Management of Atopic Eczema in primary care

@#Introduction: Atopic eczema (AE) is a common infammatory skin dermatosis that is increasing in prevalence. However, it can present in various clinical presentations, which leads to challenges in the diagnosis and treatment of the condition, especially in a primary care setting. Te Clinical Practice Guidelines on the Management of Atopic Eczema was developed by a multidisciplinary development group and approved by the Ministry of Health Malaysia in 2018. It covers the aspects of diagnosis, severity assessment, treatment, and referral.

5 years retrospective study of effectiveness of NBUVB in the treatment of chronic plaque psoriasis in Tuanku Ja'afar Seremban Hospital

Objective The aim of the study is to determine the demographic data of local psoriasis patients treated with NBUVB, their responses and complication to the treatment, factors which affect the effectiveness of NBUVB and duration of remission post treatment. Material and Methods A retrospective analysis of patients with chronic plaque psoriasis treated with NBUVB between January 2005 to December 2009 was conducted at the dermatology clinic, Tuanku Ja’afar Seremban Hospital. Patients’ demographic data and clinical characteristics, concurrent topical treatment, responses to NBUVB, complications and recurrences were reviewed. Results A total of 33 chronic plaque psoriasis patients treated with NBUVB were reviewed. There were 14 female patients and 19 male patients in the group. Their ages ranged from 27 to 78 years old (mean age = 51.8, sd = 12.7). 16 of them were Malays (Fitzpatrick skin phototype IV generally), 12 of them were Chinese (skin phototype III) and only 5 of them were Indians (skin phototype V and VI). The duration of disease before starting phototherapy ranged from 3 to 30 years (mean = 12.3, sd = 6.5). All patients had improvement after phototherapy where 9 of them achieved grade 4 response (complete flattening of plaque), 12 had grade 3 response (complete flattening except border of plaque), 11 had grade 2 response (partial flattening, less scale and erythema) while 1 with grade 1 response(slightly less scale and erythema). Only 1 of the patients had adverse reaction from phototherapy with pruritus post phototherapy. Durations of remission of plaque in response to phototherapy ranges from 1 month to 60 months (mean = 10, sd = 12.9). Conclusion NBUVB is a good treatment option for patients with chronic plaque psoriasis as most of the patients have some remission of plaques. It is safe and well tolerable with only 1 patient from our study had adverse reaction from the treatment.