Cutaneous sporotrichosis is a fungal infection caused by traumatic inoculation of Sporothrix. We aimed to study the clinical characteristics of human sporotrichosis, risk factors for infection, the yield of diagnostic methods and therapeutic response to standard clinical therapy. A cohort study of was performed. A total of 29 patients with clinical features suggestive of sporotrichosis were recruited within a one-year period from all public hospitals in Kedah, Malaysia. Majority were females (86%) who were housewives (69%). The most common comorbidities were diabetes mellitus (38%), hypertension (31%) and dyslipidaemia (21%), none was a significant risk factor for severity of infection. Mean duration of disease was 2±2 months. More than 2/3 of the patients (79%) had pet cats, 14(48%) recalled minor cat-inflicted trauma. Lymphocutaneous sporotrichosis (62%) was more common than fixed cutaneous type, affecting the upper limbs in 94%. Ulcerations and nodules were the main lesion morphology. Histopathology showed granulomatous inflammation in 72%, culture grew Sprorothrix in 55% and polymerase chain reaction (PCR) detected Sporothrix schenkii sensu stricto in 65%. Itraconazole was effective with 93% of patients achieving complete resolution with 4 months of therapy. Sporotrichosis in Malaysia remains endemic. Feline contact is the most important risk factor for infection. Diagnosis is best confirmed with tissue PCR while culture and histopathology are also useful. Sporothrix schenkii sensu stricto was the only species identified and itraconazole is an effective first line therapeutic agent.

Introduction: People often judge others and make decisions based on the physical appearance of an individual. This study assesses the perception and psychosocial judgment on patients with acne vulgaris compared to those with clear skin. Methods: This survey was conducted in Penang from October 2016 to June 2017. Respondents were those who were ≥18 years. The survey was conducted using a questionnaire which consists of three randomly selected facial pictures, with at least one acne skin and one clear skin picture. Results: A total of 435 respondents were recruited. Two third of the respondents (76%) suffered or had suffered from acne. The skin was the first thing noticed by 76.1% respondents when viewing pictures with acne compared with 24.8% with clear skin (p <0.05). People with acne were perceived as being unattractive, sad, lonely, distant, unhealthy, disheveled and shy as compared to people with clear skin (p<0.05). People with clear skin were perceived to be healthier, confident, happy, attractive, successful and intelligent (p<0.05). Respondents were more willing to engage socially with people with clear skin rather than those with acne skin. A significantly higher proportion of respondents were likely to hire or vote for those with clear skin as compared to acne skin. People with acne were also perceived to have a lower educational level and poorer leadership quality. Conclusion: The results of this survey showed that there were significantly negative perception and psychological judgement toward individuals with acne vulgaris. These negative impacts may affect social life of the acne sufferers, their prospect of employment and career opportunities.
Acne ; perception ; psychosocial judgement

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.