1.Patch Testing With Preservative Sensitizers. A Year Retrospective Study From Selayang Hospital
Malaysian Journal of Dermatology 2013;30(-):1-6
Abstract
Introduction: Other than nickel, fragrance and rubber, preservatives are well known sensitizers.
Objectives: To study the pattern of preservative allergy among patients patch tested at Patch Test
Unit Selayang Hospital.
Materials & Methods: We conducted a retrospective analysis of the data of all the patients patch
tested with preservative sensitizers present in the European Baseline Series and other commercial
series in Selayang Hospital from January 2011 to December 2011.
Results: 243 patients were patch tested. 28.4% of the patients had a positive reaction to one or more
of the preservative sensitizers. Paraben mix was the most frequently positive allergen (11.8%).
17.8% of the Indians had paraben allergy, as compared to 11.3% of Malays and 11.2% of Chinese.
Females were more significantly associated with a positive reaction to one or more of the
preservative sensitizers (p=0.010). A younger age group (<35) was more significantly associated
with formaldehyde allergy. “Face and upper limbs combined” presentation was significantly
associated with a positive reaction to formaldehyde and methylchloroisothiazolinone/
methylisothiazolinone (p=0.042 and p<0.001 respectively).
Conclusion: Our data differ from most other countries in that paraben mix was the most frequently
positive preservative sensitizer and that younger age group was significantly associated with
sensitization to formaldehyde.
2.Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS):A Review of 21 Cases over 7 years Period from Selayang Hospital
Sook Yee Michelle Voo ; Luk Chin Wong ; Hui Wen Ng ; Rohna Ridzwan
Malaysian Journal of Dermatology 2017;38(June):57-64
Introduction:
DRESS is an uncommon severe cutaneous adverse drug reaction, which is under recognized. In this
review, we aim to study the clinical characteristics of patients with DRESS that presented to our
hospital.
Methods:
We conducted a retrospective analysis on the data of all the patients with DRESS from January 2006
to December 2012 in Selayang Hospital.
Results:
Twenty-one patients were included with median age of 33 and male to female ratio of 1:1. Allopurinol
was the most frequent causative drug followed by anti-tuberculous drugs. The mean latency period
was 28.6 days. All patients had macula-papular rash of which 6 progressed to erythroderma. Liver was
the most frequent extra cutaneous organ involvement with median peak alanine transaminase of 746
iu/l, (range 45-3677) and median peak aspartate transaminase of 632 iu/l (range 30-3136). Six patients
(28.5%) had acute liver failure. The mainstay of treatment was systemic corticosteroid. Mortality rate
was 23.8%.
Conclusion:
DRESS is a severe cutaneous adverse drug reaction with a myriad of clinical presentation and is
associated with mortality. Our series has higher mortality compared to most other reported studies,
most probably due to referral bias. Early recognition is crucial.
3.Prevalence of Peripheral Arterial Disease and Abdominal Aortic Aneurysm among Patients with Acute Coronary Syndrome
Benjamin Dak Keung Leong ; Ariffin Azizi Zainal ; Jitt Aun Chuah ; Sook Yee Voo
The Medical Journal of Malaysia 2013;68(1):10-12
Introduction: Peripheral arterial disease(PAD) and
abdominal aortic aneurysm(AAA) are two important underdiagnosed vascular pathologies. As they share common risk factors with coronary arterial disease, we conducted a study to look at their prevalence among patients with acute coronary syndrome(ACS).
Materials and Methods: Patients with ACS admitted to
Queen Elizabeth Hospital, Malaysia, from February 2009 till
August 2009 were screened prospectively for PVD and AAA.
Patients’ data and clinical findings were gathered and
analyzed. Measurements of ankle brachial index (ABI) and
abdominal aortic diameter were performed by a single
assessor. PAD was defined as ABI ≤ 0.9 or diabetic patients
with signs and symptoms of PAD and absence of pedal
pulses. AAA was defined as abdominal aortic diameter ≥
3cm.
Results: 102 patients were recruited with mean age of 59.5
years old. Male: female ratio was 6:1. 40.2% of patients had NSTEMI; 45.1%, STEMI and 14.7%, unstable angina. Risk
factors profile is as follows: hypertension- 68.6%, smoking-56.9%, hypercholesterolemia- 52.9%, diabetes mellitus-35.3% and history of stroke- 5.9%. Median ABI was 1.1 with lowest reading of 0.4. Mean abdominal aortic size was 2.0cm with largest diameter of 3.3cm. PAD was present in 24.5% of patients and AAA in 2.0%. 68.0% of patients with PAD were asymptomatic. Smoking and age more than 60 years were independent predictors for PAD among ACS patients.
Conclusions: PAD is strongly correlated with CAD with old
age and smoker as independent predictors. However,
association between AAA and ACS could not be established.
5.Quality of life of leprosy patients in Sabah
The Medical Journal of Malaysia 2021;76(1):56-60
Objective: To determine the Dermatology Life Quality Index
(DLQI) among the subtypes of leprosy and to examine
correlation with deformity and lepra reactions.
Methods: This was a cross-sectional study done at
Dermatology Outpatient Clinic, Queen Elizabeth Hospital
and two health clinics in Kota Kinabalu between 1st April
2019 and 30th November 2019. A standardised case report
form was formulated to collect the demographic data and
disease profile of the leprosy patients. The quality of life
(QoL) was assessed using Dermatology Life Quality Index
(DLQI) questionnaire.
Results: A total of 54 patients were included with a male to
female ratio of 2.4:1 (38 males and 16 females). The mean
DLQI score was 8.31±6.15. The difference between the
mean DLQI scores among the leprosy subtypes was not
significant. The most affected domain was symptoms and
feeling followed by daily activities and leisure. Twenty-one
patients (38.9%) had facial deformity and they were found to
have significantly higher DLQI score. WHO grade 1 and 2
disability were observed in 37 patients (68.5%) with higher
DLQI score compared to those without any disability. More
than half of patients with MB leprosy (52.2%) developed
lepra reactions but the difference of mean DLQI scores were
not significant.
Conclusions: Leprosy-related disabilities may predispose
patients to develop psychosocial problems which may have
negative impact on QoL. Thus, periodic assessment of QoL
should be incorporated into the management of leprosy
patients
6.Leprosy in Pregnancy: A Case Series in 4 Dermatology Clinics in Malaysia
Ken Chen LOH ; Min Moon TANG ; Wooi Chiang TAN ; Lee Chin CHAN ; Sook Yee Michelle Voo ; Suganthi THEVARAJAH
Malaysian Journal of Dermatology 2018;40(June):41-48
IntroductionManagement of leprosy in pregnancy is challenging. Here we aim to describe the clinical characteristicsand the management of leprosy in pregnancy.MethodsThis is a retrospective study on pregnant women with leprosy managed in the Department ofDermatology in Hospital Kuala Lumpur, Hospital Pulau Pinang, Hospital Sultanah Bahiyah andHospital Queen Elizabeth between 1994 and 2015.ResultsThere were ten patients with 12 pregnancies with a median age of 27.5 years (range: 16-33). Fivewere foreigners. There were four cases of lepromatous leprosy, two cases of borderline lepromatous,two cases borderline tuberculoid leprosy and one case each for tuberculoid and mid borderline leprosy.Seven pregnancies (58%) were documented to have reactions. Four reversal reactions (33%), threeerythema nodusom leprosum (25%) and two Lucio’s phenomenon (17%) were documented. Bothpatients with Lucio’s phenomenon had undiagnosed leprosy and presented with preterm labour,anemia, oligohydramnios and intrauterine growth restriction. Mortality was recorded in one patientdue to dapsone induced hypersensitivity syndrome complicated with septicaemia. All patients wereprescribed multidrug therapy but in three pregnancies, the patients chose to defer the treatment. Therewas a spontaneous miscarriage at second trimester and a case of early neonatal death. The neonatalcomplications recorded for the 10 live deliveries were low birth weight, jaundice and clofazimineinducedhyperpigmentation.ConclusionThe majority of our patients with leprosy had complications throughout the pregnancies. Earlydetection and prompt treatment can prevent unfavorable fetal outcome & threatened maternal health.