Hand dermatitis is commonly seen in primary care, although it is often underdiagnosed. Exogenous causes should always be considered and a detailed environmental and occupational history taken, especially in patients presenting in adulthood. Although not life-threatening, the condition may have significant impact on the patient's quality of life and employment. Refractory cases or those suspected to be due to exogenous workplace agents may need to be referred for further investigation. Hand dermatitis can be treated effectively using pharmacotherapy and prevented by minimising subsequent exposure to irritants and allergens. Occupational skin disorders, once diagnosed, should be notified to the relevant authorities, i.e. the Ministry of Manpower in Singapore.
Adult ; Dermatitis, Irritant ; diagnosis ; Dermatitis, Occupational ; diagnosis ; therapy ; Eczema ; diagnosis ; therapy ; Female ; Hand ; pathology ; Humans ; Occupational Diseases ; diagnosis ; therapy ; Primary Health Care ; methods ; Singapore

PURPOSE: There are only a few reports of extramammary Paget disease (EMPD) of the external genitalia because it is a rare malignancy. We investigated patients with EMPD of the penis and scrotum and report the outcome of surgical management. MATERIALS AND METHODS: From 2000 to 2012, a total of 19 patients diagnosed as having penile and scrotal EMPD underwent wide local excision with or without intraoperative frozen biopsy or preoperative mapping biopsy. The medical charts of these patients were reviewed and analyzed retrospectively. Mean follow-up was 22.5 months (range, 1 to 60 months). RESULTS: The mean age of the patients was 68 years (range, 57 to 82 years). In some patients, the lesions were misdiagnosed as either eczema or some other benign skin lesion at outside institutions, with a mean delay in diagnosis of 43.5 months (range, 1 to 198 months). Intraoperative frozen biopsy or preoperative mapping biopsy was performed in 18 patients. The resection margin was negative in 9 patients (47.4%) and positive in 10 patients (57.6%). Intraepithelial EMPD without dermis invasion was observed in 5 patients (26.3%), whereas diseases with dermis invasion were noted in 14 patients (73.7%). During the follow-up period, recurrences occurred in four patients, and two patients with dermis invasion and recurrence died from the disease. CONCLUSIONS: Diagnosis of EMPD should not be delayed to allow for prompt management. Our findings suggest that intraoperative frozen biopsy or preoperative mapping biopsy cannot guarantee negative margins on final pathology. However, preoperative mapping biopsy and wide local excision with intraoperative frozen biopsy demonstrates good prognosis of EMPD, especially in those cases without dermal invasion.
Biopsy ; Dermis ; Diagnosis ; Eczema ; Follow-Up Studies* ; Genitalia* ; Humans ; Male ; Paget Disease, Extramammary* ; Pathology ; Penis ; Prognosis ; Recurrence ; Retrospective Studies ; Scrotum ; Skin

OBJECTIVE: To observe therapy efficacy of external auditory canal eczema by deeply injecting compound betamethasone and benzathine penicillin into patients muscles. METHOD: Sixty patients were randomly divided into two groups. In the treatment group 30 patients were deeply injected compound betamethasone injection 1 ml and benzathine penicillin 1 200 000 U into muscles on their hips both sides one times. In the control group 30 patients were given desloratadine 5 mg orally one times a day and amoxicillin capsules 0.5 mg orally three times a day, both kinds of medicine were continuously taken for one week. No other medication was used during the treatment of two groups, keeping skin clean and dry, and judge therapy efficacy after one week. RESULT: The cure rate was 60.00% and the total efficiency was 96.67% in the treatment group; the cure rate was 26.67% and the total efficiency was 73.33% in the control group. Compare with cure rate of two groups, chi2 = 6.67, P < 0.01, in which there was significant difference. Compare with total efficiency of two groups, chi2 = 4.71, P < 0.05, in which there was also significant difference. The therapy effect started in two hours quickly and in three days slowly in the treatment group, an average of 0.5 days. The therapy effect started in two days quickly and in five days slowly in the control group, an average of 2.5 days. CONCLUSION The method of the treatment group is simple, quick, effective and without adverse reaction.
Adolescent ; Adult ; Betamethasone ; therapeutic use ; Drug Therapy, Combination ; Ear Canal ; pathology ; Eczema ; drug therapy ; Female ; Humans ; Injections, Intramuscular ; Male ; Middle Aged ; Penicillin G Benzathine ; therapeutic use ; Young Adult

Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 +/- 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Demography ; Eczema/pathology ; Face/pathology ; Female ; Humans ; Lupus Erythematosus, Cutaneous/pathology ; Male ; Middle Aged ; Psoriasis/pathology ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Tinea/*diagnosis/microbiology ; Trichophyton/isolation & purification ; Young Adult