Background Non-scarring alopecia is a common hair disorder with paucity of clinical reviews. Objectives We aim to study the spectrum of non-scarring alopecia, its’ demographic, clinical and treatment pattern among patients at University Malaya Medical Centre. Methodology We have retrospectively reviewed the demography, clinical characteristics and treatment of non-scarring alopecia at University Malaya Medical Centre (UMMC). A total of 154 records were reviewed. Results A majority of patients had alopecia areata (28.6%), followed by androgenetic alopecia (12.3%), telogen effluvium (3.2%), tineacapitis (2.6%) and unspecified hair loss (53.2). Treatment for alopecia areata included topical steroids (53.3%), intralesional steroids (26.7%), topical minoxidil (17.8%), oral steroids (11.1%), oral finasteride (2.2%) and oral azathiopine (2.2%). Prescribed treatment for androgenetic alopecia comprised of topical minoxidil (68.1%) or oral finasteride (10.5%). Conclusion We concluded that alopecia areata was the most common cause of nonscarring alopecia diagnosed at UMMC and deduced that the high number of patients diagnosed with unspecified hair loss was attributed to the lack of confidence amongst out-patient physicians in diagnosing the cause of alopecia.

Porokeratosis is a specific disorder of epidermal keratinization, characterised histologically by the presence of cornoid lamella1. Linear is a distinct, mosaic variant of this autosomal dominant condition. There is a well recognized association between porokeratosis and malignancy, especially the linear variant which has the highest malignant potential2, 3.

An infected pre-auricular sinus presenting as a post-auricular swelling is commonly misdiagnosed as an infected dermoid or sebaceous cyst. It may even mimic a mastoid abscess leading to further unwarranted investigations and interventions. We present a case of a 25-year-old Malay man who was initially diagnosed with recurrent infected dermoid cyst. At presentation, a right post-auricular inflamed swelling was noted with an overlying old incision and drainage scar. An auricular pit was found at the crus of helix. Using a blunt probe inserted along the sinus tract pus was drained without the need for further surgical incision. Six weeks after the acute episode, patient underwent excision of the pre-auricular sinus with no evidence of recurrence at three months follow up. Awareness by the attending physician of this ‘variant type’ of pre-auricular sinus at patient’s first presentation may negate the need for unnecessary incision and drainage which may subsequently impact the outcome of surgical excision and reduce the risk of recurrence.

INTRODUCTION: Cast immobilisation remains the mainstay of treatment for various fractures in paediatric patients, yet patients commonly complain of skin irritation and discomfort. This study aimed to perform a qualitative and quantitative evaluation of the effects of cast immobilisation on the skin of children and adolescents. MATERIALS AND METHODS: Patients aged 6-17 years of age with a fracture treated in a fiberglass short-arm or short-leg cast were recruited. Transepidermal water loss (TEWL), stratum corneum (SC) hydration, hair density and presence of any skin signs were assessed before and after cast. Patients were required to complete a weekly questionnaire to rate itch, malodour, warmth, and dampness of the skin under the cast. RESULTS: A total of 60 subjects completed the study. Thirty-six patients received a short-arm cast; 24 received a short-leg cast. Upon cast removal, TEWL was significantly increased on the volar surface of the arms and legs ( <0.05), and the dorsal surface of the arm ( <0.05). Likewise, SC hydration was significantly increased at most sites ( <0.05), except the volar surface of the leg ( = 0.513). There was no change in hair density. Throughout the duration of casting, there was an increase in itch and malodour scores. CONCLUSION Moderate but significant changes in TEWL, SC hydration and subjective symptoms were observed during the duration of cast immobilisation, demonstrating that cast immobilisation for up to 4 weeks exerts moderate adverse impact on patients' skin. Further studies to explore the use of better materials for cast immobilisation to improve skin barrier function and overall patient satisfaction are warranted.

We retrospectively reviewed the clinical features, management and outcomes of patients diagnosed with basal cell carcinoma (BCC) of the vulva at the Gynaecological Cancer Centre, KK Women's and Children's Hospital, Singapore, between 1 January 2000 and 28 February 2014. Patients with vulvar BCC were identified from the cancer registry, and their medical records reviewed and analysed. A total of 11 patients with vulvar BCC were identified. Mean age at diagnosis was 63 (range 30-85) years. Ethnically, ten patients were Chinese and one was Malay. Average time from onset of symptoms to diagnosis was 13.8 (range 2-60) months. The most common presenting symptoms were lump and pruritus. All patients were managed surgically. Recurrence was noted in only one patient. Vulvar BCC, although rare, has an excellent prognosis when managed appropriately. Histological diagnosis of all persistent papules, plaques and pigmented lesions is important for early diagnosis.