A study of topical methyl-aminolaevulinate red-light photodynamic therapy in the treatment of actinic keratosis in Chinese patients: a Singaporean experience.

BACKGROUND: The incidence of skin cancers has been increasing in Singapore, owing to the country's location near the equator and its ageing population. Topical photodynamic therapy (PDT) is a treatment method employing light and a topical photosensitizer to treat actinic keratosis (AK). Most published data to date on PDT have been drawn from studies of patient with Fitzpatrick skin phototypes I and II. AIM: To evaluate the effectiveness of PDT in the treatment of AK in patients with skin phototype IV in Singapore. METHODS: This was a retrospective analysis of 13 East Asian patients with AK treated with PDT at the National Skin Centre, Singapore, from 2006 to 2013. RESULTS: The overall clearance rate of AK at 3 months was 81.8% (9 of 11 patients; the other 2 were lost to follow-up). Mild to moderate pain during therapy was a common adverse event. CONCLUSIONS: PDT is a useful treatment method for AK in East Asian patients with skin phototype IV. Further larger prospective studies will be needed to evaluate its overall efficacy in East Asian patients.

Seroprevalence of HSV-1 and 2 among sex workers attending a sexually transmitted infection clinic in Singapore.

We studied the seroprevalence of herpes simplex virus (HSV)-1 and 2 in sex workers attending a sexually transmitted infection clinic in Singapore and examined their knowledge and attitudes towards HSV infection. A total of 300 participants were recruited. Questionnaires were administered and blood was taken and analysed, using the HerpeSelect 1 and 2 Elisa IgG assays (type-specific serological test). HSV-1 serology was positive in 230 (76.7%), negative in 67 (22.3%) sex workers and indeterminate in three (1.0%) sex workers. HSV-2 serology was positive in 237 (79.0%) and negative in 63 (21.0%) sex workers. On univariate analysis, there was significant association between HSV-2 seropositivity and increasing age, nationality (locals) (P<0.001) and marital status (P<0.01). Adjusting for age, marital status and condom use, HSV-2 prevalence increased significantly with duration of years of practice of sex work. Most of the respondents (86.0%) were aware that HSV could be spread through sex without a condom and about two-thirds of them were aware that HSV could be spread in the absence of symptoms. In conclusion, HSV-2 is a common infection among sex workers in Singapore with the risk increasing with years of practice.

Genital herpes in a sexually-transmitted infection clinic in Singapore: a 1-year retrospective study.

INTRODUCTION: This study describes the clinical features of genital herpes seen in a sexually-transmitted infection (STI) clinic in Singapore and the characteristics of the affected population. The distribution of herpes simplex virus (HSV) subtypes within the population, correlation of HSV culture result with duration of disease and prescribing habits of doctors were also examined. MATERIALS AND METHODS: This is a retrospective study of cases of genital herpes seen at the Department of Sexually-transmitted Disease Control (DSC) clinic over a 1-year period. All records of clinically diagnosed HSV genital infections at the DSC clinic in 2001 were retrieved and reviewed and the data collated. RESULTS: There were 324 cases of genital herpes, of which 153 (47.2%) were first-episode and 171 (52.8%) were recurrent HSV infections. There were 259 males and 65 females; their mean age was 35.2 years (range, 17 to 75 years). Of the 241 cases with positive culture results, 28 (11.6%) tested positive for herpes simplex virus type 1 (HSV-1) and 213 (88.4%) were positive for herpes simplex virus type 2 (HSV-2). HSV-1 accounted for 19.3% of first-episode and 4.7% of recurrent infections. HSV-2 accounted for 80.7% of first-episode and 95.3% of recurrent infections. Cultures taken from lesions < or = 4 days, between 5 and 7 days and > 7 days of onset were positive in 79.2%, 75.7% and 75% of cases, respectively. Oral acyclovir was prescribed more commonly in females (53.8%) than in males (21.6%). CONCLUSION: Genital herpes is a common STI seen at the DSC clinic. HSV-2 is the most common cause of genital herpes and accounts for most of the recurrent cases seen.

Viral warts in children seen at a tertiary referral centre.

INTRODUCTION: This study aims to determine the epidemiology of viral warts in children seen at a tertiary referral centre and the treatments used. MATERIALS AND METHODS: This is a retrospective study of viral warts in children aged 12 years and below seen at the National Skin Centre in the year 2000. RESULTS: There were 302 cases of viral warts, 187 (61.9%) in boys and 115 (38.1%) in girls. The greatest number was seen at age 12 and none were noted in those below 1 year of age. The racial breakdown was as follows: 69.9% Chinese, 13.9% Malays, 11.3% Indians and 4.9% of other ethnic groups. Treatment with liquid nitrogen was used most commonly in 267 (88.4%) cases, with a clearance rate of 48.3%. Electrocautery was used in 11 cases with complete clearance in 8 cases. CONCLUSION: Viral warts are common in children, but uncommon in infants. There is no difference in distribution of warts among the races in Singapore. Liquid nitrogen and electrocautery are effective treatments of viral warts in children.