MyMedR

Nodular hidradenoma arising on the site of a BCG scar

Bhullar A, Lee BR, Shamsudin N

Australas J Dermatol, 2017 Aug;58(3):e135-e137.

Hidradenomas are tumours that arise from the adnexal structures, both eccrine and apocrine and are histologically benign. The tumours that arise from eccrine differentiation are known as poroid hidradenomas and when they arise from the apocrine glands they are called nodular hidradenomas. In our centre a 13-year-old boy presented with a slow-growing, painless erythematous fungating nodule on the left upper arm over a period of 18 months at the site of the BCG vaccination. The nodule was surgically excised and sent for histopathological examination, leading to a diagnosis of nodular hidradenoma. This case is presented to highlight its rarity, together with its clinical features that were suggestive of malignancy but proved ultimately to be benign.

Pattern of skin diseases among patients attending an outpatient dermatology clinic in a tertiary hospital in urban Malaysia

Kwan Z, Wong SM, Robinson S, Tan LL, Ismail R

Australas J Dermatol, 2017 Nov;58(4):e267-e268.

PMID: 28660702 DOI: 10.1111/ajd.12541

A case of facial burn due to the misuse of garlic face mask for acne

Hisham A, Mohamed Sukur S, Basiron N

Australas J Dermatol, 2018 Nov;59(4):336-337.

PMID: 29377074 DOI: 10.1111/ajd.12789

Polymorphisms in P53 and VEGFA genes in different subtypes of periorbital hyperpigmentation in a Malaysian Chinese population

Amini F, Thazin Oo NM, Okechukwu PN, Seghayat MS, Ng ESC

Australas J Dermatol, 2019 May;60(2):e99-e104.

PMID: 30215845 DOI: 10.1111/ajd.12918

BACKGROUND/OBJECTIVES: The unknown pathogenesis of periorbital hyperpigmentation makes its treatment difficult. Existing evidence links p53 and VEGFA genes with skin hyperpigmentation. This study was aimed at (i) identifying the clinical pattern of periorbital hyperpigmentation; and (ii) detecting the presence of VEGFA and P53 single nucleotide polymorphism (SNPs) in different subtypes of periorbital hyperpigmentation in Malaysian Chinese.

METHODS: A cross-sectional study was conducted among Malaysian Chinese. Clinical assessments were performed, and medical history was collected. Three regions of p53 and two of VEGFA were amplified by PCR followed by direct sequencing using saliva-extracted DNA.

RESULTS: Eighty-four participants were recruited (average age 22.2 years). In the majority (n = 62), both eyelids were affected. Facial pigmentary, demarcation lines, tear trough and eye bags were not observed. Mixed (pigmented-vascular) was the most common subtype. Thirteen SNPs were found, nine of which are new. Only three out of 13 SNPs showed significant association with periorbital hyperpigmentation presentation. TA genotype in rs1437756379 (p53) was significantly more prevalent among participants with mixed subtype (P = 0.011) while AC genotype in rs1377053612 (VEGFA) was significantly more prevalent among pigmented subtype (P = 0.028). AA genotype in rs1479430148 (VEGFA) was significantly associated with allergic rhinitis in mixed subtype (P = 0.012).

CONCLUSION: Mixed subtype was the most prevalent type of periorbital hyperpigmentation in the study population. Three polymorphisms in p53 and VEGFA genes were statistically linked with different clinical presentations of periorbital hyperpigmentation.

Characteristics of skin cancers among adult patients in an urban Malaysian population

Han WH, Yong SS, Tan LL, Toh YF, Chew MF, Pailoor J, et al.

Australas J Dermatol, 2019 Nov;60(4):e327-e329.

PMID: 31222718 DOI: 10.1111/ajd.13106

There has been a rising incidence of skin cancers among Asians in recent years. We present a retrospective analysis of 106 skin cancers and analysed the demography, clinical subtypes of skin cancers and surgical techniques used for skin cancer treatment. In our population, skin cancers were most frequently basal cell carcinomas and diagnosed among ethnic Chinese patients.

Gemcitabine and vinorelbine treatment in cutaneous T-cell lymphoma in four patients

Affandi AM, Blumetti TP, Wells J, Hertzberg M, Fernandez-Peñas P

Australas J Dermatol, 2015 Nov;56(4):294-7.

PMID: 25496219 DOI: 10.1111/ajd.12270

Treatment options for advanced stage cutaneous T-cell lymphoma (CTCL) are limited by the their efficacy and side-effects profile. Gemcitabine, a pyrimidine analogue, has been reported to be efficacious in CTCL. Most of the studies published used gemcitabine as a single agent in treating advanced CTCL. Our small case series demonstrated that a combination of gemcitabine and vinorelbine induced partial remission in all four patients with refractory or advanced CTCL, although the effects were not sustained for a long duration (2-6 months). Two patients had neutropenia and one had acute hepatitis, requiring discontinuation of treatment.

Objective assessment of vitiligo with a computerised digital imaging analysis system

Shamsudin N, Hussein SH, Nugroho H, Fadzil MH

Australas J Dermatol, 2015 Nov;56(4):285-9.

PMID: 25367709 DOI: 10.1111/ajd.12247

An objective tool to quantify treatment response in vitiligo is currently lacking. This study aimed to objectively evaluate the treatment response in vitiligo by using a computerised digital imaging analysis system (C-DIAS) and to compare it with the physician's global assessment (PGA). Tacrolimus ointment 0.1% (Protopic; Astellas Pharma Tech,Toyama, Japan) was applied twice daily on selected lesions which were photographed every 6 weeks for 24 weeks. The primary efficacy end-point was the mean percentage of repigmentation (MPR), as assessed by the digital method (MPR-C-DIAS) or by the PGA. The response was categorised into none (0%), mild (1-25%), moderate (26-50%), good (51-75%) and excellent (76-100%).

Acquired idiopathic lipoatrophic panniculitis in a 12-month-old infant

Ng SY, D'Arcy C, Orchard D

Australas J Dermatol, 2015 Nov;56(4):e102-4.

PMID: 24635514 DOI: 10.1111/ajd.12159

Lipoatrophic panniculitis is a rare condition affecting mainly children, often associated with connective tissue disease. We report a healthy 12-month-old girl with no clinical or laboratory features of connective tissue disease who presented with the progressive appearance of annular atrophic plaques beginning at the left arm. A histopathological analysis revealed lobular panniculitis, with fat necrosis and an associated inflammatory infiltrate supporting the diagnosis of lipoatrophic panniculitis. Lipoatrophic panniculitis should be considered in infants and young children with clinical features of panniculitis and fat atrophy even without clinical or serologic evidence of connective tissue disease.

Methotrexate toxicity presenting as ulcerated psoriatic plaques

Wong SM, Chong YT, Thevarajah S, Baba R

Australas J Dermatol, 2012 Feb;53(1):81-3.

PMID: 22309341 DOI: 10.1111/j.1440-0960.2011.00779.x

Methotrexate toxicity is known to cause erosions of existing psoriatic plaques, although rare. We describe two patients who developed painful ulcerated psoriatic plaques as an early presenting sign of methotrexate toxicity and review the risk factors associated with this manifestation.

Psoriasis among Sarawakian natives in a tertiary skin centre in Sarawak

Yap FBB

Australas J Dermatol, 2010 Aug;51(3):210-1.

PMID: 20695864 DOI: 10.1111/j.1440-0960.2010.00647.x

A prospective cross-sectional study was done between December 2007 and June 2009 in the skin clinic, Sarawak General Hospital, to determine the clinical characteristics of 138 Sarawakian natives with a clinical diagnosis of psoriasis. Women made up 50.7% and the mean age of the patients was 45.2 years. Of the group, 94.2% had chronic stable plaque psoriasis, 86.9% had a body surface area involvement of less than 10%, 60.9% had nail disease, 22.5% had joint disease and 55.1% had minimal effects to their quality of life because of their psoriasis.

Study site: skin clinic, Sarawak General Hospital

Primary localised cutaneous amyloidosis in Malaysians

Looi LM

Australas J Dermatol, 1991;32(1):39-44.

PMID: 1930004

A review of consecutive biopsies from 85 Malaysian patients with primary localised cutaneous amyloidosis (PLCA) revealed 63 with papular amyloidosis (PA) and 22 with macular amyloidosis (MA). PLCA appeared to affect the Chinese more frequently than the other major ethnic groups but MA was more common than expected among the Indians. Of patients with PA, one had systemic lupus erythematosus, one scleroderma and in another, connective tissue disease was suspected. MA was not found to be associated with any other disease. Histologically, PA differed from MA by the larger size of amyloid deposits in the papillary dermis. There was no difference in their tinctorial and immunohistochemical characteristics. Deposits were permanganate-resistant and negative for AA protein, immunoglobulin light chains and keratin. A few cases exhibited positively for cytokeratin. Strong immunoreactivity for AP protein was observed. PA and MA appear chemically similar and are likely to be of epidermal origin.

Erythema multiforme: epidemiology, clinical characteristics and natural history in fifty-nine patients

Ting HC, Adam BA

Australas J Dermatol, 1984 Aug;25(2):83-8.

PMID: 6529404

The first reported case of mycetoma caused by Streptomyces somaliensis in Malaysia

Soo-Hoo TS, David CV

Australas J Dermatol, 1982 Aug;23(2):87-9.

PMID: 7181789

Black piedra in west Malaysia

Adam BA, Soo-Hoo TS, Chong KC

Australas J Dermatol, 1977 Apr;18(1):45-7.

PMID: 883925

Dermatology in Penang, Malaysia

Nagreh DS

Australas J Dermatol, 1976 Dec;17(3):121-5.

PMID: 1023874

Multiple clustered dermatofibroma presenting in a segmental distribution

Bhabha FK, Magee J, Ng SY, Grills CE, Su J, Orchard D

Australas J Dermatol, 2016 Feb;57(1):e20-2.

PMID: 25557526 DOI: 10.1111/ajd.12257

Multiple dermatofibromas is a rare entity consisting of more than fifteen lesions. Multiple clustered dermatofibroma is a distinct variant of multiple dermatofibromas and is defined as a well-demarcated plaque composed of individual dermatofibromas. We report a 16-year-old boy with multiple clustered dermatofibroma in a segmental distribution, which has previously not been reported in the literature.

Lupus vulgaris on the arm mistaken for keloid

Kiing JW, Hasnan Najib SFBZ, Muniandy P

Australas J Dermatol, 2021 Dec 20.

PMID: 34929049 DOI: 10.1111/ajd.13766

Cutaneous manifestations of patients with Human Immunodeficiency Virus (HIV) Infection: A retrospective review of a tertiary referral centre with clinicopathological correlation

Han WH, Yong JY, Yong SS, Faheem NAA, Toh YF, Chew MF, et al.

Australas J Dermatol, 2021 Aug;62(3):286-291.

PMID: 33729571 DOI: 10.1111/ajd.13580

INTRODUCTION: The majority of patients with Human Immunodeficiency Virus (HIV) will have cutaneous manifestation during their disease course. We report the spectrum of cutaneous manifestations and clinicopathological concordance in the diagnosis of skin diseases in patients with HIV.

METHODS: A retrospective review of all cutaneous manifestations of HIV-infected patients with skin biopsy-proven histopathological confirmation, treated in the University of Malaya Medical Centre, from 2016 till 2018, was performed. Clinical characteristics and histopathological correlation of these patients were reviewed.

RESULTS: A total of 38 cases were included where the median age was 40.5 (interquartile range (IQR) 13.3). The median duration of HIV diagnosis to the development of skin disease was 3 years (IQR 7.8). Majority of our patients were male (89.5%, n = 34), and the commonest mode of transmission is men who have sex with men (36.8%, n = 14). Most patients (92.1%, n = 35) had Acquired Immunodeficiency Syndrome when they presented with skin diseases, predominantly non-infectious types (51.4%, n = 19). Commonest skin diseases include eczema (n = 7) and pruritic papular eruption of HIV (n = 6). Papules and plaques were the commonest morphology for both infectious and non-infectious skin diseases. Duration of HIV diagnosis (P = 0.018) and non-compliance to Highly Active Antiretroviral Therapy (HAART) (P = 0.014) were significantly associated with the development of non-infectious skin diseases. Overall, clinicopathological concordance was 84.2% in our centre.

CONCLUSION: A wide spectrum of cutaneous diseases can occur in HIV patients depending on the degree of immunosuppression. skin biopsy along with appropriate stains, and microbiological cultures are important in helping clinicians clinch the right diagnosis.

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