Report of the 11th World Congress of Pediatric Dermatology in Bangkok,Thailand

Abstract: The 11th World Congress of Pediatric Dermatology took place at the Queen Sirikit National Convention Center, Bangkok, Thailand on 17 to 19 November 2009. The theme was “Health and Beauty in Pediatric Dermatology.” This report highlights several presentations discussing hemangiomas, infections, and novel and future diagnostic methods and treatment of pediatric dermatologic conditions. This report is not intended as a substitute for reading the conference educational handouts, online updates and related references quoted in this article.     

2019年中国医学科学院皮肤病医院门诊病种分析

【摘要】 目的 分析2019年中国医学科学院皮肤病医院门诊就诊患者初诊及复诊皮肤病病种。方法 收集2019年1月1日至12月31日中国医学科学院皮肤病医院门诊电子病历信息系统数据,回顾性分析门诊就诊患者初诊、复诊诊断病种。结果 2019年诊疗人次为1 440 580,日均诊疗人次4 332。其中,初诊941 755例,占65.37%;复诊498 825人次,占34.63%。初诊中前10位的病种依次为湿疹、痤疮、荨麻疹、银屑病、脂溢性皮炎、白癜风、神经性皮炎、色素痣、足癣、甲癣,合计739 175人次,占初诊总门诊量的78.49%。复诊中前10位的病种依次是湿疹、痤疮、银屑病、荨麻疹、白癜风、脂溢性皮炎、神经性皮炎、色素痣、瘢痕疙瘩、玫瑰痤疮,合计399 594人次,占复诊总门诊量的80.11%。结论 2019年本院门诊病种以湿疹、痤疮等常见病为主。     

Basal Cell Carcinoma: Seven Years' Experience at the Institute of Dermatology in Bangkok

Sixty-seven patients with basal cell carcinoma (BCC) were observed at the Institute of Dermatology, Bangkok, Thailand between 1982 and 1989. The male:female ratio was 1:2. The average age of the patients at first examination was 60.6 years. Lesions in sun-exposed areas were three times more frequent than lesions in covered areas. The principal location was the face, including the cheek, nose, periorbital area, ears, and forehead. The remainder were on the scalp, breast, abdomen, back, thigh, and knee. Ulceration was the most frequent symptom, followed by a mass. Histopathologically, pigmented BCC was the most frequent, followed by solid BCC, superficial BCC, adenoid BCC, morphoeic BCC, cystic BCC, basosquamous BCC, mixed carcinoma, keratotic BCC, and fibroepitheliomatous BCC. In patients younger than 50 years of age, solid or pigmented tumors were frequent. The morphoeic type was present only on the face and scalp. In females, solid BCC or adenoid BCC predominated. Only 4 of our 67 patients had histories of ingestion of herbal medicine with arsenic as one of the ingredients. Sixty-one patients were treated surgically. There was only one case of tumor recurrence after surgery. The remaining patients were treated by electric cautery, liquid nitrogen, or irradiation. No patients developed distant metastasis.     

Healthcare-seeking behaviours for sexually transmitted infections among women attending the National Institute of Dermatology and Venereology in Vietnam

OBJECTIVES: To investigate the determinants of delay in seeking healthcare for sexually transmitted infections (STIs) among Vietnamese women attending the National Institute of Dermatology and Venereology (NIDV), through assessing to what extent women's sociodemographic backgrounds and their knowledge, attitudes and practices (KAP) relating to STIs/STI prevention influence their delay in seeking healthcare for STIs. METHODS: A face-to-face semistructured interview of 60 women over 18 years old attending the NIDV, who were diagnosed with an STI by clinicians from the NIDV and volunteered to participate in the study. The relationship between demographic and KAP variables and delay (7 days or more between onset of symptoms and seeking care) and the interval of delay were assessed using chi(2), Fisher's exact, Mann-Whitney U and Kruskal-Wallis tests. RESULTS: Of those women reporting delay before first seeking care, 82% delayed by > or =7 days. Women with lower education and from rural or remote areas waited significantly longer before first seeking care than those with higher education and from urban areas. Women who delayed in seeking care knew significantly less routes of STI transmission and engaged significantly more in sex while having symptoms than women who did not delay in seeking care. No relationships existed between delay behaviours and women's income, age or attitudes towards STIs/STI prevention. CONCLUSIONS: Early healthcare-seeking behaviour for STIs could be facilitated through improving women's basic knowledge regarding STIs, changing their sexual behaviour and creating a social support environment for early care-seeking.     

The role of Haemophilus ducreyi in penile ulcers in Bangkok, Thailand

In October 1982, penile ulcers were identified in 248 (19%) of 1282 men at Bangrak Hospital, Bangkok, Thailand. The etiology of the ulcers was determined for 120 (48%) of these patients. Haemophilus ducreyi was isolated from 45 (38%), herpes simplex virus from 14 (12%), and Neisseria gonorrhoeae from two (2%) of 120 patients. Syphilis was detected in one patient. Two patients had both H. ducreyi and herpes simplex virus isolated from the same ulcer. Thirty-five per cent of patients had a single ulcer, 56% had two to four ulcers, and 9% had more than four. Ulcers were located on the prepuce or coronal sulcus (69%), frenulum (18%), shaft (9%), and glans (4%). Inguinal adenopathy was present in only 11% of patients. H. ducreyi infection was diagnosed by gram stain in 28 (62%) of 45 patients from whom H. ducreyi was isolated and in only one of 75 patients from whom H. ducreyi was not isolated. Of the 45 isolates of H. ducreyi, 42 (93%) were isolated with use of media containing horse blood and 34 (76%) with use of media containing rabbit blood.     

Prevalence of antibody to HTLV-III/LAV in a population attending a sexually transmitted diseases clinic

To determine whether HTLV-III/LAV is transmitted to men by heterosexual contact and whether contact with prostitutes plays a role in such transmission, a serosurvey was conducted in clinics for sexually transmitted diseases in New York City. Two hundred ninety-five male heterosexual nonusers of intravenous drugs were studied. Antibody to HTLV-III/LAV was found in sera from ten men (3.4%); this rate is approximately 15 times the prevalence found in healthy blood donors. Seropositivity was associated with serologic evidence of syphilis (odds ratio, 11.2; 95% confidence interval, 2.1-52) and hepatitis B infection (odds ratio, 9.1; 95% confidence interval, 2.0-55). Antibody to HTLV-III/LAV was not associated with self-reported exposure to prostitutes (odds ratio, 0.8; 95% confidence interval, 0.08-4.2). These findings suggest heterosexual transmission of HTLV-III/LAV to men but fail to implicate contact with prostitutes as a mode of such transmission.     

Haematuria presenting in outpatients attending a department of genitourinary medicine.

Of all the patients attending a department of genitourinary medicine during a 10-month period, about 2% (1 out of 50) presented with haematuria, or haematuria was discovered on initial examination. In about 25% of cases, the haematuria was due to Escherichia coli infection of the lower genitourinary tract. Gonococcal infection was the next commonest cause; one patient with gonorrhoea presented with frank urethral bleeding. In the remaining patients other causes of haematuria, which included renal cyst. carcinoma of the ureter, bilharziasis, and IgA disease, required more extensive investigations and follow up.     

Haematuria presenting in outpatients attending a department of genitourinary medicine.

Of all the patients attending a department of genitourinary medicine during a 10-month period, about 2% (1 out of 50) presented with haematuria, or haematuria was discovered on initial examination. In about 25% of cases, the haematuria was due to Escherichia coli infection of the lower genitourinary tract. Gonococcal infection was the next commonest cause; one patient with gonorrhoea presented with frank urethral bleeding. In the remaining patients other causes of haematuria, which included renal cyst. carcinoma of the ureter, bilharziasis, and IgA disease, required more extensive investigations and follow up.     

Ethnic differences in stratum corneum functions between Chinese and Thai infants residing in Bangkok,Thailand

Background/Objectives

Ethnic and racial differences in infant skin have not been well characterized. The purpose of this study was to establish whether there are ethnic differences and similarities in the stratum corneum (SC) functions of Thai and Chinese infants.

Methods

Healthy infants 6 to 24 months of age (N = 60; 30 Thai, 30 Chinese) who resided in Bangkok, Thailand, were enrolled. Transepidermal water loss (TEWL) and SC hydration (capacitance) on the thigh, buttock, and upper arm were measured. Ceramide content was determined in the SC on the upper arm.

Results

SC hydration was not remarkably different between the two ethnicities at any site measured, but TEWL was significantly higher in Chinese infants than in Thai infants at all sites. Hydration of the SC was not significantly correlated with age in either ethnicity. TEWL had significant but weak correlations with age on the thigh and upper arm in Thai infants. Ceramide content was significantly higher in Chinese SC than in Thai SC. No relationship between ceramide content and TEWL or hydration was observed in either ethnicity.

Conclusion

The significant differences in TEWL and ceramide contents between Chinese and Thai infant skin could prove useful in designing skin care and diapering products that are best suited for each ethnicity.     

Occurrence of Demodex in nose follicles of outpatients attending an otorhinolaryngology clinic

The occurrence of Demodex in sebum from nasolabial folds was studied in fifty outpatients attending an otorhinolaryngology clinic. Thirty-one male and nineteen female patients aged fifteen to eighty years were examined. Twenty percent (eight men and two women) showed positive findings, demonstrating one to six parasites per specimen. A higher detection rate was found in older patients, and more mite particles were seen in subjects with otitis media. It is suggested that examination of nasolabial folds may serve as a screening test for the possible presence of Demodex in the ears.     

Prevalence of skin diseases in Ibadan, Nigeria

AIM: To study the pattern of skin diseases in patients attending the skin clinic of the University College Hospital, Ibadan, Nigeria, and to compare our findings with studies performed earlier in the same clinic. PATIENTS AND METHODS: The study involved 1091 new patients who had attended the skin clinic of the University College Hospital, Ibadan, Nigeria, between January 1994 and December 1998. The patients were examined by the authors, and laboratory investigations were ordered when necessary to make a diagnosis. RESULTS: An increased prevalence of eczema, idiopathic pruritus, urticaria, connective tissue diseases, and fixed drug eruptions was observed. Infections, such as scabies, candidiasis, and tinea versicolor, had also increased. Pyoderma, leprosy, onchocerciasis, and dermatophytoses showed a decline. Psoriasis was uncommon, although there was a slight increase in prevalence. Vitiligo and alopecia were stable. Cutaneous tuberculosis, such as lupus vulgaris, was rare. CONCLUSIONS: Allergic conditions have increased; connective tissue disorders, such as systemic lupus erythematosus, scleroderma, and discoid lupus erythematosus, have also increased. Cutaneous disorders associated with human immunodeficiency virus infection, such as seborrheic dermatitis, have increased. Health workers need to be educated on the management and treatment of these conditions, and should be advised to refer patients to appropriate health facilities when necessary.     

American Journal of Dermatology and genito-urinary diseases

Ohne Zusammenfassung

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American Journal of Dermatology and genito-urinary diseases

     

Quality of life of patients with vitiligo attending the Regional Dermatology Training Center in Northern Tanzania

Background Vitiligo is an acquired, predominantly asymptomatic, depigmenting disorder with profound psychological effects. Methods This was a cross‐sectional study conducted at the Regional Dermatology Training Center in Moshi, Tanzania. All 88 patients with vitiligo older than 15 years of age who attended the skin clinic from October 2009 to April 2010 were recruited. Data were collected using a structured questionnaire, Dermatology Life Quality Index questionnaire (DLQI), and Vitiligo European Task Force form. Results Vitiligo moderately affects patient’s quality of life, as indicated by a DLQI mean score of 7.2 ± 4.8. The mean age was 41 years with a male/female ratio of 1:1.7. The mean age of disease onset was 33.5 years (range 16–83 years); vitiligo vulgaris was the most common disease form seen (n = 49). None of the factors considered were found to be significantly associated with impaired quality of life on multivariate analysis. The majority of patients (73.8%) perceived that their disease was moderate to severe in contrast to the clinical grading in which only 49.2% patients were classified as having mild disease. This difference in classification of disease severity was statistically significant (Fishers exact test = 0.001). Conclusion Patients with vitiligo of African descent have a moderate impairment of quality of life.