototoxicity (0.2%).. Narrow-band UVB was the most frequently prescribed phototherapy modality in our center. The most common indication for phototherapy in our setting was psoriasis. Acute adverse events occurred in a third of patients, although these side effects were mild.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Dermatology; Female; Hospital Departments; Humans; Malaysia; Male; Middle Aged; Phototherapy; PUVA Therapy; Retrospective Studies; Skin Diseases; Young Adult

Topics: Anti-Bacterial Agents; Aspartate Aminotransferases; Doxycycline; Female; Fever of Unknown Origin; Headache; Hemoglobins; Humans; Malaysia; Middle Aged; Myalgia; Orientia tsutsugamushi; Scrub Typhus; Skin Diseases; Travel; Travel-Related Illness

Topics: Adolescent; Adult; Aged; Dermatomycoses; Eczema; Female; Humans; Leprosy; Malaysia; Male; Middle Aged; Outpatient Clinics, Hospital; Psoriasis; Retrospective Studies; Sex Factors; Skin Diseases; Skin Neoplasms; Tertiary Care Centers; Urban Health Services; Young Adult

Low-dose isotretinoin is used to reduce side effects albeit higher relapse. This study aimed to determine the efficacy and safety of fixed-dose 10 mg daily isotretinoin for the treatment of acne.. This prospective study was performed between 2011 and 2015. All 150 patients were given 10 mg daily isotretinoin until a cumulative dose of 90-110 mg/kg.. The mean age was 26.6 years with 64.7% moderate acne, 29.3% severe, and 6% very severe. The mean cumulative dose was 98.8 ± 6.05 mg/kg. All 150 patients had total clearance with a mean time to clearance of 24.0 weeks. Patients with severe/very severe acne had higher cumulative dosage (102.1 vs. 97.0, P < 0.001) and longer duration to clearance (32.9 weeks vs. 19.1 weeks, P < 0.001). Mild relapse was seen in 4%. The mean time to relapse was 32.3 weeks. Lip dryness was the commonest side effects (100%). Mild transient elevation of liver enzymes was detected in 3.3% and a slight increase of serum lipid in 2.7% with no treatment discontinuation.. Fixed-dose 10 mg daily treatment with isotretinoin until a cumulative dose of 90-110 mg/kg is safe with low relapse rate.

Topics: Acne Vulgaris; Adult; Dermatologic Agents; Female; Humans; Isotretinoin; Lipids; Liver; Malaysia; Male; Prospective Studies; Recurrence; Skin Diseases

The presence of cutaneous nodules is reported in vulnerable populations of Irrawaddy dolphins Orcaella brevirostris from Malaysia (Kuching, Bintulu-Similajau, Kinabatangan-Segama and Penang Island), India (Chilika Lagoon) and Bangladesh (Sundarbans). Approximately 5700 images taken for photo-identification studies in 2004 to 2013 were examined for skin disorders. Nodules were detected in 6 populations. They appeared as circumscribed elevations of the skin and varied in size from 2 to >30 mm, were sparse or numerous and occurred on all visible body areas. In 8 photo-identified (PI) dolphins from India and Malaysia, the lesions remained stable (N = 2) or progressed (N = 6) over months but did not regress. The 2 most severely affected individuals were seen in Kuching and the Chilika Lagoon. Their fate is unknown. Cutaneous nodules were sampled in a female that died in a gillnet in Kuching in 2012. Histologically, the lesions consisted of thick collagen bundles covered by a moderately hyperplasic epithelium and were diagnosed as fibropapillomas. Whether the nodules observed in the other O. brevirostris were also fibropapillomas remains to be investigated. Disease prevalence ranged from 2.2% (N = 46; Bintulu-Similajau) to 13.9% (N = 72; Chilika) in 4 populations from Malaysia and India. It was not significantly different in 3 study areas in eastern Malaysia. In Chilika, prevalence was significantly higher (p = 0.00078) in 2009 to 2011 (13.9%) than in 2004 to 2006 (2.8%) in 72 PI dolphins. The emergence of a novel disease in vulnerable O. brevirostris populations is of concern.

Topics: Animals; Bangladesh; Dolphins; Female; India; Malaysia; Skin Diseases

In 1997, the Ministry of Health Malaysia introduced a surveillance programme for occupational and work-related diseases including poisonings for cases seen in government health facilities. Between June 1997 and November 1998, there were 36 cases of respiratory disease and 95 cases of poisoning by chemicals and pesticides notified while skin diseases were 108 cases. Respiratory diseases reported were predominantly occupational asthma (25%), pneumoconiosis (17%) and infections (39%). The commonest reported skin disease was contact dermatitis (87%). The commonest causes of occupational poisonings were paraquat (19%), organo-phosphates (16%), agro-chemicals excluding pesticides (15%) and gases (10%). The number of cases reported is still relatively few compared to data from other countries, suggesting that there is still considerable under reporting.

Topics: Adult; Aged; Female; Humans; Lung Diseases; Malaysia; Male; Middle Aged; Occupational Diseases; Poisoning; Skin Diseases; Time Factors

A retrospective analysis of 182 HIV positive Malaysians was done in two centers, the University Hospital Kuala Lumpur (UHKL) and the General Hospital Kuala Lumpur (GHKL) from March 1997 to February 1998. Demographic and clinical data were analyzed. The analysis showed that 130 out of 182 patients had mucocutaneous disorders (71.4%). In the study there were 125 males (96.2%) and 5 females (3.8%). The majority of the patients were in the age group from 20 to 50 years. The patients who presented with mucocutaneous disease also had low CD4+ T lymphocyte counts, and most of them had AIDS defining illnesses. The number of cases with generalized hyperpigmentation was very high (35.7%), followed by papular eruptions (29.1%) and xerosis (27.5%). Seborrheic dermatitis was seen in 19.2% of the cases and psoriasis in 7.7%. The most common infections were oral candida 35.7%, tinea corporis and onychomycosis 9.9%, and herpes infection 4.3%. However, mucocutaneous manifestations of Kaposi's sarcoma were rare. The results suggested that mucocutaneous findings are useful clinical predictors of HIV infection or a sign of the presence of advanced HIV infection.

Topics: Adult; Disease Progression; Female; HIV Infections; Humans; Malaysia; Male; Medical Records; Middle Aged; Mucous Membrane; Retrospective Studies; Skin Diseases

Mucocutaneous lesions directly related to human immunodeficiency virus (HIV) infection usually present as initial manifestations of immune deficiency. The most common mucocutaneous lesions are Kaposi's sarcoma, histoplasmosis, oro-esophageal candidiasis, oral hairy leukoplakia, and, in Asia, Penicillium marneffei infection. Non-HIV-related skin lesions, such as psoriasis, seborrheic dermatitis, and nodular prurigo, may be the initial presentation among HIV infected patients attending outpatient clinics.. A retrospective analysis was performed on 145 HIV-positive Malaysians of Chinese descent from two centers at the University Hospital Kuala Lumpur (UHKL) and the General Hospital Kuala Lumpur (GHKL) from March 1997 to February 1998. Demographic data and clinical data were analyzed.. The analysis showed that 104 out of 145 patients had mucocutaneous disorders (71.7%). In the study, there were 100 men (96.2%) and four women (3.8%). The majority of patients were in the age group 20-50 years. The patients who presented with mucocutaneous disease also had low CD4+ T-lymphocyte counts and most had acquired immunodeficiency syndrome (AIDS) defining illness. The number of cases with generalized hyperpigmentation was very high in the group (35.9%), followed by nodular prurigo (29.7%) and xerosis (27.6%). Seborrheic dermatitis was seen in 20.7% of cases, with psoriasis in 8.3%. The most common infections were oral candidiasis (35.9%), tinea corporis and onychomycosis (9.7%), and herpes infection (5.5%); however, mucocutaneous manifestations of Kaposi's sarcoma were rare.. The results suggest that mucocutaneous findings are useful clinical predictors of HIV infection or signs of the presence of advanced HIV infection.

Topics: Adult; CD4 Lymphocyte Count; China; Female; HIV Infections; Humans; Malaysia; Male; Middle Aged; Retrospective Studies; Skin Diseases

A review of consecutive biopsies of adnexal tumours from 112 patients, received by the Department of Pathology, University of Malaya, over a 13-year period was undertaken. The age range of the patients was from 1 to 84 years, with a mean of 29.8 years. Thirty-three (32%) patients were under 20 years of age. There were 68 females with a male to female ratio of 1.0:1.5. In 105 cases (93.7%), the neoplasm was solitary. The tumour measured less than 2 cm in the largest dimension in 103 cases (92%). The common sites of occurrence were the head and neck region (59%) and extremities (25%). Neoplasms of hair follicle origin accounted for 63.4% (71 cases) of all lesions. Intra-tumour deposition of amyloid was noted in one of the 14 cases of trichoepithelioma.

Topics: Adolescent; Adult; Aged; Apocrine Glands; Biopsy; Carcinoma, Skin Appendage; Child; Child, Preschool; Eccrine Glands; Female; Hair Diseases; Hospitals, University; Humans; Infant; Malaysia; Male; Middle Aged; Pathology Department, Hospital; Pilomatrixoma; Sebaceous Glands; Skin; Skin Diseases; Skin Neoplasms; Sweat Gland Neoplasms

We report seven cases of Kawasaki disease (KD) who were admitted to Hospital University Sains Malaysia over a period of 8 years. The average age at the time of admission was 29.4 months and four of the children were boys. Five children had all six criteria for diagnosis. Ileus was present in three, and hydrops of the gall bladder and pneumonia in two each, but coronary artery dilatation was seen in only one patient. We also review all the cases of KD reported so far from Malaysia and compare the epidemiological data, clinical course and laboratory findings of the Malaysian patients with those from other parts of the world. The epidemiological and clinical features of Malaysians with KD differ from those seen in Singapore and Japan, but are similar to those seen in Thailand, Australia and North America. The incidence of cardiac complications is low in Malaysians.

Topics: Anti-Bacterial Agents; Aspirin; Cardiovascular Diseases; Child; Child, Preschool; Drug Therapy, Combination; Echocardiography; Female; Hospitalization; Humans; Infant; Malaysia; Male; Mucocutaneous Lymph Node Syndrome; Skin Diseases

Congo red screening of 27,052 routine biopsy specimens from 22,827 patients over a 5 1/2-year period in the Department of Pathology, University of Malaya detected 186 cases of amyloidosis. The categories of amyloidosis encountered and their prevalences in relation to each other were: systemic AL (5.9%); systemic AA (3.2%); isolated atrial (14%); primary localized cutaneous (7.5%); other primary localized deposits (3.2%); localized intratumour (58%); and dystrophic (8.6%). A third of patients with systemic AL amyloidosis had coexistent immunocyte abnormality. The commonest underlying pathology for systemic AA amyloidosis was leprosy. Notable among the types of localized amyloidosis revealed by this study were isolated atrial amyloidosis, which appeared to complicate chronic rheumatic heart disease, and intratumour amyloidosis complicating nasopharyngeal carcinoma. Other tumours in which amyloid deposits were observed included basal cell carcinoma, islet cell tumour and medullary carcinoma of the thyroid. Dystrophic amyloidosis was observed in fibrotic tissues, such as damaged cardiac valves and osteoarthritic joints. Heredofamilial amyloidosis, senile systemic amyloidosis and degenerative cerebral amyloidosis were notably absent from this study.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amyloid; Amyloidosis; Cardiomyopathies; Child; Humans; Immunoglobulin kappa-Chains; Immunoglobulin lambda-Chains; Immunohistochemistry; Malaysia; Microscopy, Electron; Middle Aged; Neoplasms; Potassium Permanganate; Prevalence; Skin Diseases

A review of consecutive biopsies from 85 Malaysian patients with primary localised cutaneous amyloidosis (PLCA) revealed 63 with papular amyloidosis (PA) and 22 with macular amyloidosis (MA). PLCA appeared to affect the Chinese more frequently than the other major ethnic groups but MA was more common than expected among the Indians. Of patients with PA, one had systemic lupus erythematosus, one scleroderma and in another, connective tissue disease was suspected. MA was not found to be associated with any other disease. Histologically, PA differed from MA by the larger size of amyloid deposits in the papillary dermis. There was no difference in their tinctorial and immunohistochemical characteristics. Deposits were permanganate-resistant and negative for AA protein, immunoglobulin light chains and keratin. A few cases exhibited positively for cytokeratin. Strong immunoreactivity for AP protein was observed. PA and MA appear chemically similar and are likely to be of epidermal origin.

Topics: Adolescent; Adult; Aged; Amyloidosis; Child; China; Female; Humans; Immunohistochemistry; Malaysia; Male; Middle Aged; Serum Amyloid A Protein; Skin Diseases

Topics: Acne Vulgaris; Eczema; Humans; Impetigo; Malaysia; Pharmacopoeias as Topic; Pruritus; Rural Health; Scabies; Skin Diseases; Skin Ulcer; Tinea; Urticaria; Warts

Topics: Ascomycota; Female; Hair; Humans; Malaysia; Male; Mycoses; Piedra; Skin Diseases

Topics: Adult; Child; Darier Disease; Delivery of Health Care; Dermatitis; Female; Humans; Ichthyosis; Leprosy; Malaysia; Male; Mycobacterium; Pityriasis; Scabies; Skin Diseases; Sunlight

Topics: Dermatology; Hospital Departments; Hospitals, General; Humans; Malaysia; Skin Diseases

Topics: Bacterial Infections; Cross Infection; Disease Outbreaks; Fingers; Humans; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Medical Staff, Hospital; Nails; Nurseries, Hospital; Skin Diseases; Veillonella

Topics: Abscess; Animals; Bacterial Infections; Humans; Malaysia; Male; Scalp; Skin Diseases; Trematoda; Treponemal Infections