A Practical Approach to Genital Growths and Rashes

Genital rashes and growths are not uncommon and sometimes uncomfortable reasons for seeking medical attention. It is important to make the correct diagnosis after a tactful history and a meticulous examination. The diagnosis is usually clinical; near-patient investigations may be required to confirm it but may not be easily available or convenient. Patients often fear they may have been infected with a sexually transmitted infection (which should be excluded) or even a malignancy which often heightens their anxiety. Physicians should be familiar with normal and variants of anatomy and the genital specific symptoms and signs of common conditions and their respective management aspects.

Melanoma: differences between Asian and Caucasian patients

<p><b>INTRODUCTION</b>Cutaneous melanoma is rare in Asia and the clinical presentation and outcome of melanoma is not well described in Southeast Asia. In addition, it is unclear if ethnic variations exist between the various racial groups. The objective of our study is to present the clinical characteristics of melanoma in Singapore and to highlight ethnical differences between Asians and Caucasians living in Singapore.</p><p><b>MATERIALS AND METHODS</b>Data were retrospectively collected from 48 patients with histological confirmation of melanoma who were seen in both the National Skin Centre and National Cancer Centre of Singapore.</p><p><b>RESULTS</b>Acral lentiginous melanoma (ALM) was the most common subtype of melanoma in Singapore (50%). A higher proportion of non-ALM subtypes of melanoma compared to ALM were diagnosed at stage 1 (48% vs. 25%). The delay in diagnosis of ALM was 27 months compared to 12 months in other subtypes. Compared to Caucasians, there was a trend towards Asian patients being older, having a higher proportion of ALM and a longer delay to diagnosis.</p><p><b>CONCLUSION</b>Geographical and ethnic variations in the clinical presentation of melanoma exist. Specially adapted programmes are necessary to increase awareness of the different clinical presentation of melanoma in Asia and to encourage examination of the palms and soles in order to reduce the delay in diagnosis.</p>

Rising trends of STIs and HIV infection in Singapore-- a review of epidemiology over the last 10 years (1994 to 2003)

<p><b>INTRODUCTION</b>This is a review of the epidemiology and trends of sexually transmitted infections (STIs) in Singapore from 1994 to 2003.</p><p><b>MATERIALS AND METHODS</b>Data collated for both notifiable and non-notifiable STIs from 1994 to 2003 were analysed. This data consisted of STI notifications from medical practitioners in Singapore as well as from the Department of STI Control clinic itself.</p><p><b>RESULTS</b>There was a decline in the overall STI incidence in Singapore in the first half of the last decade from 215 cases per 100,000 population (7,200 cases) in 1994 to 162 cases per 100,000 population (6,318 cases) in 1999, followed by an increasing trend in the number of acute STIs (both bacterial and viral) over the past 5 years to 195 cases per 100,000 population (8,175 cases) in 2003 (P <0.001). The incidence of HIV has risen sharply over the last decade whilst that of other viral STIs has not decreased. Singaporeans are becoming sexually active at a younger age, with casual partners constituting the main primary contacts.</p><p><b>CONCLUSIONS</b>Although there has been a significant decline in the overall incidence of STIs in Singapore over the last decade, a rise in acute STIs over the last 5 years has resulted in the need to identify the causal factors, and to intensify existing as well as develop new STI/HIV prevention programmes for the general population and certain core groups.</p>