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Bullous contact allergy from cinnamon

Goh CL, Ng SK

Derm Beruf Umwelt, 1988 Nov-Dec;36(6):186-7.
PMID: 3069433

A young Malay female presented with a bullous eruption as a manifestation of contact allergy to cinnamic aldehyde in cinnamon. The clinical and histological features resembled bullous pemphigoid but immunological markers for pemphigoid were absent. The patient responded to a short course of oral steroids. Contact allergy can mimic pemphigoid.
Hepatitis B virus markers in prostitutes in Singapore

Goh CL, Kamarudin A, Chan SH, Rajan VS

Genitourin Med, 1985 Apr;61(2):127-9.
PMID: 3980022

The prevalence of hepatitis B virus markers in 121 men and 239 women prostitutes was studied. Of 33 (9.7%) with hepatitis B surface antigen (HBsAg), nine (27.3%) also had hepatitis Be antigen, which was more prevalent in men than women. Antibodies to HBsAg (anti-HBs) and to hepatitis B core antigen (anti-HBc) were found in about 71% of men and women prostitutes. Hepatitis B virus markers were more prevalent in men than in women prostitutes. Compared with other people, prostitutes had a significantly greater prevalence of hepatitis B virus markers. This study strongly suggested the importance of sexual transmission of infection with hepatitis B virus in a country where infection is endemic.
Adsorptive behaviour of palm oil mill sludge biochar pyrolyzed at low temperature for copper and cadmium removal

Goh CL, Sethupathi S, Bashir MJ, Ahmed W

J Environ Manage, 2019 May 01;237:281-288.
PMID: 30802752 DOI: 10.1016/j.jenvman.2018.12.103

In this work, the influence of pyrolysis temperature on the physicochemical properties of palm oil mill sludge biochar (POSB) and its adsorption properties towards cadmium (Cd) and copper (Cu) was investigated. Characterization experiments suggested that POSBs' surface functional groups play the major role in the adsorption process. POSB pyrolyzed at 400 °C showed the best characteristics for Cu and Cd removal. Adsorption study indicated that contact time and shaking speed enhances the adsorption capacity of POSB. It was affirmed that pH adjustment is not necessary for POSB to adsorb Cu and Cd. Mechanism studies fitted well with Langmuir and Pseudo-Second Order model. Thermodynamic parameters indicated that the adsorption was spontaneous, endothermic and correspond to chemical adsorption. The highest uptakes of Cu and Cd were recorded at 48.8 mg/g and 46.2 mg/g respectively. This work verifies that the temperature used for palm oil mill sludge (POS) pyrolysis and adsorption condition played the most prominent role in Cu and Cd removal from aqueous solutions.
The prevalence and descriptive epidemiology of atopic dermatitis in Singapore school children

Tay YK, Kong KH, Khoo L, Goh CL, Giam YC

Br J Dermatol, 2002 Jan;146(1):101-6.
PMID: 11841373

BACKGROUND: Atopic dermatitis is a common disease that appears to be increasing in frequency during recent decades. Most of the studies are based on the Western population, and there are few data in the Asian population.
OBJECTIVES: To determine the prevalence and descriptive epidemiology of atopic dermatitis among school children in the general community in Singapore.
METHODS: This is a questionnaire study of 12 323 students done over a 1-year period, comprising 7 year olds (4605), 12 year olds (3940) and 16 year olds (3778) from 19 primary and 17 secondary schools randomly selected in Singapore. All children had a complete cutaneous examination. The diagnosis of atopic dermatitis was based on the U.K. Working Party diagnostic criteria. The questionnaire was translated into Chinese and both the English and Chinese versions were issued simultaneously to the students.
RESULTS: The 1-year period prevalence of atopic dermatitis was 20.8%. Atopic dermatitis was present in 22.7% of 7 year olds, 17.9% of 12 year olds and 21.5% of 16 year olds. The overall sex ratio was equal. There were slightly more boys with atopic dermatitis among the younger children (6 and 12 year olds, 1.18 : 1 and 1.19 : 1, respectively) but more girls were affected (1.57 : 1) among the 16 year olds. Atopic dermatitis was more common among the Chinese (21.6%) and Malays (19.8%) compared with the Indians (16%) and other races (14%). The onset of the disease occurred before the age of 10 years in 49.5% of the 16 year olds. "Pure" atopic dermatitis without concomitant respiratory allergies was noted in 788 respondents (30.7%); 1775 (69.3%) suffered from a "mixed" type, with 34.3% having allergic rhinitis, 9.5% having asthma and 25.5% having both asthma and allergic rhinitis. More boys had atopic dermatitis and concomitant respiratory allergies whereas more girls were affected with "pure" atopic dermatitis alone (1.4 : 1). At least one first-degree family member with atopy was noted in 1435 children (56%): atopic dermatitis (70%), asthma (62%) and allergic rhinitis (68%). Among siblings with one parent with atopic dermatitis, 37% had either a father or a mother with atopic dermatitis. Common aggravating factors reported included exercise, heat and sweating, grass intolerance, thick clothing and stress. Pityriasis alba was noted in 25% of the study population, keratosis pilaris in 13% and ichthyosis vulgaris in 8%. Most respondents had mild to moderate atopic dermatitis that could be controlled with a fairly simple regimen of moisturizers, topical steroids, antihistamines and antibiotics.
CONCLUSIONS: The high prevalence of atopic dermatitis in Singapore is similar to that observed in developed countries, suggesting that environmental factors may be important in determining the expression of the disease.
Optimization of activated palm oil sludge biochar preparation for sulphur dioxide adsorption

Iberahim N, Sethupathi S, Goh CL, Bashir MJK, Ahmad W

J Environ Manage, 2019 Oct 15;248:109302.
PMID: 31377539 DOI: 10.1016/j.jenvman.2019.109302

Palm oil sludge (POS) is an organic waste generated from the palm oil industry. POS causes environmental pollution if it is improperly disposed. In this study, the potential of activated POS biochar, as an adsorbent for the removal of SO2 gas was tested. POS biochar was physically activated using CO2 gas. The effects of activation preparation variables i.e. activation temperature (300-700 °C), activation time (30-150 min) and CO2 flow rate (100-500 ml/min) were investigated using design expert version 8.0.7.1 software. Central Composite Design (CCD) was used to develop a quadratic model to correlate the operating variables with the activated biochar adsorption capacity. Analysis of variance (ANOVA) was performed to identify the significant factors on the experimental design response. The optimum preparation conditions of activated POS biochar were found to be at activation temperature of 442 °C, activation time of 63 min and CO2 flow rate of 397 ml/min. The maximum adsorption capacity at the optimum conditions was recorded as 16.65 mg/g. The adsorption capacity increased significantly after the activation process. Characteristics of the activated POS biochar proposed that SO2 was physically adsorbed. Furthermore, it was found that the adsorption capacity can be further enhanced by increasing the reaction temperature to 100 °C or with 15% of relative humidity in the inlet gas. The prepared adsorbents can be regenerated by thermal treatment.
Frequency and characteristics of acne-related post-inflammatory hyperpigmentation

Abad-Casintahan F, Chow SK, Goh CL, Kubba R, Hayashi N, Noppakun N, et al.

J Dermatol, 2016 Jul;43(7):826-8.
PMID: 26813513 DOI: 10.1111/1346-8138.13263

In patients with darker skin types (Fitzpatrick phototypes III-VI), acne is often accompanied by post-inflammatory hyperpigmentation (PIH). Further, acne-related pigmentation can pose a greater concern for the patient than the acne lesions. There has been little formal study of this acne-related PIH. Recently, the Asian Acne Board - an international group of dermatologists with interest in acne research - made a preliminary evaluation of the frequency and characteristics of PIH in seven Asian countries. A total of 324 sequential acne subjects were evaluated for the presence of PIH. The majority (80.2%) of subjects had mild to moderate acne and there were more females than males (63.0% vs 37.0%). In this population of patients consulting a dermatologist for acne, 58.2% (188/324) had PIH. The results also showed that pigmentation problems are often long lasting: at least 1 year for more than half of subjects and 5 years or longer in 22.3%. In accordance with our clinical experience, patients reported that PIH is quite bothersome, often as bothersome or more so than the acne itself and sometimes more problematic. Excoriation was commonly reported by patients, and may represent a modifiable risk factor that could potentially be improved by patient education.
Fulltext South-East Asia study alliance guidelines on the management of acne vulgaris in South-East Asian patients

Goh CL, Abad-Casintahan F, Aw DC, Baba R, Chan LC, Hung NT, et al.

J Dermatol, 2015 Oct;42(10):945-53.
PMID: 26211507 DOI: 10.1111/1346-8138.12993

The management of acne in South-East Asia is unique, as Asian skin and local variables require a clinical approach unlike that utilized in other parts of the world. There are different treatment guidelines per country in the region, and a group of leading dermatologists from these countries convened to review these guidelines, discuss current practices and recent advances, and formulate consensus guidelines to harmonize the management of acne vulgaris in the region. Emphasis has been placed on formulating recommendations to impede the development of antibiotic resistance in Propionibacterium acnes. The group adopted the Acne Consensus Conference system for grading acne severity. The group recommends that patients may be treated with topical medications including retinoids, benzoyl peroxide (BPO), salicylic acid, a combination of retinoid and BPO, or a combination of retinoids and BPO with or without antibiotics for mild acne; topical retinoid with topical BPO and a oral antibiotic for moderate acne; and oral isotretinoin if the patient fails first-line treatment (a 6- or 8-week trial of combined oral antibiotics and topical retinoids with BPO) for severe acne. Maintenance acne treatment using topical retinoids with or without BPO is recommended. To prevent the development of antibiotic resistance, topical antibiotics should not be used as monotherapy or used simultaneously with oral antibiotics. Skin care, comprised of cleansing, moisturizing and sun protection, is likewise recommended. Patient education and good communication is recommended to improve adherence, and advice should be given about the characteristics of the skin care products patients should use.
Fulltext Meeting the Challenges of Acne Treatment in Asian Patients: A Review of the Role of Dermocosmetics as Adjunctive Therapy

Goh CL, Noppakun N, Micali G, Azizan NZ, Boonchai W, Chan Y, et al.

J Cutan Aesthet Surg, 2016;9(2):85-92.
PMID: 27398008 DOI: 10.4103/0974-2077.184043

Conventional acne treatment presents several challenges such as intolerable side effects and antibiotic resistance. Dermocosmetic products may be used to reduce these unwanted effects. Dermocosmetics include skin cleansers, topical sebum-controllers, skin antimicrobial/anti-inflammatory agents, moisturizers, sunscreens, and camouflage products. Appropriate use of these products may help augment the benefit of acne treatment, minimize side effects, and reduce the need for topical antibiotics. In Asia, there is currently limited scientific data on the application and recommendations for dermocosmetic use in acne vulgaris (AV). This article reviews the evidence on dermocosmetics for AV and provides practice recommendations as discussed during the 4(th) Asia-Pacific Acne Leaders' Summit held in Bangkok, Thailand, on 7 and 8 February 2015. Through a premeeting survey, a series of plenary lectures, a stepwise program of discussion sessions, and Medline article review, the Expert Panel set forth relevant recommendations on the role of dermocosmetics as adjunct for treating AV in Asian patients.
Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne

Thiboutot DM, Dréno B, Abanmi A, Alexis AF, Araviiskaia E, Barona Cabal MI, et al.

J. Am. Acad. Dermatol., 2018 02;78(2 Suppl 1):S1-S23.e1.
PMID: 29127053 DOI: 10.1016/j.jaad.2017.09.078

Scientific advances are continually improving the knowledge of acne and contributing to the refinement of treatment options; it is important for clinicians to regularly update their practice patterns to reflect current standards. The Global Alliance to Improve Outcomes in Acne is an international group of dermatologists with an interest in acne research and education that has been meeting regularly since 2001. As a group, we have continuously evaluated the literature on acne. This supplement focuses on providing relevant clinical guidance to health care practitioners managing patients with acne, with an emphasis on areas where the evidence base may be sparse or need interpretation for daily practice.