Waranya Boonchai

Pruritic papular eruption in HIV seropositive patients: a cutaneous marker for immunosuppression.

Background Previous reports have shown the correlation between certain skin disorders and immune status in human immunodeficiency virus (HIV) infected patients. Pruritic papular eruption (PPE) is the most common cutaneous manifestation in HIV infected patients. The purpose of this study is to define the relationship between the presentation of PPE and the immune status in HIV infection, as measured by the T‐cell subset, and to establish the usefulness of this common eruption as a predictor of CD4 count.

Assessment of nickel release from earrings randomly purchased in China and Thailand using the dimethylglyoxime test

Background: China and Thailand produce large amounts of jewellery that are sold domestically and abroad.

Trend of contact allergy to cosmetic ingredients in Thais over a period of 10 years

Background. Contact allergy to cosmetic ingredients is common. However, there are no recent comprehensive studies on contact allergy to cosmetic ingredients in Asia.

Panniculitis in tuberculosis: a clinicopathologic study of nodular panniculitis associated with tuberculosis

Background Certain types of panniculitis, erythema induratum of Bazin and erythema nodosum, have been well documented as tuberculids. Many histopathologic diagnoses of panniculitis have been reported in tuberculosis patients. This study investigates the correlation between underlying tuberculosis and clinicopathologic findings of panniculitis.

Familial presenile sebaceous gland hyperplasia

Sebaceous gland hyperplasia occurs frequently, particularly in men past middle age. 1 A few cases of sebaceous gland hyperplasia have been described in younger age groups. 2-6 Recently, two brothers with premature sebaceous hyperplasia were described by Dupre, Bonafe, and Lamon. 5 W e describe a family with premature sebaceous hyperplasia in five consecutive generations. The pedigree suggests autosomal dominant inheritance with incomplete penetrance.

Risk factors for common contact allergens and patch test results using a modified European baseline series in patients tested during between 2000 and 2009 at Siriraj Hospital.

BACKGROUND Surveillance of contact allergy using patch testing has demonstrated its value in detecting time trends. This study demonstrates the results of patch testing performed between 2000 and 2009 at the contact dermatitis clinic, Siriraj Hospital, Bangkok and risk factors for the top 5 common allergens. METHODS A retrospective review of medical records was conducted from January 2000 to December 2009. All Patients who were patch tested using a modified European baseline series were studied. RESULTS There were 852 cases (206 males and 646 females; mean age 39.14 years). The top 5 most frequent allergens were gold sodium thiosulfate (30.7%), nickel sulfate (27.6%), potassium dichromate (20.8%), fragrance mix (18.3%) and cobalt chloride (16.0%), respectively. There was no statistically significant difference in the trends of positive patch test reactions for individual allergens during the 2000s. Gold sensitivity was found more common in females and in the head and neck regions. Nickel sensitivity was more common in females. Chromate sensitivity was more common in males and subjects aged = 40 years. Fragrance sensitivity was more common in females and subjects aged = 40 years. Among the patients with metal (chromate, nickel, cobalt and gold) allergy, the patients recollection of a history of an allergic reaction to metal was significantly associated with a positive patch test reaction to either one of these metals, (P < 0.001; OR, 2.56; 95%CI, 1.87-3.50). CONCLUSIONS The prevalence of contact sensitization appears to have not changed much during the decade. Further study, involving patients from all institutions in Bangkok, would provide a more comprehensive view of contact allergens in the region and lead to the creation of a local standard series.

Latex glove-related symptoms among health care workers: a self-report questionnaire-based survey.

BackgroundThe use of latex gloves by health care workers (HCWs) can lead to multiple symptoms: eczema, contact urticaria, rhinitis, conjunctivitis, asthma, and anaphylaxis. ObjectivesThe objectives of this study were to reveal the prevalence of latex glove–related symptoms of HCWs at Siriraj Hospital and to determine risk factors associated with those symptoms associated with the use of latex gloves. MethodsSelf-administered questionnaires were sent to 6880 HCWs who were working at Siriraj Hospital and using latex rubber gloves in their duty. ResultsThe questionnaire response rate was 65.8%. Of 4529 respondents, the male-to-female ratio was 1:8.6 and the mean age was 34.3 years. The majority of respondents were nurses (83%). The prevalence of glove-related symptoms among the HCWs is 13.3%. Glove-related cutaneous and noncutaneous symptoms were found in 11.3% and 5.9% of the respondents. ConclusionsThe hospital housekeepers emerged as the job with the significantly higher prevalence rate of glove-related symptoms than that of the other job categories. Factors associated with glove-related cutaneous symptoms are frequency and duration of glove use, history of atopy, and history of allergy to fruit cross-reacting with latex. The quantity of glove use, history of atopy, and allergy to fruits cross-reacting with latex are risk factors for the occurrence of glove-related noncutaneous symptoms.

Green Pigmentation on the Palms and Soles

Aman inhis50spresentedwithabrupt-onsetasymptomaticgreen and brown pigmented lesions on both his palms and soles (Figure, A). He had had progressive jaundice for a month and was recently diagnosedashavingadvanced intrahepaticcholangiocarcinoma.The cutaneous eruption developed 3 days after a high-grade fever during admission for palliative endoscopic retrograde cholangiopancreatography with metallic stent insertion. The investigation for cause of fever showed influenza A infection. He denied history of contact with any greenish substances on his palms and soles during admission. His sweat was colorless. Physical examination revealed generalized marked jaundice and bilateral symmetrical greenish brown macules and patches on hyperkeratotic palms and soles. The potassium hydroxide examination and Gram stain results were negative for any organisms. Laboratory tests showed a total to direct bilirubin level of 32.7/ 25.5 mg/dL; aspartate aminotransferase level of 93 U/L; alanine aminotransferase level of 82 U/L; and alkaline phosphatase level of 973 U/L. (To convert bilirubin to micromoles per liter, multiply by 17.104; to convert asparatate aminotransferase, alanine aminotransferase, and alkaline phosphatase to microkatals per liter, multiply by 0.0167.) Figure, B, shows the dermatoscopic finding of peeling skin. An incisional biopsy specimen from a nondesquamated greenish brown patch on the left palm, 1 day after the appearance of lesions, was stained with hematoxylin-eosin (Figure, C). What is your diagnosis?

Cosmetic preservative labelling on the Thai market.

Preservatives are added to cosmetics and other consumer products to prevent microbial growth and product degradation. Many cosmetic preservatives are skin sensitizers and frequent causes of contact dermatitis. The use of preservatives may vary by country and/or region, according to legislation, and may be reflected in differences in the prevalence rates of preservative allergy worldwide.

Assessment of nickel and cobalt release from jewelry from a non-nickel directive country.

BackgroundA directive restricting nickel release from jewelry and other skin-contact products has not been initiated in Thailand or in the United States. The prevalence of nickel and cobalt allergies is increasing, and the main cause of sensitization seems to be jewelry. ObjectivesWe aimed to investigate nickel and cobalt release from jewelry available in Thai marketplaces and to study the factors associated with nickel and cobalt release. MethodsUsed costume jewelry items were collected from volunteers. They were tested with the dimethylglyoxime and cobalt tests. ResultsFive hundred fifty-one items, including belt buckles, bracelets, earrings, necklaces, rings, and watches, were tested; 216 (39.2%) gave positive dimethylglyoxime tests, and 206 (37.4%) gave positive cobalt tests. The factors that determined nickel or cobalt release were shopping location and jewelry price. Cobalt-containing jewelry could be identified by its dark color. ConclusionsA large proportion of the jewelry sold in Thai markets release nickel or cobalt.