RESUMEN
Allergens of Dermatophagoides and Blomia species are well-characterized but not for other species. This study was conducted to determine the prevalence of allergic sensitization to house dust (HDM) and storage mites (SM). One hundred adult subjects (aged > 18) were recruited. The mite specific IgE of all allergic subjects were higher compared with healthy subjetcs despite being not statistically significant except for D. farinae and G. malaysiensis. The mean serum IgE levels against HDM and SM for allergic subjects were significantly higher compared with those in healthy subjects. They were mainly sensitized to Dermatophagoides farinae (35%) and Glycycometus malaysiensis (37%). Immunoblots revealed not all allergic subjects showed positive immuno-reactivity against the mites tested. Single or multiple bands were observed for different species. The subjects were commonly sensitized to Group 2 (9-12 kDa), 10 (38 kDa) and 18 (40-48 kDa) allergens. Twenty-one out of 60 allergic subjects were sensitized to either one or more species. The majority of them (71%) were sensitized to single species. The allergic subjects were mainly sensitized to D. pteronyssinus, followed by Tyrophagus putrecentiae and Aleuroglyphus ovatus. Seven were solely sensitized to HDM while 10 were solely sensitized to SM. Four subjects were sensitized to both. Preadsorption study revealed no cross-reactivity. There was difference between the prevalence and reactivity to allergens of HDM and SM in these subjects. Both ELISA and immunoblot did not correlate well but can complement each other in improving the detection of mite allergens to the species level.
RESUMEN
Objectives To evaluate the efficacy and safety of tacrolimus ointment 0.1% in adult and 0.03% in pediatric patients with moderate to severe atopic dermatitis in Malaysia. Methods This is an open-labeled and single arm multi-center study. 36 adult and 37 pediatric patients were enrolled. Tacrolimus ointment is applied twice daily for four weeks. The primary efficacy outcome is based on the Physician’s Global Evaluation of Clinical Response (PG) at Week 4. The secondary efficacy outcomes are Eczema Area and Severity Index (EASI) score, changes from baseline in individual scores of signs and symptoms and body surface area affected and Patients Assessment of Treatment Effects. Results Overall success rate were 97.1% and 91.2% in the adult and pediatric groups respectively. The decline in EASI, percentage of total BSA affected and patient’s assessment of pruritus were significant (P<0.001). Of adults and pediatric patients, 97.2% and 75.7% respectively reported adverse effect. The most common adverse effect reported was skin burning sensation in 91.7% adult patients and pruritus in 67.6% pediatric patients. Conclusion Tacrolimus ointment 0.1% in adult and 0.03% in pediatric patients is effective for the treatment of moderate to severe atopic dermatitis in Malaysia.
RESUMEN
Cutaneous tuberculosis is an old and rare infectious disease. Laennec reported the first case of cutaneous tuberculosis in 1826 and M.tuberculosis was discovered by Koch in 18821. Since then, many cases of cutaneous tuberculosis have been described and classified. The different forms of diseases correlate with the immunologic status of the host, host’s prior sensitization, route of disease transmission, layer of skin primarily involved and rate of disease progression. Nevertheless, the most widely accepted classification is based on the mechanism of disease propagation which can be via direct inoculation, through contiguous infection or via hematogenous route2. Bacterial load has also been used to categorize this disease into multibacillary and paucibacillary forms. Diseases under the multibacillary forms include primary inoculation tuberculosis (tuberculous chancre), scrofuloderma, tuberculous perioficialis, acute miliary tuberculosis and tuberculous gumma. Paucibacillary forms include lupus vulgaris, tuberculosis verrucosa cutis and tuberculids. Strains of M. Tuberculosis complex that can be isolated include M.tuberculosis, M. africanum, M. canetti and M. bovis, M. microti and M.bovis BCG.
RESUMEN
Pemphigus is an autoimmune blistering disease characterized by circulating autoantibodies directed against the keratinocyte cell surface. Majority of patients with pemphigus develop the disease spontaneously. However, there is a small group of patients who develop pemphigus after treatment with certain medications, of which Dpenicillamine (DPA) and captopril are the best documented. We report a case of DPA-induced pemphigus vulgaris in a young Chinese lady treated with DPA for Wilson disease.
RESUMEN
Sweet’s syndrome was first described by Dr. Robert Douglas Sweet in 19641. It was originally described as an ‘acute febrile neutrophilic dermatosis’1. There are primarily three subtypes of Sweet’s syndrome, ie. classical Sweet’s syndrome, malignancy-associated Sweet’s syndrome and drug-induced Sweet’s syndrome.We are reporting a case of classical Sweet’s syndrome in a 47-year-old man.