1.Clinico-epidemiological profile, including body mass index of Malaysian children with psoriasis
Siew Eng Choon ; Chin Fang Ngim ; Premaa Supramaniam ; Kwee Eng Tey ; Nalini Nanu Madhavan
The Medical Journal of Malaysia 2016;71(4):171-176
background: Limited information exists regarding paediatric
psoriasis and its association with body mass index (bMI) in
Asia.
Objectives: to determine the clinico-epidemiological profile
and to compare the bMI of children with and without
psoriasis.
Methods: A case-control study of 92 children with psoriasis
versus 59 with atopic eczema and 56 with non-inflammatory
skin conditions.
results: Psoriasis was more common in Malay and Indian
children when compared to Chinese with odds ratios (Or) of
4.30 (95% CI, 1.85-9.99) and 3.00 (95% CI, 1.02-8.81)
respectively. Prevalence of psoriasis was similar between
Malay and Indian children (Or 1.43, 95% CI, 0.63-3.25).
Male:female ratio was 1:1.09. the mean onset age of
psoriasis was 7.9 years. Median onset age was earlier in
males (6.5 years versus 9.0 years in females, p=0.05).
Plaque psoriasis was the most common phenotype (89.1%)
and 94.5% had scalp lesions. Arthritis was seen in 4.3%.
Odds of excess adiposity, defined as bMI ≥85th percentile,
was higher in children with psoriasis versus noninflammatory
controls (Or 2.35, 95% CI 0.99-5.56, p= 0.052).
No increased risk of adiposity was noted between children
with psoriasis and eczema (Or 1.14, 95% CI 0.5-2.62,
p=0.753). More children with psoriasis (17.4%) and eczema
(20.3%) were underweight (bMI <5th percentile) compared to
non-inflammatory controls (10.7%).
Conclusion: Malays and Indians are three to four times more
likely than Chinese to have psoriasis in multi-ethnic
Malaysia. Plaque psoriasis is the most common phenotype.
Odds of excess adiposity is about two times higher in
children with psoriasis compared to non-inflammatory
controls although this observation just missed conventional
statistical significance.
Psoriasis
2.Clinical characteristics, culprit drugs and outcome of patients with Acute Generalised Exanthematous Pustulosis seen in Hospital Sultanah Aminah, Johor Bahru
Siew Eng CHOON ; Yi Shan DER ; Nai Liang Joel Lai ; Evelyn Sing Ee Yu ; Xiao Ling YAP ; Nalini Nanu MADHAVAN
The Medical Journal of Malaysia 2018;73(4):220-225
Background: Acute generalised exanthematous pustulosis(AGEP) is a rare, cutaneous reaction characterised bysudden onset of numerous, non-follicular, sterile pustuleson oedematous erythematous skin, accompanied by feverand neutrophilia. AGEP is predominantly drug-induced. Skinlesions appear rapidly within 1-3 days of drug exposure andupon drug withdrawal, resolve rapidly within 15 days.Objective: To determine the clinical characteristics, culpritdrugs and outcome of patients with AGEP.Methods: A retrospective note review of all AGEP patientsseen from 2001-2015.Results: Among 21 AGEP patients, 76% were Malays, 9.5%Chinese, 9.5% Indians, and 5% Iban. Sixteen were femalesand 5 were males. Median age of patients was 40 years (IQR:26). The main culprit drug was amoxicillin (10 cases),followed by cloxacillin (three cases), phenytoin (two cases)and one case each of carbamazepine, sulphasalazine,allopurinol, cephalexin, ceftriaxone, celecoxib and herbalproduct. The median time from drug initiation to onset ofAGEP was 3 days (IQR: 5.5). Fever was documented in 52.4%, mucosal involvement 9.5%, purpura 4.7% and blisters4.7%. Neutrophilia was observed in 63.6% of patients andeosinophilia in 28.5%. While most patients requiredadmission (67%), all achieved complete recovery within 15days without any sequela.