MyMedR

Successful treatment of confluent and reticulated papillomatosis with a combination of doxycycline and topical tretinoin

Ting IPL, Kiing JW

J R Coll Physicians Edinb, 2024 Mar;54(1):59-61.

PMID: 38357752 DOI: 10.1177/14782715241227468

Falsely low serum creatinine caused by immunoglobulin M paraprotein interference with enzymatic method

Ting HY, Ting IPL, Lo SC, Loh TP

Pathology, 2022 Dec;54(7):959-962.

PMID: 35527046 DOI: 10.1016/j.pathol.2022.01.012

Spectrum of cutaneous granulomatous lesions: A 5-year experience in a tertiary care centre in Sarawak

Ting IPL, Tan HZ, Teo HG, Kiing JW, Muniandy P

Med J Malaysia, 2023 Mar;78(2):184-189.

PMID: 36988528

INTRODUCTION: Granulomatous skin lesions can have various histopathological features leading to diagnostic confusion. The study aimed to determine the frequency and pattern of different granulomatous skin lesions.

MATERIALS AND METHODS: This was a 5-year retrospective study done between April 2017 and March 2022 at Dermatology Department, Sarawak General Hospital. Subjects with a clinicopathological diagnosis of granulomatous diseases were included in the analysis.

RESULTS: A total of 1718 skin biopsies were done during the study periods, with 49 (2.8%) confirmed granulomatous skin lesions. Most patients were aged 40-60 with a male predominance of 51%. Most of the skin biopsy samples were taken from the upper limb (36%). In this study, epitheloid granuloma was the commonest subtype (21, 43%) followed by suppurative granuloma (12, 24%), tuberculoid granuloma (8, 16%) and foreign body granuloma (5, 10%). The commonest aetiology of granulomatous skin lesions in our study was infections (30, 61%) followed by foreign body inoculation (8, 16%). Fungal infection was the most common infective cause, followed by cutaneous tuberculosis.

CONCLUSION: The major cause of granulomatous dermatoses in developing countries is still infections, fungal and tuberculosis being the leading causes.

Secukinumab for Netherton syndrome: a Malaysian experience

Ting IPL, Lee TS, Teo HG, Albela H, Tang MM, Leong KF

Clin Exp Dermatol, 2023 Nov 16;48(12):1366-1369.

PMID: 37503742 DOI: 10.1093/ced/llad253

Secukinumab therapy for paediatric patients with various phenotypes of congenital ichthyosis

Albela H, Ting IPL, Lee TS, Ooi D, Leong KF

Clin Exp Dermatol, 2024 Jul 19;49(8):920-922.

PMID: 38470562 DOI: 10.1093/ced/llae082

Fulltext Challenges in Managing a Lepromatous Leprosy Patient Complicated with Melioidosis Infection, Dapsone-Induced Methemoglobinemia, Hemolytic Anemia, and Lepra Reaction

Tang ASO, Wong QY, Yeo ST, Ting IPL, Lee JTH, Fam TL, et al.

Am J Case Rep, 2021 May 26;22:e931655.

PMID: 34038399 DOI: 10.12659/AJCR.931655

BACKGROUND Leprosy is an infection caused by Mycobacterium leprae. An extensive literature search did not reveal many reports of melioidosis in association with leprosy. CASE REPORT A 22-year-old woman, who was diagnosed with multibacillary leprosy, developed dapsone-induced methemoglobinemia and hemolytic anemia, complicated by melioidosis. Methemoglobinemia was treated with methylene blue and vitamin C. Two weeks of ceftazidime was initiated to treat melioidosis, and the patient was discharged on amoxicillin/clavulanic acid and doxycycline as melioidosis eradication therapy. However, she developed drug-induced hypersensitivity. Trimethoprim/sulfamethoxazole, as an alternative treatment for melioidosis eradication, was commenced and was successfully completed for 12 weeks. During the fifth month of multidrug therapy, the patient developed type II lepra reaction with erythema nodosum leprosum reaction, which was treated with prednisolone. Leprosy treatment continued with clofazimine and ofloxacin, and complete resolution of skin lesions occurred after 12 months of therapy. CONCLUSIONS Our case highlighted the challenges posed in managing a patient with multibacillary leprosy with multiple complications. Clinicians should be aware that dapsone-induced methemoglobinemia and hemolysis might complicate the treatment of leprosy. Our case also highlighted the safety and efficacy of combining ofloxacin and clofazimine as a leprosy treatment regimen in addition to gradual steroid dose titration in the presence of type II lepra reaction.

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