Nowaday, the increasing incidence of immunocompromised conditions, especially HIV infections have brough about more opportunistic infections including bacterial, virus and fungus. Some of them rarely occurred previously while some were the problem in endemic areas. Penicillium marneffei is a thermally dimorphic fungus that is thought to be endemic to southeast Asia and southern China. It is capable of causing life-threatening disseminated illness, involving the skin, bone marrow, live, lymph nodes, bones and lungs in immunocompromised and immunocompetent persons. Despite the prevalence in the southeast Asia among AIDS patients, there have been only few reports in dermatology literature.
Asia, Southeastern ; Bone Marrow ; China ; Dermatology ; Fungi ; HIV ; HIV Infections ; Humans ; Incidence ; Lung ; Lymph Nodes ; Opportunistic Infections ; Penicillium ; Prevalence ; Skin

INTRODUCTIONThis study evaluated the knowledge, attitudes and practices of Southeast Asian dermatologists in the management of atopic dermatitis (AD).

MATERIALS AND METHODSA questionnaire survey of 255 dermatologists in Indonesia, Malaysia, the Philippines, Singapore, Thailand and Vietnam.

RESULTSFamiliarity with diagnostic criteria varied considerably. The usage of moisturisers by the respondents from Vietnam and Indonesia was significantly less frequent than the other countries. Most respondents (91% to 100%) used topical corticosteroids in children with mild-to-moderately severe dermatitis. Some respondents in the Philippines (17% to 19%) and Vietnam (11% to 25%) only used topical corticosteroids for severe disease. For infected eczema, most respondents would prescribe systemic antibiotics for mild-to-moderate infection. A minority in the Philippines (14%) and Vietnam (11%) did so only for severe infection. The top 4 systemic antibiotics prescribed most frequently were: erythromycin, cloxacillin, cephalosporin and amoxicillin/clavulanic acid. In Indonesia, a large proportion of the respondents (47%) prescribed amoxicillin most frequently. The majority of respondents (60% to 100%) prescribed both sedating and non-sedating oral antihistamines. Most respondents used oral corticosteroids to treat severe AD. Some in Malaysia, Singapore and Vietnam used cyclosporin (7% to 58%), azathioprine (5% to 31%) and methotrexate (5% to 14%). With the exception of those in Singapore, the majority of respondents (71% to 97%) did not use phototherapy.

CONCLUSIONFamiliarity with diagnostic criteria, the early and judicious use of moisturisers and topical corticosteroids, as well as the treatment of Staphylococcus aureus superinfection with penicillinase-stable antibiotics should be emphasised in this region.

Anti-Bacterial Agents ; therapeutic use ; Asia, Southeastern ; epidemiology ; Dermatitis, Atopic ; diagnosis ; drug therapy ; epidemiology ; Drug Administration Routes ; Glucocorticoids ; administration & dosage ; therapeutic use ; Health Knowledge, Attitudes, Practice ; Histamine H1 Antagonists ; therapeutic use ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Outcome Assessment (Health Care) ; Population Surveillance ; Severity of Illness Index