ABSTRACT
Background: The association between chronic hepatitis C infection with lichen planus (LP) remains controversial. Geographical and immunogenetic factors may play a role in this association. Objectives: We sought to compare the prevalence of hepatitis C in patients with LP with healthy blood donors at our centre. Materials & Methods: We conducted a retrospective study in Hospital Kuala Lumpur, Malaysia. All patients with biopsy- proven LP who had undergone hepatitis C serology screening from January 2007 to June 2012 were recruited. The prevalence of Hepatitis C seropositivity among healthy blood donors in Malaysia was used as comparison. Results: Thirty five patients with LP were included in the study. Majority of the patients were Indians (71.4%) followed by Malays (14.3%), Chinese (8.6%) and other ethnicity (5.7%). 82.6% of patients had classical cutaneous LP out of which 17% had oral involvement. Anti-HCV was reactive in 2.9% patients. Among the healthy blood donors, anti-HCV was positive in 1.5% of patients. There was no significant difference between the prevalence of hepatitis C seropositivity between the two groups (p=0.431). Conclusion: There is no significant association between chronic hepatitis C infection and LP among our patients. We recommend screening for hepatitis C in LP patients should be limited to those with risk factors.
ABSTRACT
Background: Non-adherence is a major hindrance to treatment success in any disease. In chronic diseases, adherence to long term treatment is about 50% but existing data on adherence to topical treatment in dermatological diseases are limited. In atopic eczema (AE), adherence to topical therapy is essential to control inflammation and maintain adequate moisturization but these treatment aims will not be achieved without optimal adherence. Objectives: To assess the frequency of treatment adherence among our patients with AE and to identify the influencing factors. Methods: We carried out a questionnaire-based study involving dermatology outpatients with AE. Demographic data were collected and patients or carers were interviewed to assess steroid phobia, knowledge, perception on treatment and use of alternative treatment. Results: Out of 75 patients included in the study, only 14.7% were adherent to treatment. 58.7% of patients had steroid phobia but this did not significantly affect adherence. 41% of patients who use alternative treatment had poor adherence compared to patients who did not. Conclusion: Adherence to topical treatment is poor among our AE patients and multi-pronged intervention is needed to improve adherence. For clinicians, non-adherence should be considered when managing patients who appear ‘resistant’ to optimized treatment.
ABSTRACT
Introduction: Photodermatitis had become more common reason for referral to dermatology clinics. In Southeast Asia, research regarding idiopathic photodermatitis is not well established. Photo and photo-patch tests are commonly used diagnostic investigations to support this diagnosis. Objective: To describe the epidemiological and clinical features of idiopathic photodermatitis referred for photo and photo-patch tests. Methods: This retrospective study reviewed the clinical data of patients with idiopathic photodermatitis who were referred for photo and photo-patch tests from January 2009 to July 2011. Patients’ demographics, spectrum of clinical presentations, results of photo and photo-patch tests and clinical outcome were reviewed. Results: 38 patients were included in the analysis. Majority of patients were males. The mean age was 47.2 years. 55.3% were Malays, 26.3% Chinese and 18.4% Indians. Most patients have Fitzpatrick’s skin type IV. The commonest clinical presentations were polymorphic eruptions consisted of erythematous patches, papules and eczema at the sun-exposed areas. On average, the patients have had the cutaneous eruption for more than 1 year prior to the initial clinic visit. 32 patients had photo test and 6 had photo and photo-patch tests. 56.3% had positive photo test and the lowest MED is 50mJ/cm2 in skin type IV. 20% had positive photo and photo-patch tests. Patients were treated with potent topical corticosteroid, physical sunblock and oral antihistamines which managed to control the disease severity. Conclusion: Most patients with idiopathic photodermatitis referred for photo test were middle-aged Malay males with skin type IV. The commonest cutaneous presentations were polymorphic eruptions at the sun exposed sites.
ABSTRACT
Background Leprosy is often complicated by deformities, disabilities and intermittent hypersensitivity reactions. In the course of management, the physical impact of this disease is often assessed thoroughly but its psychological impact and quality of life is often left unaddressed. Objective To assess the effect of leprosy on the quality of life (QOL) among our patients. Methods This cross sectional study was conducted on patients diagnosed with leprosy in Kuala Lumpur Hospital. The patients were interviewed using World Health Organization Quality of Life Assessment - abbreviated version (WHOQOL-BREF) questionnaire which consists of 26 questions exploring four domains: physical, psychological, social relationships and environmental. Patient’s perception towards diagnosis was also assessed. Results Out of the 26 respondents, 19 (73.1%) were males and 7 females with the mean age of 41 years. 84.6% were of Malay descent and 14 (53.8%) patients were foreigners. Twenty three patients (88.5%) were diagnosed multibacillary and 3 (11.5%) had paucibacillary leprosy. Mean QOL scores by domains were: physical 13.0, psychological 12.5, social relationships 13.4 and environmental 14.2. The mean total QOL score among males were 52.9 and 54 for females but the difference was not statistically significant. Fear was the commonest reaction to initial diagnosis. Conclusion Quality of life is reduced among our patients with leprosy. Early detection and treatment can prevent deformities and disabilities but the importance of incorporating counselling and patient education in overall management cannot be overemphasized.