ABSTRACT
Background: Atopic Dermatitis (AD) is a chronic relapsing, pruritic inflammation of the skin which is often colonized by Staphylococcus aureus. Antibiotic resistance of S. aureus is a constant challenge for clinicians who manages atopic dermatitis. Aim: To determine S. aureus antibiotic resistance pattern among patients with non-infected atopic dermatitis and its association with disease severity. Methods: One hundred and seventy eight participants (89 AD patients and 89 controls) were recruited from Universiti Malaya Medical Centre (UMMC). Participants were subjected to a questionnaire on demographics, personal and family medical conditions as well as antibiotic administration. AD severity were determined using Scoring Atopic Dermatitis (SCORAD). Skin swab was taken from eczematous lesion in patients and from left forearm in controls. Antibiotic susceptibility towards methicillin, vancomycin, rifampicin, fusidic acid, erythromycin, gentamicin, clindamycin, sulphamethoxazole, cefuroxime and penicillin were determined using disk diffusion method. Results for antibiotic resistance were categorized as none, sensitive and resistant. Results: Colonization of S. aureus in AD were significantly higher than control (p<0.001). Highest antibiotic resistance was reported for Penicillin (32/39, 82.1%), followed by Fusidic Acid (7/39, 17.9%) as well as Clindamycin and Erythromycin (3/39, 7.7% respectively). Two AD patient (5.1%) were resistant to Gentamicin. In addition, 1 AD patient (2.6%) was resistant towards Methicillin, Sulfamethoxazole and Cefuroxime respectively. No antibiotic resistance was reported for Vancomycin and Rifampicin among the AD patients. Conclusion: High resistance were found for Penicillin and Fusidic acid. Their usage and prescription should be reduced to preserve its sensitivity.
ABSTRACT
Introduction Skin cancer is ranked the ninth commonest cancer among males and tenth among females in Malaysia. Objectives To review the pattern of skin cancers at University Malaya Medical Centre (UMMC). Methods This is a retrospective review of all histo-pathological confirmed skin cancers at UMMC from 2004 till 2010. Results Among the 155 patients reviewed, basal cell carcinoma (BCC) was the commonest skin cancer (44.5%), followed by squamous cell carcinoma (SCC) (27.1%) and malignant melanoma (MM) (11.6%). The nodulo-ulcerative subtype made up 46% of all BCC while 50% of MM was of acral lentiginous subtype. Patients with BCC were significantly older (>60 years old), (p=0.003). A majority of skin cancers were found on the head and neck. Conclusion BCC was the commonest skin cancer, with significantly older patients and located mainly on head and neck. MM was the least common skin cancer but associated with the highest mortality.
ABSTRACT
Background: Skin cancer is ranked the ninth commonest cancer among male and tenth among female in Malaysia. Objective: To determine the pattern of skin cancers and demography of skin cancer sufferers in University Malaya Medical Centre (UMMC). Methods: This is a retrospective review of all histo-pathologically confirmed skin cancers in UMMC from 2004 to 2010. Patients with incomplete or missing data were excluded. Results: A total of 155 patient records were reviewed. The commonest skin cancer was basal cell carcinoma (BCC) (44.5%), followed by squamous cell carcinoma (SCC) (27.1%) and malignant melanoma (MM) (11.6%). The other skin cancers included dermatofibrosarcoma protuberans and cutaneous lymphoma (5.2% each), extramammary Paget’s disease 3.2% and Kaposi sarcoma 2.6%. A majority (78%) of BCC was of nodulo-ulcerative subtype while 50% of MM was of acral lentiginous melanoma subtype. BCC had a significantly higher number of patients from the older age group (>60 years old) compared to other skin cancers (p=0.003). SCC had significantly more male patients than other skin cancers (p=0.006). With the exception of MM, a majority of skin cancers were found on the head and neck. Conclusions: BCC was the commonest skin cancer followed by SCC and MM. Patients with BCC were older with a female preponderance and mainly located on the head and neck. MM was the least common of the three major skin cancers, but has the highest risk of metastasis and mortality.
ABSTRACT
Introduction Onychomyosis is a common infection of the nails, caused by dermatophytes, nondermatophyte moulds or yeasts. There are four main types of onychomycosis which include lateral and distal onychomycosis, proximal onychomycosis, superficial white and total dystrophic onychomycosis. We performed a retrospective analysis looking into the recent trends of onychomycosis in a University Hospital in Malaysia. Materials and methods Data was collected from all patients who had their nail clippings cultured for fungal infection from January 2004 to December 2008, and were analysed. Results There were 272 nail specimens in total. The majority of specimens were from adults (65.8%), followed by the elderly (23.9%) and children and adolescents made up 10.3%. The mean age of the study population was 49.9 ± 19SD years. Of the 189 specimens with positive fungal culture, 110 (40.4%) were non-dermatophyte moulds, followed by yeasts predominantly Candida species (17.6%), 3 (1.1%) were dermatophytes, and 28 (10.3%) were a mixed infection of dermatophytes, non-dermatophyte moulds and yeasts. Conclusion From this study, it was found that onychomycosis in our hospital from 2004 to 2008 were mainly caused by non-dermatophyte moulds. Treatment may be challenging as nondermatophyte onychomycosis are more resistant to treatment.