Therdpong Tempark

Attitudes, knowledge, and behaviors of secondary school adolescents regarding protection from sun exposure: a survey in Bangkok, Thailand

Sun protection behavior is a proven intervention for aging skin and skin cancer prevention, especially if training on prolonged sun exposure can be performed early in life. Despite the fact that there are several study reports from multicenters in the West, there are limited data on sun protection in tropical countries where the prevalence of sunburn as well as sun protection behavior and knowledge are low. In Bangkok, sun protection behavior among adolescents is different from the studies performed in the West. Schools are key institutions in encouraging students to prevent themselves from acquiring problems of long‐time sun exposure.

Flood‐related skin diseases: a literature review

Flood is one of the most common natural disasters, which commonly occurs in all parts of the world. The effects of the disasters considerably become enormous problems to overall public health systems. Flood‐related skin diseases are a portion of these consequences presenting with cutaneous manifestations and/or signs of systemic illnesses. We conducted a systematic literature review of research publications relating to flooding and skin diseases. The purpose of this review was to provide dermatologists as well as general practitioners with comprehensive conditions of flood‐related skin diseases and suggested treatments. Moreover, we categorized these flood‐related diseases into four groups comprising inflammatory skin diseases, skin infections, traumatic skin diseases, and other miscellaneous skin diseases in a bid to implement early interventions and educate, prevent, and efficaciously handle those skin diseases under such a catastrophic situation so that better treatment outcomes and prevention of further complications could be ultimately achieved and accomplished.

The natural course of childhood atopic dermatitis: a retrospective cohort study.

BACKGROUND Atopic dermatitis (AD) is generally considered to be the initial step of the so-called atopic march, which following steps are allergic rhinitis (AR) and asthma. There are few data about the progression of AD, including factors associated with the remission of AD in Asians and further research is needed. OBJECTIVE To study the progression and factors associated with the remission of childhood AD diagnosed by pediatric dermatologists. METHODS This study included 303 AD patients who visited the pediatric dermatology unit at King Chulalongkorn Memorial Hospital, Thailand, between 2002 and 2010. An interview, performed by a physician via telephone using a preformed questionnaire, was completed for 205 children. RESULTS A total of 205 children were observed, with a median observation time of 5.2 (3.5-8.0) years, and an initial AD severity score of mild (61.0%), moderate (29.3%) and severe (9.7%). The prevalence of AD during the first two years of life was 64.4%. AD completely disappeared in 102 cases (49.8%) by the median age of 3.5 (1.5-7.8) years. Early onset and severity of AD were major determinant of prognosis. The prevalence of AR and asthma was 36.6%, and 9.3%, respectively. The risk factors associated with respiratory allergy were the onset of AD after aged two years, a family history of atopy, increased serum IgE level, and sensitization to inhalant allergens. CONCLUSIONS Half of AD had completely disappeared at preschool age. Good prognosis was mostly determined by early onset AD and mild severity. Late onset, family history of atopy and increased serum IgE level are associated with respiratory allergy.

Dapsone-induced severe cutaneous adverse drug reactions are strongly linked with : 01 allele in the Thai population hla-b : 01 allele in the Thai population*13: 01 allele in the Thai population

Objectives A previous publication in Chinese leprosy patients showed that the HLA-B*13:01 allele is a strong genetic marker for dapsone-induced drug hypersensitivity reactions, however there are no data describing whether HLA-B*13:01 is a valid marker for prediction of dapsone-induced drug hypersensitivity reactions in other ethnicities or nonleprosy patients. The aim of this study is to investigate whether there is an association between HLA genotypes and dapsone-induced severe cutaneous adverse reactions (SCARs) in Thai nonleprosy patients. Patients and methods HLA-B genotypes of 15 patients with dapsone-induced SCARs (11 drug reaction with eosinophilia and systemic symptoms, 4 Stevens–Johnson syndrome/toxic epidermal necrolysis), 29 control patients, and 986 subjects from the general Thai population were determined by the reverse PCR sequence-specific oligonucleotides probe. Results The HLA-B*13:01 allele was significantly associated with dapsone-induced SCARs compared with dapsone-tolerant controls (odds ratio: 54.00, 95% confidence interval: 7.96–366.16, P=0.0001) and the general population (odds ratio: 26.11, 95% confidence interval: 7.27–93.75, P=0.0001). In addition, HLA-B*13:01 associated with dapsone-induced SJS-TEN (OR: 40.50, 95% confidence interval: 2.78-591.01, P=0.0070) and DRESS (OR: 60.75, 95% confidence interval: 7.44-496.18, P=0.0001). Conclusion This study demonstrated an association between HLA-B*13:01 and dapsone-induced SCARs including Stevens–Johnson syndrome/toxic epidermal necrolysis and drug reaction with eosinophilia and systemic symptoms in nonleprosy patients. Moreover, these results suggest that the HLA-B*13:01 allele may be a useful genetic marker for prediction of dapsone-induced SCARs in Thai and Han-Chinese populations.

Dermatological Complications of Circumcision: Lesson Learned from Cases In a Pediatric Dermatology Practice

We discuss 11 cases of boys who presented with dermatologic complications of circumcision in an outpatient pediatric dermatology clinic. A medical practitioner had previously circumcised all patients during the newborn period. The majority of cases were found incidentally during initial thorough dermatologic examination. Late cutaneous complications included penile skin bridge, glandular adhesion of remnant foreskin, concealed penis, and a penile epidermal inclusion cyst. Minor surgical procedures under local anesthesia were performed in all but two cases. These cases should help dermatologists recognize the common late cutaneous complications of male newborn circumcision and provide insight into potential options for early intervention and management.

Association of HLA-A and HLA-B Alleles with Lamotrigine-Induced Cutaneous Adverse Drug Reactions in the Thai Population

Background: Lamotrigine (LTG) is commonly used for treatment of epilepsy and bipolar disorder. It is one of the common cause of cutaneous adverse drug reactions (CADR). Clinical symptoms of LTG-induced CADR range from maculopapular exanthema (MPE) to severe cutaneous adverse reactions (SCAR). This study aimed to determine the association of the LTG-induced CADR with human leukocyte antigen (HLA) alleles in Thai patients. Methods: Fifteen patients with LTG-induced CADR [10 MPE; 4 Stevens–Johnson syndrome; and 1 drug reaction with eosinophilia and systemic symptoms] and 50 LTG-tolerant controls were included in the study. HLA-A and HLA-B genotyping was performed using polymerase chain reaction-sequence-specific oligonucleotides probes. Results: The proportion of HLA-A∗02:07 and HLA-B∗15:02 allele carriers were significantly higher in the LTG-induced CADR group than in the tolerant controls [odds ratio (OR): 7.83; 95% confidence interval (CI): 1.60–38.25; P = 0.013, and OR: 4.89; 95% CI: 1.28–18.67; P = 0.014]. In addition, subjects with HLA-A∗33:03, HLA-B∗15:02, and HLA-B∗44:03 were significantly higher in the LTG-induced MPE group than in the tolerant controls (OR: 8.27; 95% CI: 1.83–37.41; P = 0.005, OR: 7.33; 95% CI: 1.63–33.02; P = 0.005; and OR: 10.29; 95% CI: 1.45–72.81; P = 0.029). In contrast to the LTG-induced MPE group, there were no significant differences between HLA alleles and LTG-induced SCAR group. Conclusion: HLA-A∗02:07 and HLA-B∗15:02 were associated with LTG-induced CADR in Thai patients. We also identified an association between HLA-A∗33:03, HLA-B∗15:02, and HLA-B∗44:03 and LTG-induced MPE in this population. These results suggest that these alleles could be useful screening markers for preventing CADR before LTG treatment in Thai patients, but further replication studies with larger sample sizes are needed.

Randomized, controlled trial split-faced study of 595-nm pulsed dye laser in the treatment of acne vulgaris and acne erythema in adolescents and early adulthood

The high prevalence of acne vulgaris in teenagers has increased comorbidities. Lasers offer alternative options for acne treatment because they have rapid action, low systemic adverse effects, and do not require everyday treatment. To study the efficacy and patients’ satisfaction of 595‐nm pulse dye laser (PDL) treatment of acne vulgaris and acne erythema in adolescents and early adulthood, we designed a blocked‐randomized, split‐faced 595‐nm PDL (fluence 8 J/cm3 pulse duration 10 ms, spot size 7 mm, 2 session every 2 weeks) study in patients with mild to moderate acne by comparing the laser‐treated and non‐treated side. The acne lesion counts, acne erythema grading, and acne severity grading were evaluated at baseline and 2, 4, and 8 weeks. Thirty patients were recruited. The results showed no statistically significant difference except the papule count at week 4 which was −1.828 on the treated side and 0.103 on the non‐treated side of the face, P‐value 0.0018. There was no statistically significant difference of acne severity grading and acne erythema grading between both sides of the face. The mean scores of patients’ satisfaction on the laser‐treated side were 75, 81, and 81%, respectively. The PDL treatment in this study reveals no significant improvement in acne therapy; however, the patients were satisfied with this laser treatment.

Lupus panniculitis of the scalp presenting with linear alopecia along the lines of Blaschko

S. Lueangarun, U. Subpayasarn, P. Chakavittumrong, T. Tempark and W. Suthiwartnarueput Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Bangkok, Thailand; Department of Pediatrics, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand; and Department of Pathology and Forensic Medicine, Thammasat University Faculty of Medicine, Bangkok, Thailand

Efficacy of MAS063DP lotion vs 0.02% triamcinolone acetonide lotion in improving post-ablative fractional CO2 laser resurfacing wound healing: a split-face, triple-blinded, randomized, controlled trial

Proven as effective acne scar treatment, ablative fractional carbon dioxide (AFCO2) laser requires post‐laser wound healing care. MAS063DP is a multicomponent nonsteroidal anti‐inflammatory moisturizer for effective post‐laser treatment. This study compares the efficacy of MAS063DP and 0.02% triamcinolone acetonide (TA) lotion for post‐laser wound healing and complications. A split‐face, triple‐blinded, clinical study was performed in 16 patients, aged 20–50 years, receiving AFCO2 on both sides of the face, with MAS063DP on one side and 0.02% TA on the other side for 7 days twice daily. Digital photography, hemoglobin, and melanin index at baseline were obtained immediately after laser treatment and then at days 3, 5, 7, and 30. Erythema, edema, crusting, adverse effects, and post‐inflammatory hyperpigmentation (PIH) were followed every visit. Sixteen patients, mean age 38.6 (8.4) years, with moderate–severe atrophic scar and skin phototype III–IV completed the study. Clinical improvement of edema, erythema, crusting, and hyperpigmentation was observed from day 3 to day 30 (P < 0.001), with no statistically significant difference in both groups. There was also no statistical difference of hemoglobin, melanin index, and texture at days 3, 5, 7, and 30. Melanin index at day 30 was significantly less than baseline in both MAS063DP and 0.02% TA. With PIH in 50% of cases, both treatments demonstrated good safety profiles and no serious adverse reactions. MAS063DP could be an effective treatment for post‐laser wound healing and complications, compatible to 0.02% TA.

Nail Scabies: An Unusual Presentation Often Overlooked and Mistreated

Nail scabies is an interesting clinical presentation of scabies. Although it is usually found concomitant with characteristic dermatologic manifestations, it may present as an isolated finding in the immunocompromised host. This condition is commonly mistaken with other diseases such as nail dystrophy, nail psoriasis and onychomycosis. We report two cases of unusual nail presentations that provide clues to diagnosis. Also, literature on unusual nail and dermatologic presentations was reviewed to recognize dermatologist consideration for appropriate treatment options.