The spectrum of skin diseases seen in a Jamaican tertiary academic medical center.

BACKGROUND: The diversity of skin diseases seen in a dermatology clinic varies with the composition of the population. OBJECTIVE: The aim was to document the spectrum of cutaneous disorders seen and the variation with sex, age, and seasons. METHODS: This was a retrospective study on new patients attending an academic dermatology clinic in Jamaica during 2018. Disease frequencies and prevalence by sex, seasons, and age group were recorded. RESULTS: There were 547 new patients with 329 females (60%) and 218 males (40%). The mean age was 36.8 years, ranging from 2 weeks old to 103 years old. The largest number of patients were in the third decade (20-29 years) (n = 139). More patients presented in the dry season and in spring and summer. The most common diagnoses were: seborrheic dermatitis (n = 65, 11.9%), acne (n = 56, 10.2%), and contact dermatitis (n = 38, 6.9%). The most common disease groups were dermatitis (n = 161, 29.4%), infections (n = 130, 23.8%), and inflammatory disorders (n = 129, 23.6%). LIMITATIONS: The generalizability of our findings may be limited, and selection bias may play a role in patients choosing to attend an academic dermatology clinic. CONCLUSIONS: Skin diseases varied with age, sex, and season with seborrheic dermatitis being most common.

A case of disseminated phaeohyphomycosis caused by Cladosporium devriesii

In 1984, Gonzalez and co-workers reported a new fungus, Cladosporium devriesii. This was obtained from a young woman living in Grand Cayman, and was associated with deep organ involvement. Subsequently, this patient was treated at the University Hospital of the West Indies, Mona. There was no evidence of HIV infection. Following her demise, a full autopsy was performed, and fungal cultures were examined by electron microscopy. This is the first report of disseminated phaeohyphomycosis in the West Indies (AU)

Contact dermatitis: or detective dermatology - abstract

The technique of patch testing is the recognised method of confirming a suspected diagnosis of allergic contact dermatitis. Routinely, a number of tests are applied at the same time - the so-called standard battery. This paper reports on the introduction of standard battery patch testing on 103 consecutive patients tested between March 1986 and December 1987 at the Dermatology Unit of the University Hospital of the West Indies. The North American Standard battery series was used. Forty percent of the 104 patients had positive tests. The commonest allergens were formaldehyde, 7; p-tert-butylphenol formaldehyde resin, 7 (PTBP is an adhesive used mainly in the shoe manufacturing process); nickel, 6; lanolin, 5 (wool fat used as a base for emollient creams and cosmetics), and thuiran, 4 (rubber chemical). The commonest referral diagnosis were eczema of the hands and feet (31/103) either singly or in combination, chronic leg ulcers with surrounding eczema or delayed healing (23/103), and atopic eczema presenting with unusal features (11/103). The highest number of positive tests was found in patients with the diagnosis of eczema of the feet (10/14); 7 of the 10 were allergic to PTBP, the adhesive in their shoes. These results confirm that patch testing is a useful and cost-effective diagnostic tool. Further battery patch testing should be done in Jamaica, as well as in other West Indian islands, with a view to establishing our own standard battery to replace the American one currently being used (AU)

Perirenal abscess and urinary calculus in pregnancy

Urinary calculi complicating pregnancy are an infrequent occurrence. In this paper, we report a case of right-sided pelvi-calyceal calculus in a 25-year-old multiparous woman. She was initially diagnosed as having recurrent right pyelonephritis, and renal angle ultrasound confirmed the presence of a calculus. She later developed a right perirenal abscess which was surgically drained. The clinical presentation and the outcome of the case are discussed in the context of other reports in the literature (AU)

Leptospirosis: a review of the Jamaican experience compared with other Caribbean territories

A review of the current literature relating to leptospirosis and its recent increased incidence in Jamaica has been undertaken. The data up to 1979 revealed that the greatest number of cases occurred in the parishes of Kingston and St. Andrew, St. Thomas, St. Catherine and Manchester. A more recent report, however, has shown that the largest number of cases came from the western parishes. Leptospirosis is an occupational hazard for field and factory workers, and these occupational groups demonstrated the highest incidence of the disease. Control of leptospirosis involves treatment of affected cases and attempts at eliminating carriers (AU)