ABSTRACT
Background@#Psoriasis can be a presenting feature of human immunodeficiency virus (HIV) infection. Our objective was to determine the frequency of HIV infection among patients with psoriasis and to describe the clinical features, treatment and quality of life in this population.@*Methods@#This is a multi-centre retrospective cross-sectional study of psoriasis patients who were registered to the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018.@*Results@#Of a total of 21,735 patients registered, 105 (0.5%) had HIV infection. Among these patients, 90 (85.0%) were male, mean age was 40.90 ± 10.85 years, and plaque psoriasis was the most frequently encountered presentation (85.7%). Significantly more patients with HIV had severe psoriasis (61.3% vs 49.9%, p=0.043), face and neck (62.7% vs 51.4%, p=0.022) involvement, and nail disease (69.9% vs 56.2%, p=0.005) compared to those without HIV. Only n patients (8.7%) had psoriatic arthropathy, and only 9 (8.8%) received systemic therapy, namely acitretin and methotrexate. None received a biologic, and only one patient was treated with narrowband ultraviolet-B therapy. The mean Dermatology Life Quality Index (DLQI) score at enrolment was 10.98 ± 7.07 for the HIV cohort compared to 8.68 ± 6.60 for the non-HIV cohort (t=2.190, p=0.029). More patients with HIV reported a DLQI score >10 compared to those without HIV (51.5% vs 40.2%, p=0.021).@*Conclusion@#The frequency of HIV infection among patients with psoriasis in the MPR was 0.5%. Patients with HIV had more severe disease, more nail, face and neck involvement, and greater impairment of quality of life. Treatment of HIV patients with psoriasis remains conservative in Malaysia.
Subject(s)
HIV Infections , PsoriasisABSTRACT
Introduction:The Department of Dermatology, Hospital Kuala Lumpur has been providing cutaneous laser therapyservices for over 20 years. We aim to describe the utilization of cutaneous laser therapy at the Departmentof Dermatology, Hospital Kuala Lumpur and the post treatment complications.Methods:We reviewed all patients who received cutaneous laser therapy at the Department of Dermatology, HospitalKuala Lumpur from January 2012 till December 2016. Complications were defined as dyspigmentation,infection, scarring, blisters, ulcerations, skin textural changes or contact dermatitis secondary to post/ pre-lasertopical therapy.Results:A total of 1190 patients with a male to female ratio of 1:2.21 and a mean age of 35.8 years received single,repeated or combination cutaneous laser therapy from 2012 till 2016 for 48 different skin conditions. Annually,an average of 1314 laser sessions were performed. Indications included seborrhoeic keratosis (249, 20.9%),port wine stain (162, 13.6%), solar lentigines (144, 12.1%), syringoma (105, 8.8%), viral warts (88, 7.4%),and Naevus of Ota (82, 6.9%) among others. Majority underwent Q-switched Nd:YAG laser (36.5%) followedby pulsed dye laser (33.6%), ablative conventional carbon dioxide laser (29.2%) and fractional carbon dioxidelaser (0.7%). Over the past 5 years, 3 patients developed severe complication post laser therapy which wasblisters. Pain was tolerable with application of topical 5% EMLA? (lidocaine 2.5% and prilocaine 2.5%) creampre-laser treatment.Conclusion:Q-switched Nd:YAG laser therapy was the most frequently employed laser in the Department ofDermatology, Hospital Kuala Lumpur. Our centre has a high volume of cases with a low rate of posttreatment complication.