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Lie CJL, Marimuttu VJ, Wee LWY, Ho VPY, Gan EY, Alagappan U, Wong SMY, Koh MJA. Self-induced panniculitis in adolescence: Three cases and review of the literature. Pediatr Dermatol 2022. [PMID: 36519692 DOI: 10.1111/pde.15225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
Abstract
Self-induced trauma is a rare cause of panniculitis in adolescents and may be associated with undiagnosed underlying psychological conditions. The condition often poses a diagnostic challenge as patients usually present with non-specific signs and symptoms, and often a concealed history of self-induced trauma. Here, we present three adolescent patients with self-induced traumatic panniculitis. All three patients were repeatedly admitted with non-specific cutaneous lesions as well as multiple somatic complaints. After extensive evaluation to exclude organic causes, psychiatric assessment eventually revealed underlying psychosomatic disorders as a cause of the self-induced trauma.
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Affiliation(s)
- Cheryl J L Lie
- Department of Dermatology, KK Women's & Children's Hospital, Singapore, Singapore
| | - Vicknesan J Marimuttu
- Psychological Medicine Service, KK Women's & Children's Hospital, Singapore, Singapore
| | - Lynette W Y Wee
- Department of Dermatology, KK Women's & Children's Hospital, Singapore, Singapore
| | - Valerie P Y Ho
- Department of Dermatology, KK Women's & Children's Hospital, Singapore, Singapore
| | - Emily Y Gan
- Department of Dermatology, KK Women's & Children's Hospital, Singapore, Singapore
| | - Uma Alagappan
- Department of Dermatology, KK Women's & Children's Hospital, Singapore, Singapore
| | - Sharon M Y Wong
- Department of Dermatology, KK Women's & Children's Hospital, Singapore, Singapore
| | - Mark J A Koh
- Department of Dermatology, KK Women's & Children's Hospital, Singapore, Singapore
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2
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Bishnoi P, Ng YZ, Wei H, Tan EC, Lunny DP, Wong XFCC, Kin Fon L, Gondokaryono SP, Diana IA, Common JEA, Koh MJA, Lane EB. Self-improving dystrophic epidermolysis bullosa: First report of clinical, molecular, and genetic characterization of five patients from Southeast Asia. Am J Med Genet A 2020; 185:625-630. [PMID: 33258232 DOI: 10.1002/ajmg.a.61975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/12/2020] [Accepted: 10/24/2020] [Indexed: 11/05/2022]
Abstract
Self-improving dystrophic epidermolysis bullosa is a rare subtype of dystrophic epidermolysis bullosa (DEB) characterized by significant improvement in skin fragility within the first few years of life. Genetic inheritance has previously been reported as autosomal dominant or recessive with both forms harboring mutations in COL7A1. To date, there have been no reports of this rare clinical entity from various Southeast Asian ethnicities. Here, we describe the clinical and molecular features of five patients from the Southeast Asia region who presented with predominantly acral-distributed blisters and erosions in the first few days of life. Blistering resolved over several months, without appearance of new blisters. By immunofluorescence, intraepidermal retention of Type VII collagen was observed in all patient skin biopsies when investigated with antibody staining. Genetic analysis of four patients revealed pathogenic variants in COL7A1 which have not been previously reported. The clinical diagnosis in these rare patients is confirmed with molecular histology and genetic characterization.
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Affiliation(s)
- Priya Bishnoi
- Dermatology Service, KK Women's & Children's Hospital, Singapore, Singapore
| | - Yi Zhen Ng
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Heming Wei
- Research Laboratory, KK Women's & Children's Hospital, Singapore, Singapore
| | - Ene-Choo Tan
- Research Laboratory, KK Women's & Children's Hospital, Singapore, Singapore
| | - Declan P Lunny
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - X F Colin C Wong
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Leong Kin Fon
- Pediatric institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Srie Prihianti Gondokaryono
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Inne Arline Diana
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - John E A Common
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Mark J A Koh
- Dermatology Service, KK Women's & Children's Hospital, Singapore, Singapore
| | - E Birgitte Lane
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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Leong K, Ong TWY, Foong YW, Wong YP, Lim W, Liew HM, Koh MJA. Multidisciplinary management of chronic atopic dermatitis in children and adolescents: a prospective pilot study. J DERMATOL TREAT 2020; 33:822-828. [PMID: 32530338 DOI: 10.1080/09546634.2020.1782321] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Atopic dermatitis (AD) is a chronic, pruritic disorder affecting 10-20% of children and is associated with psychological issues and impaired quality of life (QoL). The role of psychosocial support in the treatment of AD is increasingly important. We studied the impact of a multidisciplinary clinic (MDC) in the management of AD in a tertiary children's hospital in Singapore.Methods: We performed a prospective pilot interventional study on 34 pediatric patients with AD and concomitant psychosocial impairment. Patients were recruited into an MDC, comprising a dermatologist, clinical psychologist and medical social worker. AD severity was scored using Scoring Atopic Dermatitis (SCORAD), while QoL was assessed using the Children's Dermatology Life Quality Index Questionnaire (CDLQI) and Family Dermatology Life Quality Index Questionnaire (FDLQI). Biopsychosocial assessments and interventions were also performed. Eighty-three percent of patients received cognitive behavioral therapy, while 40% received social work intervention.Results: There was an overall improvement in mean SCORAD, CDLQI, and FDLQI scores across MDC visits. A correlation between AD severity and QoL was established. A patient satisfaction survey showed improvement in severity, understanding, and control of the disease.Conclusion: Our study suggests the effectiveness of a multidisciplinary approach in managing pediatric AD patients with psychosocial co-morbidities.
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Affiliation(s)
- Kylie Leong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Thomas W Y Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yee-Wah Foong
- Dermatology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yen-Peng Wong
- Psychology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Winnie Lim
- Medical Social Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Hui-Min Liew
- Dermatology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Mark J A Koh
- Dermatology Service, KK Women's and Children's Hospital, Singapore, Singapore
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Abstract
The Rumpel-Leede phenomenon (RLP) is a rare clinical presentation and in some cases shown to be related to serious systemic conditions. In children, it has been described in association with idiopathic thrombocytopenic purpura and Henoch-Schönlein purpura. We present a series of pediatric cases of RLP with mechanical etiologies that had a benign course. We propose minimal investigations for pediatric RLP cases who are systemically well and have a clear suggestive history of a mechanical cause.
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Affiliation(s)
| | - Jin Ho Chong
- Raffles Hospital, Children's Centre, Singapore, Singapore
| | - Priya Bishnoi
- KK Women's and Children's Hospital, Dermatology Service, Singapore, Singapore
| | - Mark J A Koh
- KK Women's and Children's Hospital, Dermatology Service, Singapore, Singapore
| | - Sharon M Y Wong
- KK Women's and Children's Hospital, Dermatology Service, Singapore, Singapore
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5
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Wei H, Wee LWY, Born B, Seang S, Koh MJA, Yee R, Lin G, Rafi'ee K, Mey S, Tan EC. Palmoplantar keratoderma, oral involvement, and homozygous CTSC mutation in two brothers from Cambodia. Am J Med Genet A 2019; 182:296-302. [PMID: 31846207 DOI: 10.1002/ajmg.a.61447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/22/2019] [Accepted: 11/26/2019] [Indexed: 12/28/2022]
Abstract
Haim-Munk syndrome (HMS) and Papillon-Lefevre syndrome (PLS) are phenotypic variants of palmoplantar keratoderma (PPK) with progressive early-onset periodontitis and dental caries. HMS and PLS have been associated with homozygous or compound heterozygous mutations in the lysosomal protease gene Cathepsin C (CTSC). There have been only a few documented cases of CTSC mutations in patients from South-East Asia. We report the clinical findings of two Cambodian brothers who presented with diffuse, demarcated PPK with transgrediens extending to the elbows and knees, as well as pachyonychia and dental caries. Arachnodactyly and periodontitis were also found in the older brother. Next-generation sequencing unveiled a homozygous missense variant in CTSC (NM_001814.5: c.1337AC: p.(Asp446Ala)) in both brothers. Both parents were heterozygous for the variant, while an unaffected older brother was homozygous for the wild-type allele. Our study adds to the spectrum of mutations and associated clinical presentations for this rare genodermatosis.
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Affiliation(s)
- Heming Wei
- Research Laboratory, KK Women's & Children's Hospital, Singapore
| | - Lynette W Y Wee
- Dermatology Service, KK Women's & Children's Hospital, Singapore
| | - Bori Born
- Department of Dermatology, Preah Kossamak Hospital, Phnom Penh, Cambodia
| | - Sokheng Seang
- Department of Dermatology, Preah Kossamak Hospital, Phnom Penh, Cambodia
| | - Mark J A Koh
- Dermatology Service, KK Women's & Children's Hospital, Singapore.,Paediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, Singapore
| | - Ruixiang Yee
- Dental Service, KK Women's & Children's Hospital, Singapore
| | - Grace Lin
- Research Laboratory, KK Women's & Children's Hospital, Singapore
| | - Khadijah Rafi'ee
- Research Laboratory, KK Women's & Children's Hospital, Singapore
| | - Sithach Mey
- Department of Dermatology, Preah Kossamak Hospital, Phnom Penh, Cambodia
| | - Ene-Choo Tan
- Research Laboratory, KK Women's & Children's Hospital, Singapore.,Paediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, Singapore
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Colin Tan W, Wang DY, Seghers AC, Koh MJA, Nicholas Goh SG, Joyce Lee SS. Should we biopsy melanonychia striata in Asian children? A retrospective observational study. Pediatr Dermatol 2019; 36:864-868. [PMID: 31576600 DOI: 10.1111/pde.13934] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Melanonychia striata is common in children of darker-skinned Asian races, while subungual melanoma is extremely rare and it is difficult to make a diagnosis clinically. However, performing nail unit biopsies in children is particularly challenging and can result in permanent nail dystrophy. The aim of this study was to review the clinical and histologic characteristics of melanonychia striata in pediatric patients of Asian descent to aid in the clinical decision regarding nail biopsy. METHODS Sixty-two pediatric patients presenting with melanonychia striata involving single or multiple nails at two tertiary pediatric dermatology clinics in Singapore between 2005 and 2015 were reviewed. Clinical and histopathological data were analyzed, including age at onset, age at presentation, location, color, width, presence of Hutchinson's sign, pseudo-Hutchinson's sign, nail dystrophy, length of follow-up, and clinical evolution. Histopathological assessment was performed by three senior dermatopathologists independently for cases that underwent a nail biopsy. RESULTS No cases of subungual melanoma were detected in our series. Solitary melanonychia of the thumbnail with a single uniform color was the most common presentation. Pseudo-Hutchinson's sign was commonly observed. Consensus in histological diagnosis emerged amongst all three dermatopathologists in only half of the cases biopsied. CONCLUSION The occurrence of melanoma in Asian children presenting with melanonychia is extremely rare. We recommend clinical follow-up and anticipatory guidance for these patients and nail unit biopsy only in the presence of high-risk clinical features.
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Affiliation(s)
| | | | | | - Mark J A Koh
- KK Women's and Children's Hospital, Singapore City, Singapore
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van Galen LS, Xu X, Koh MJA, Thng S, Car J. Eczema apps conformance with clinical guidelines: a systematic assessment of functions, tools and content. Br J Dermatol 2019; 182:444-453. [PMID: 31179535 DOI: 10.1111/bjd.18152] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Eczema is a prevalent complex skin condition requiring active disease monitoring and personalized education. No studies have assessed the quality of apps that aim to support eczema self-management. OBJECTIVES To evaluate the quality and comprehensiveness of English, Chinese and Spanish self-management eczema smartphone apps for patients and/or their caregivers. METHODS A systematic assessment of eczema apps from July 2018 to November 2018. The assessment criteria were based on conformance with international eczema guidelines. The following domains were assessed: consistency and comprehensiveness of eczema-specific educational information; quality and comprehensiveness of eczema-specific tracking functions; compliance with health information best practice principles. RESULTS In total, 98 apps were assessed: 82 (84%) provided educational information; 38 (39%) tracking functions; and 13 (13%) both. We found that 34% (28/82) of apps provided misleading information, particularly regarding aspects of treatment and disease progression of eczema. Only 15% (12/82) provided international guideline supported information on pharmacological therapies and 16% (13/82) on nonpharmacological therapies. Among 38 apps with a tracking function, 82% (31/38) measured specific symptoms, disease severity or current skin condition and 89% (34/38) helped users to record medication usage including application of topicals. Environmental or dietary allergens were recorded by 34% (13/38). None of the included apps complied with all criteria for educational information, tracking functions or health information principles. CONCLUSIONS Eczema apps have not yet reached their potential. The large variance in quality of eczema apps highlights the need for quality assurance mechanisms for health apps and guidance for clinicians that would enable them to make personalized recommendations for patients and caregivers. What's already known about this topic? There is limited information about the quality of eczema self-management smartphone apps on the global market. What does this study add? This systematic assessment evaluated all English, Chinese and Spanish language apps that support eczema self-management. The majority did not conform with information in guidelines and insufficiently support evidence-based self-management. The large variance in the quality of eczema apps highlights the need for mechanisms to ensure app quality and to guide personalized app selection for patients, caregivers and doctors.
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Affiliation(s)
- L S van Galen
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, 11 Mandalay Road, Singapore, 308232, Singapore.,Section of Acute Medicine, Department of Internal Medicine, Amsterdam UMC location VUmc, the Netherlands
| | - X Xu
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, 11 Mandalay Road, Singapore, 308232, Singapore
| | - M J A Koh
- Dermatology Service, KK Women's and Children's Hospital, Singapore
| | - S Thng
- National Skin Centre, 1 Mandalay Road, 308205, Singapore
| | - J Car
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, 11 Mandalay Road, Singapore, 308232, Singapore.,Global Digital Health Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, 3rd floor Reynolds Building, St Dunstan's Road, London, W6 8RP, U.K
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8
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Nagaputra JC, Koh MJA, Brett M, Lim ECP, Lim HW, Tan EC. Piebaldism with multiple café-au-lait-like hyperpigmented macules and inguinal freckling caused by a novel KIT mutation. JAAD Case Rep 2018; 4:318-321. [PMID: 29693058 PMCID: PMC5911795 DOI: 10.1016/j.jdcr.2017.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - Mark J A Koh
- Dermatology Service, KK Women's & Children's Hospital, Singapore.,Paediatrics Academic Clinical Programme, SingHealth Duke-NUS Medical School, Singapore
| | - Maggie Brett
- Research Laboratory, KK Women's & Children's Hospital, Singapore
| | - Eileen C P Lim
- Research Laboratory, KK Women's & Children's Hospital, Singapore
| | - Hwee-Woon Lim
- Research Laboratory, KK Women's & Children's Hospital, Singapore
| | - Ene-Choo Tan
- Paediatrics Academic Clinical Programme, SingHealth Duke-NUS Medical School, Singapore.,Research Laboratory, KK Women's & Children's Hospital, Singapore
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9
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Cheok S, Yee F, Song Ma JY, Leow R, Ho MSL, Yew YW, Tay YK, Rebello SA, Luo N, Koh MJA. Prevalence and descriptive epidemiology of atopic dermatitis and its impact on quality of life in Singapore. Br J Dermatol 2017; 178:276-277. [PMID: 28415136 DOI: 10.1111/bjd.15587] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S Cheok
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - F Yee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - J Y Song Ma
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - R Leow
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Y W Yew
- National Skin Center, Singapore
| | - Y K Tay
- Dermatology Department, Changi General Hospital, Singapore
| | - S A Rebello
- Saw Swee Hock School of Public Health, Singapore
| | - N Luo
- Saw Swee Hock School of Public Health, Singapore
| | - M J A Koh
- Dermatology Service, KK Women's & Children's Hospital, Singapore
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10
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Abstract
We describe a case of lymphocytic thrombophilic arteritis in a 15-year-old girl who had previously taken minocycline for a year. Cutaneous polyarteritis nodosa and lymphocytic thrombophilic arteritis share many features and may both be triggered by minocycline. There may be a long latency between drug exposure to minocycline and development of disease.
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Affiliation(s)
- Colin W X Tan
- Dermatology Service, KK Women's and Children's Hospital, Singapore
| | - Mark J A Koh
- Dermatology Service, KK Women's and Children's Hospital, Singapore
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11
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Abstract
This is a case report of a 4-month-old full-term, fully breastfed boy who presented with a persistent periorificial and groin rash associated with poor weight gain and irritability. His serum zinc level was low. The mother's breast milk zinc level was found to be low despite her serum zinc levels being normal, confirming the diagnosis of transient neonatal zinc deficiency. Mutational analysis revealed a novel mutation in the mother's SLC30A2 gene, which encodes a zinc transporter expressed in mammary gland epithelial cells.
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Affiliation(s)
- Hui M Liew
- Dermatology Service, KK Women's and Children's Hospital, Singapore City, Singapore
| | - Colin W Tan
- Dermatology Service, KK Women's and Children's Hospital, Singapore City, Singapore
| | - Clement K M Ho
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore City, Singapore
| | - Jade N Chee
- Dermatology Service, KK Women's and Children's Hospital, Singapore City, Singapore
| | - Mark J A Koh
- Dermatology Service, KK Women's and Children's Hospital, Singapore City, Singapore
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12
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Abstract
Hydroa vacciniforme is a photosensitivity disorder characterized by the childhood onset of necrotic vesiculopapules on exposed areas. We present a case of a 10‐year‐old boy with a 1‐year history of papular lesions over his face. In this report, we discuss the in‐depth histology of hydroa vacciniforme, and the management options.
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Affiliation(s)
- Jade N Chee
- Dermatology Service KK Women's & Children's Hospital Singapore Singapore
| | - Mark J A Koh
- Dermatology Service KK Women's & Children's Hospital Singapore Singapore
| | - Hui-Min Liew
- Dermatology Service KK Women's & Children's Hospital Singapore Singapore
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13
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Koh WL, Tay YK, Koh MJA. Danazol-induced Stevens-Johnson syndrome in a patient with systemic lupus erythematosus. Dermatol Online J 2015; 21:13030/qt24v513b9. [PMID: 25612133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 01/15/2015] [Indexed: 06/04/2023] Open
Abstract
A patient with Stevens-Johnson syndrome related to danazol is presented.
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Affiliation(s)
- W L Koh
- Changi General Hospital, Singapore.
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15
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Affiliation(s)
- C C Ang
- Department of Dermatology, Changi General Hospital, Singapore.
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16
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Koh MJA, Teo RYL, Liu TT. Multiple epidermal cysts occurring in a tattoo. Singapore Med J 2009; 50:e376-e377. [PMID: 19960148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In decorative tattooing, pigment is introduced into the skin with needles or a tattoo gun to create a picture, motif or symbol. Various skin reactions have been reported in association with tattoos. These include acute inflammatory reactions, eczematous hypersensitivity reactions, pseudolymphomatous reactions and skin infections. We present a 24-year-old Malay man who developed multiple epidermal cysts a month after tattooing. To the best of our knowledge, this is the first case in the literature of epidermal cysts occurring after skin tattooing.
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Affiliation(s)
- M J A Koh
- Department of Dermatology, Changi General Hospital, Singapore.
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17
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Koh MJA, Seah PP, Teo RYL. Zosteriform herpes simplex. Singapore Med J 2008; 49:e59-e60. [PMID: 18301829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Herpes simplex virus (HSV) infection, though most commonly seen in the oral, perioral and genital areas, can occur anywhere on the body. After primary infection, HSV then establishes latency in sensory nerve ganglia and reactivates intermittently, precipitated by various factors. These reactivations may be recurrent and appear in a dermatomal distribution, mimicking herpes zoster, often leading to misdiagnosis if no confirmatory laboratory tests are carried out. We report a 65-year-old man who presented with recurrent episodes of a "zosteriform eruption", who was initially clinically diagnosed and treated as for recurrent herpes zoster, but was subsequently found to have recurrent herpes simplex virus type 2 after laboratory investigations.
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Affiliation(s)
- M J A Koh
- Department of Dermatology, Changi General Hospital, 2 Simei Street 3, Singapore 529889.
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