Background: Although Dermatology is primarily a non-acute, outpatient-centered clinical specialty, some of them require in-patient care for intensive skin management. We aim to describe the demographic data, clinical characteristics, and outcomes of Dermatology inpatients in Hospital Kuala Lumpur (HKL). Methods: This is a retrospective study on all dermatology inpatients in HKL between 2016 and 2020. Data was obtained from admission records and further analyzed. Results: A total of 1567 patients were admitted to the Dermatology ward between 2016 and 2020 accounted for 2292 admissions. The mean age was 45 years (range 8-93). The male to female ratio was 1.16:1. The majority were Malaysian (99.2%). Most Malaysian were Malays (60%) followed by Chinese (19.3%) and Indian (17.1%). About 91% of the admissions were arranged from the dermatology clinic. The mean length of stay was 5.06 days (range 0-63). About 20% of the patients required multiple admissions. The main dermatological diagnosis requiring inpatient care were non-infective dermatoses (60.4%) which included eczematous dermatoses, autoimmune dermatoses, psoriasis, cutaneous adverse drug reactions, inflammatory and non-inflammatory dermatoses. This was followed by cutaneous infections (24.5%) and drug allergy testing & drug provocation tests (7.9%). About 3% of patients were transferred to other departments for further intensive management, and the rest were discharged home well. No mortality occurred in the Dermatology ward. Conclusion The Dermatology ward HKL managed 2292 admissions between 2016 and 2020. The three main dermatological diagnoses requiring intensive skin management were eczematous conditions, cutaneous infections, and autoimmune dermatoses.
Dermatology ; Inpatients ; Hospital Kuala Lumpur (Malaysia)

Background: Adolescents, who aged between 10 and 19 years old, comprise about 20% of the world’s population. They are vulnerable to acquisition of sexually transmitted infections (STIs). Here, we aim to determine the demography and pattern of STIs among adolescents attending Genito-Urinary Medicine (GUM) Clinic, Hospital Kuala Lumpur (HKL). Methods: This is a retrospective study on all adolescents attending GUM clinic between 2014 and 2018. Data was obtained from case notes and further analysed. Results: A total of 111 adolescents attended GUM clinic between 2014 and 2018. The mean age was 18 years (range 12-19). The male to female ratio was 2.26:1. All patients were Malaysian. Only 2 were foreign nationals. The majority were Malays (85.3%) followed by Indians (11%) and Chinese (3.7%). About 46.8% were still schooling, 28.8% were employed and 23.4% were unemployed. About 8.3% had a history of substance abuse. The majority (67.6%) were heterosexual, about 17.1% were homosexual and 3.6% were bisexual. Nearly 95% engaged in unprotected sex. Majority (46%) had casual sex. The most frequent presenting symptoms for male and female adolescents were discharge (43.2%) followed by swelling/growth (23.4%). About 83% had confirmed STIs. The most common STIs among the male were gonorrhoea (44.1%), genital warts (23.4%) and non-gonococcal urethritis (14.7%). The most common STIs among the female were herpes genitalis (50%), genital warts (33.3%) and syphilis (8.3%). Six patients were infected with the human immunodeficiency virus (HIV). Conclusion The most common STI among adolescents between 2014 and 2018 was gonorrhoea for male and herpes genitalis for female.
Sexually Transmitted Diseases ; Adolescent ; Genitourinary Medicine Clinic Hospital Kuala Lumpur (Malaysia)

Background: Oral lichen planus is an idiopathic autoimmune inflammatory condition and oral lichenoid reactions are lesions that resemble oral lichen planus clinically and histopathologically, but develop secondary to various underlying causes. Oral lichenoid reactions have been reported to be caused by contact allergy to dental materials. This study aims to describe the characteristics of patients with a clinical and/or histopathological diagnosis of oral lichen planus who underwent patch testing in Hospital Kuala Lumpur, Malaysia. Methods: This is a 5-year retrospective study of patients who had oral lichen planus and had undergone patch testing at the Department of Dermatology, Hospital Kuala Lumpur, Malaysia between January 2015 and Cecember 2019. Patch tests were performed with European Baseline Series and relevant extended series, which include dental and metal series as well as patients’ own products. Patch test results were recorded according to the International Contact Dermatitis Research Group recommendation. Results: There were 41 patients with oral lichen planus who underwent patch test. The median age was 56 (range 21 to 73) with 70.7% of patients being female. There were 29 (70.7%) patients who developed at least one positive reaction. The most frequent sensitizing allergens were nickel sulfate (34.1%), gold(I)sodium thiosulphate dihydrate (22.0%), fragrance mix I (19.5%), cobalt chloride (14.6%), Peru balsam (12.2%) and sodium tetrachloropalladate (II) hydrate (12.2%). Current relevance was recorded in 16 patients (39.0%) and of these patients, 12 of them had positive patch test reactions to allergens found in dental materials such as dental fillings, dental implants, orthodontic braces, dentures and dental crowns. Conclusion Contact sensitization was detected in about 70% of our patients with oral lichen planus. The most common sensitizing allergen was nickel sulfate. Current relevance was found mainly towards dental materials.
Lichen Planus, Oral--diagnosis ; Dermatitis, Allergic Contact ; Department of Dermatology, Hospital Kuala Lumpur (Malaysia)

Thalassemia prevalence in Malaysia is highest in Sabah. This study was conducted to characterize the demographic and socioeconomic profile of transfusion-dependent β-thalassemia major patients in Sabah, to explore their parents’ background, and to identify factors associated with having more than one thalassemia major children in the family. Methods: This was a cross-sectional study conducted in Hospital Wanita dan Kanak-Kanak Sabah and Hospital Kota Belud Sabah between February 2018 and Jun 2019. A total of 108 patients attending Thalassemia Treatment Clinic at both centers were selected randomly for interview. Results: β-thalassemia major patients in this study were majority from the indigenous ethnic groups (Kadazan, Dusun, Murut, Rungus, Sungai). Parents of the thalassemia patients mostly had low education level and socioeconomic status. Thirty-seven percent of parents have more than one children with thalassemia major and a high proportion (41.7%) have intermarriages. Parents with a higher number of children in the family are associated with having more than one thalassemia major children (OR: 2.1, 95% CI: 1.5, 2.9, P-value = 1.3 x 10-5). Conclusions: A considerably high proportion of parents have more than one children with thalassemia major in this study. Knowledge and counselling are important to parents with low educational level and socioeconomic status to ensure their understanding of thalassemia risk and prevention
Hospital Queen Elizabeth II, Ministry of Health Malaysia, 88300, Kota Kinabalu, Sabah, Malaysia 2 Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200, Kepala Batas, Pulau Pinang, Malaysia 3 Hospital Wanita dan Kanak-Kanak Kuala Lumpur, Ministry of Health Malaysia, 50586, Kuala Lumpur, Malaysia 4 Hospital Wanita dan Kanak-Kanak Sabah, Ministry of Health Malaysia, 88996, Kota Kinabalu, Sabah, Malaysia 5 Hospital Kota Belud, Ministry of Health Malaysia, 89158, Kota Belud, Sabah, Malaysia

The National Blood Center, Kuala Lumpur interprets laboratory results for the von Willebrand factor (VWF) profile based on guidelines which were established based on the Caucasian population. The VWF profiles among the Malay population has not yet been established. The current study aims to determine the VWF profiles of the different ABO blood types among Malays and to evaluate their association with demographic characteristics and smoking habits. Methods: One hundred and forty Malay donors were involved. Factor VIII (FVIII:C), VWF antigen (VWF:Ag), and ristocetin cofactor (VWF:RiCof) levels and collagen binding activity (VWF:CBA) were measured by coagulometric clot detection, latex agglutination, and enzyme-linked immunosorbent assay. Results: The majority of donors (59.3%) were 30–49 years old, male (81.43%), non-smokers (74.3%), and overweight (71.4%). The Malay VWF:Ag were slightly higher than those of Caucasians, Indians, Thais, and Chinese, but the average ratios of VWF activity (i.e., VWF:RiCof level and VWF:CBA) to VWF:Ag were slightly lower than those of the other populations. The highest level of VWF:Ag was found among those with the B blood group, followed by types A and O. Conclusion: Malays with type O blood had lower values of the components of the VWF profile compared to subjects with non-O blood. The higher levels of these elements and lower VWF activity to VWF:Ag ratio in Malays compared to other populations suggest that ethnicity impacts the plasma VWF levels and their interaction with collagen and platelets.
Medical Transfusion Unit, Pathology Department, Hospital Sultan Ismail, Johor Bahru, Malaysia. 2 National Blood Center, Jalan Tun Razak, 50400, Kuala Lumpur, Malaysia. 3 Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Pulau Pinang, Malaysia