ABSTRACT
Background: Allergic contact dermatitis (ACD) was thought to be infrequent in children. However, there was an increasing number of case reports and cross-sectional studies in the past three decades indicating that ACD is not as rare as previously thought. Understanding the pattern of allergic contact dermatitis in children would help with the diagnosis and prevention of this disease. Aim: This study explored the spectrum of contact allergens in schoolchildren. Methodology: This is a retrospective analysis of all primary and secondary schoolchildren who underwent patch test at the Department of Dermatology, Hospital Selayang, Malaysia between January 2012 and March 2013. Patch tests were performed with European Baseline Series and other additional commercial series from Chemotechnique Diagnostics in IQ chambers. The parameters studied included sites of dermatitis, positive patch test reactions and sources of the allergens. Readings were recorded according to the International Contact Dermatitis Research Group recommendation. Results were analyzed using the SPSS Version 12.0. Results: 84 out of 327 (25.7%) patients who underwent patch tests were primary and secondary schoolchildren. Of the 84 schoolchildren, 60.7% had at least one positive patch test reaction. The most common allergens were preservatives found in cosmetic series (51%), rubber chemicals (47.1%), nickel sulfate (31.3%), fragrances (19.6%) and topical medicaments (19.6%). The majority (86%) of patients with facial dermatitis were positive to allergens in dental series, whereas 41.9% of patients with dermatitis involving the upper limbs and 50% of patients with dermatitis involving the lower limbs had positive patch test to rubber chemicals. Patients with dermatitis involving the trunk mostly had positive patch test to fragrances (50%). Sources of fragrances were mainly found in toiletries, topical medicaments and cosmetics. Discussion: This results of this study were interesting because of the high rate of sensitization to preservatives, mainly paraben mix. There were also high sensitization rates to rubber chemicals, which could be due to contact with rubberized shoes, sports equipment and stationery. Conclusions: Schoolchildren with face, limbs or trunk dermatitis should be patch tested with additional dental, rubber and fragrance series respectively.
ABSTRACT
Background Nursing progress notes in Selayang Hospital was found to be non-compliance according to Malaysian local accreditation bodies in 2007. In June 2008, Department of Dermatology were assigned with dedicated nurses. Aim To look into the quality of monitoring of Dermatology patients by nurses which is reflected by the content in nursing progress notes before and after being taught by Dermatology nurses. Methodology A retrospective comparative audit of the quality of nursing progress notes in ward patients that required Dermatology management in May 2006 and May 2009 in Selayang Hospital was performed. Parameters assessed include the patient’s general condition, skin symptoms and signs, alerting doctor whenever there is change in skin condition and nursing intervention. Exclusion criteria include documentation by the same nurse at different times. Results 325 nursing progress notes were reviewed in 2006 and also in 2009. 70% of nurses described the symptoms and signs of skin lesions at that point of time in 2009 whereas only 5% of nurses did that in 2006. Documentation of intervention performed for the current skin lesions in 2009 and 2006 were 81% and 48% respectively. Only 4% of nurses informed doctor on finding a change in skin condition 2006 as compared to 71% in 2009. Conclusion The audit shows that designated skin nurses can assist the ward nurses to improve their clinical documentation.