Treatment of Hori's nevus with the Q-switched Nd:YAG laser.

BACKGROUND: Hori's nevus is an acquired pigmented lesion involving bilateral blue-brown facial macules. There has been a dearth of reported treatment modalities for this condition. OBJECTIVE: The purpose of this study was to evaluate the efficacy of the Q-switched Nd:YAG laser for the treatment of Hori's nevus. METHODS: The Q-switched Nd:YAG laser was used to treat Hori's nevus in 66 Asian patients. Patients were treated up to seven times. The follow-up time after the final treatment ranged from 3 to 44 months. RESULTS: Twenty six percent of patients showed good to excellent clearing after one to two treatments. Fifty percent of patients who underwent more than two treatments received good to excellent results. CONCLUSION: The Q-switched Nd:YAG laser can be used to treat Hori's nevus. Results are not as good as those seen with nevus of Ota.

Erbium:YAG laser resurfacing in Asians.

BACKGROUND: Although laser resurfacing has become increasingly popular in the treatment of Caucasian skin, concerns about healing and postinflammatory pigmentary changes have limited its use in Asian skin. OBJECTIVE: The purpose of this study was to determine the efficacy and safety of the Erbium(ER):YAG laser used in the treatment of Asian skin. METHODS: Fifty Asian individuals with Rhytids, scars, pigmentary alteration, and a variety of cutaneous growth were treated with the Erbium:YAG laser. Patients were evaluated for clinical efficacy, wound healing, post-operative erythema, and post-inflammatory pigmentary changes. RESULTS: Significant improvement was noted in all individuals. Shorter periods for re-epithelization and erythema duration were noted when compared to previously reported results following carbon dioxide laser resurfacing. CONCLUSION: The Erbium:YAG laser is safe and effective in the treatment of Asian skin.

Clinical and histopathological features of secondary syphilis.

Fifty-four patients with secondary syphilis were studied in regard to the clinical manifestations, response to treatment and histopathology of the skin lesions. The correlation between the skin lesions and histopathology, between the duration of skin lesions and VDRL titer, between type of skin lesions and VDRL titer were also determined. The clinical manifestations varied from macular, maculopapular, papular, papulosquamous and urticarial lesions. The hair loss usually occurred on the scalp, but the eyebrows or even total body hair loss could occur. The response to treatment was good, only one patient relapsed. The histopathology was related to the clinical manifestations, there was sparse inflammatory cell infiltration in the dermis in macular lesions, but more dense infiltration as well as more epidermal change in papular and papulosquamous lesions. There were significant correlation between the duration of skin lesions and VDRL titer, but no correlation between types of skin lesions and VDRL titer.

Drug resistance of Haemophilus ducreyi.

Chancroid, the disease caused by H. ducreyi is one of the common sexually transmitted diseases (STD) in Thailand and other tropical countries. In Thailand, the diagnosis of chancroid is still based on clinical appearance which may be confused with other STD manifested by genital ulcers. In recent years the increasing resistance strains of H. ducreyi to these antimicrobial agents has been reported so that cultivation and antimicrobial susceptibility tests of this organism have become more important. This study showed that MBV is the best medium for isolation with a success rate of 48%. All strains tested from isolates of this study were resistant to ampicillin, due to production of beta-lactamase. Approximately 99% of the strains were resistant to tetracycline 92% of strains were resistant to sulfamethoxazole and 32% were resistant to trimethoprim. All isolates were susceptible to chloramphenicol, ceftriaxone, erythromycin and the fluorinated quinolones ciprofloxacin, norfloxacin, ofloxacin and pefloxacin. Beta-lactamase enzymes produced by 37 strains of H. ducreyi were determined for their isoelectric point (pI). All had pI of 5.4, indicative of plasmid-mediated beta-lactamase type TEM-1.

Cutaneous leukocytoclastic vasculitis: clinical and laboratory features of 45 patients seen in Ramathibodi Hospital.

Forty-five patients with histologically proved cutaneous leukocytoclastic vasculitis were studied with regard to the clinical features, laboratory findings and etiology. There were 12 males and 33 females, with an age range of 13 to 64 years. The most common skin lesions were palpable purpura which appeared mostly on the lower part of the legs. Renal involvement was the most common systemic manifestation, which occurred in 45 per cent of the patients. Abdominal pain occurred in 42 per cent of the male patients while none of the female patients had this symptom. Arthralgia occurred in 20 per cent of the patients. The most common laboratory abnormalities were elevation of ESR, which was significantly more common in females than in males (P = 0.047). The possible etiology of leukocytoclastic vasculitis was identified in 5 patients, these included streptococcal infection in 2 patients, in the other patients the possible causes were penicillin hypersensitivity, systemic lupus erythematosus and livedoid vasculitis, respectively.

Ofloxacin treatment of nongonococcal urethritis. A multi-center study in Asia.

Ofloxacin, a new quinolone antibacterial agent, is active in vitro against gonococcal and nongonococcal urogenital pathogens. Chlamydia trachomatis infection is the most common cause of nongonococcal urethritis. In a multicenter study in seven Asian countries, 105 mal patients with chlamydial urethritis and 46 male patients with nongonococcal and nonchlamydial urethritis were treated with oral ofloxacin at a dosage of 200 mg twice daily for 5 to 10 days. The evaluation performed at day 5 and/or day 10 after treatment revealed good results in 58.2% and 96.8% of the chlamydial urethritis group, and 73.1% and 79.4% of the nongonococcal, nonchlamydial urethritis group, respectively. No severe side effects were observed. Ten-day treatment with ofloxacin showed good clinical efficacy on nongonococcal urethritis.

Prevalence of chlamydial infection in patients with gonococcal urethritis.

Using a fluorescein labelled monoclonal antibody ("Microtrak") to identify Chalmydia elementary bodies in urethral smears, we detected Chlamydia trachomatis in 32 (26.67%) of 120 male patients after treatment of their gonococcal urethritis. Sixteen of these 32 patients (50%) had normal urethral smear. Only 16 (50%) of the patients yielding chlamydia would have received treatment in the absence of diagnostic service for chlamydial infection.

Penicillin concentrations in cerebrospinal fluid after different treatment regimens for syphilis.

The concentrations of penicillin in the cerebrospinal fluid (CSF) were compared simultaneously with those in the serum in 17 patients with syphilis. The antibiotic concentrations were measured by the agar well diffusion method. There were no detectable concentrations of penicillin in the CSF after administration of benzathine penicillin 2.4 megaunits, benzathine penicillin 7.2 megaunits, procaine penicillin in aluminium monostearate (PAM) 12 megaunits, or aqueous procaine penicillin G 2.4 megaunits. Only after high doses of aqueous penicillin G 24 megaunits daily or aqueous penicillin G 2 megaunits daily together with oral probenecid 2 g daily was penicillin detectable in the CSF. The concentrations after the latter regimen were the highest and much higher than the minimum inhibitory concentration for Treponema pallidum.