Displaying all 17 publications

  1. Wong SM, Baba R
    Int J Dermatol, 2012 Feb;51(2):158-61.
    PMID: 22250623 DOI: 10.1111/j.1365-4632.2011.04932.x
    Vitiligo is a chronic disease and can have significant impairment on patients' quality of life (QoL). Studies have shown that limitations in QoL are similar in magnitude to patients with other chronic skin diseases like psoriasis. The objective of this study was to assess the quality of life (QoL) of patients with vitiligo attending the dermatology clinic of a tertiary hospital in Malaysia.
    Study site: Dermatology clinic, Hospital Kuala Lumpur, Malaysia
  2. Wong SM, Tang JJ
    Med Mycol, 2012 May;50(4):404-6.
    PMID: 22074310 DOI: 10.3109/13693786.2011.630684
    Disseminated sporotrichosis is uncommon and usually occurs in patients who are immunodeficient. Here we describe a male patient who was otherwise in good physical condition, who presented with disseminated sporotrichosis. The only significant event in his past medical history was lepromatous leprosy which had been treated 42 years earlier.
  3. Ch’ng CC, Wong SM, Tan CT
    Neurology Asia, 2016;21(3):261-264.
    Background & Objective: Symptomatic sarcocystosis has been said to be rare until recent years, when there were reports of outbreaks of febrile myositis for travellers returning from the Malaysian island resorts. In 2012, an outbreak of Sarcocystis nesbitti infection involving 92 college students and staff occurred after returning from Pangkor Island, Malaysia. A few months after recovering from the febrile illness, some patients complained of hair loss. This study aimed to determine the prevalence, clinical features and outcome of this disorder.
    Methods: All patients who became sick in the outbreak were asked whether they had the hair loss. For those who had, they were interviewed with standard questionnaires, examined and investigated. Patients were followed-up via an online survey 2 years later.
    Results: Out of 89 patients who were ill, 19 patients (21.4%) complained of alopecia. The mean peak onset was 4 months after the initial illness. Eleven patients (57.9%) reported the hair fall of more than 100 per day. The other symptoms were itch 10 (52.6%), scaling 10 (52.6%), erythema 4 (21.1%), none had scarring. Eleven patients (57.8%) had positive antinuclear factor with high titre (speckled or nucleolar pattern). Two years after the event, 10 had complete or near complete spontaneous recovery, 1 had partial response and 1 had no improvement.
    Conclusions: A delayed transient diffuse alopecia is seen in close to half of patients with Sarcocystis nesbittiinfection. This high frequency of positive ANF suggested an immune-mediated mechanism.

    Study site: Dermatology Clinic, Universiti Malaya Medical Centre (UMMC)
  4. Ch'ng CC, Wong SM, Lee YY
    Cutis, 2017 Jan;99(1):E1-E3.
    PMID: 28207013
  5. Wong SM, Ng TG, Baba R
    J Dermatol, 2013 Nov;40(11):874-80.
    PMID: 24111816 DOI: 10.1111/1346-8138.12265
    Staphylococcus aureus is frequently found in patients with atopic dermatitis (AD) and contributes to disease exacerbation. The objective of this study was to evaluate the efficacy and safety of bleach baths as an adjunctive treatment in AD patients. Patients between 2 and 30 years old with moderate to severe AD were enrolled in a prospective, randomized, placebo-controlled study. Patients soaked in diluted bleach or distilled water baths for 10 min, twice a week for 2 months. Efficacy assessments included the Eczema Area and Severity Index (EASI) scores and S. aureus density was determined using quantitative bacterial cultures. Patients in the treatment group showed significant reductions in EASI scores. A 41.9% reduction in S. aureus density from baseline was seen at 1 month further reducing to 53.3% at 2 months. Equal numbers of patients in both groups experienced mild side-effects. This study demonstrates that diluted bleach baths clinically improved AD in as little as 1 month. No patient withdrew from the treatment arm because of intolerance to the baths.
  6. Ng LC, Lee YY, Lee CK, Wong SM
    Int J Dermatol, 2013 Jan;52(1):102-5.
    PMID: 23278617 DOI: 10.1111/j.1365-4632.2011.05436.x
    BACKGROUND: Methotrexate (MTX) is a common and efficacious systemic agent used for the treatment of moderate to severe psoriasis. Nevertheless, its use is associated with the risk of hepatotoxicity. This study was performed to study the association of MTX dose with regards to hepatotoxicity as evidenced by deranged transaminases.
    METHODS: This was a retrospective review of patients with psoriasis on MTX from 2000 to 2009 at the outpatient dermatology clinic, University Malaya Medical Centre (UMMC). We analyzed patients' demography, serial laboratory investigations, liver ultrasounds, and liver biopsies of patients on MTX.
    RESULTS: Sixty-six of 710 (9.30%) patients with psoriasis were prescribed MTX throughout the 10-year period. Among them 57.6% developed deranged transaminases, with six requiring MTX withdrawal due to hepatotoxicity. The mean cumulative dose of MTX at the detection of liver enzyme derangement was 552.3 ± 596.1 mg.
    CONCLUSION: A high proportion of patients on MTX had deranged transaminases. However, the number of serious events was low. We concluded from this study that the use of MTX is relatively safe in patients with moderate to severe psoriasis.

    Study site: outpatient dermatology clinic, University Malaya Medical Centre (UMMC
  7. 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.
  8. Kwan Z, Pailoor J, Tan LL, Robinson S, Wong SM, Ismail R
    Lepr Rev, 2014 Sep;85(3):170-6.
    PMID: 25509717
    OBJECTIVES: Leprosy remains a public health concern in Malaysia and globally. We aim to review the characteristics of leprosy patients in a tertiary institution in urban Malaysia.
    DESIGN: This is a case series of 27 leprosy patients who presented between 2008 and 2013.
    RESULTS: The majority of our patients consisted of male (74.1%), Malaysian (63.0%), blue collar workers (51.9%) and married (59.3%) patients; 48.1% had lepromatous leprosy. All except one of the patients presented with skin lesions, 25.9% had nerve involvement and 33.3% developed lepra reactions. Forty-four point four percent (44.4%) of the cases seen initially in the primary care setup were misdiagnosed.
    CONCLUSIONS: Doctors need to have a high index of suspicion for leprosy when patients present with suggestive skin, nerve or musculoskeletal lesions. Immigrants accounted for 37% of cases and these patients may become a reservoir of infection, thus accounting for the rise in incidence. An increasing trend in multibacillary cases may be attributed to the spread from migrants from countries with a high burden of leprosy.
  9. Kwan Z, Che Ismail RB, Wong SM, Tan LL, Robinson S, Lim KS
    Int J Dermatol, 2014 Oct;53(10):e477-9.
    PMID: 25209632 DOI: 10.1111/ijd.12579
  10. Khor AH, Lim KS, Tan CT, Wong SM, Ng CC
    Epilepsia, 2014 Nov;55(11):e120-4.
    PMID: 25266342 DOI: 10.1111/epi.12802
    This study aimed to investigate the prevalence and association of HLA-B*15:02 with carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (CBZ-SJS/TEN) in the Indian population in Malaysia, which mostly originated from Southern India. HLA-B alleles in five Indian case patients with CBZ-SJS/TEN and 52 CBZ-tolerant controls, and followed by a pooled sample of seven cases from two centers in Malaysia were analyzed. Positive association for HLA-B*15:02 with CBZ-SJS/TEN was detected in Indians (40% [2/5] vs. 3.8% [2/52], odds ratio [OR] 16.7, p = 0.0349), of which 80% (4/5) of the Indian patients originated from Southern India. A pooled sample of seven cases showed stronger association between HLA-B*15:02 and CBZ-SJS/TEN (57.1% [4/7] vs. 3.8% [2/52], OR 33.3, 95% confidence interval [CI] 4.25-162.21, p = 1.05 × 10(-3)). Subsequent meta-analysis on Indians from Malaysia and India further demonstrated a significant and strong association between HLA-B*15:02 and CBZ-SJS/TEN (OR 38.54; 95% CI 6.83-217.34, p < 1.0 × 10(-4)). Our study is the first on Indians predominantly from Southern India that demonstrated HLA-B*15:02 as a strong risk factor for CBZ-SJS/TEN despite a low population allele frequency. This stressed the importance of testing for HLA-B*15:02, irrespective of the ancestral background, including populations with low allele frequency.
  11. Kwan Z, Wong SM, Robinson S, Tan LL, Looi LM, Ismail R
    Ann Acad Med Singap, 2015 Dec;44(12):577-9.
    PMID: 27090079
  12. Yong SS, Han WH, Faheem NAA, Puvan N, Tan LL, Wong SM, et al.
    Photodermatol Photoimmunol Photomed, 2022 Nov;38(6):541-547.
    PMID: 35324018 DOI: 10.1111/phpp.12787
    BACKGROUND: Airline pilots face significant ultraviolet radiation exposure resulting in an increased risk of sun damage and skin cancers. We aimed to evaluate sun-protective practices and associated factors among airline pilots.

    METHODS: We disseminated an online questionnaire evaluating the use of sunscreen, sunglasses, hats and protective clothing during daytime hours in the cockpit and during outdoor activities to 346 global commercial airline pilots, and we received 220 completed responses. The Pearson chi-squared test or Fisher's exact test where necessary were used to determine possible factors associated with the use of sun-protective practices. Potential confounders were adjusted for using multivariate analyses.

    RESULTS: The most common sun protective behaviour was the wearing of sunglasses during daytime flights (89.5%), followed by the use of caps during outdoor activities (47.7%). More pilots applied sunscreen during daytime flights (14.1%) compared with walk-arounds (8.2%). Males were less likely to use sunscreen during flights (adjusted odds ratio, aOR = 0.76), use sunscreen for walk-arounds (aOR = 0.175) and wear long sleeves (aOR = 0.013). Pilots who flew less than 30 h a month in high latitude regions were less likely to use a cap or hat outdoors (aOR = 0.419) or use sunscreen during walk-arounds (aOR = 0.241). Younger pilots were also less likely to use caps or hats outdoors (aOR = 0.446).

    CONCLUSION: Male pilots and those who spent less time in high latitudes were less likely to practice sun protection. Targeted educational efforts may be implemented to reduce occupational ultraviolet exposure.

  13. Tan BC, Tan SK, Wong SM, Ata N, Rahman NA, Khalid N
    PMID: 25883671 DOI: 10.1155/2015/451870
    The distribution patterns of flavonoids and cyclohexenyl chalcone derivatives in conventional propagated (CP) and in vitro-derived (CPA) field-grown plants of an important medicinal ginger, Boesenbergia rotunda, are described. A total of eight compounds were extracted from six organs (rootlet, rhizome, shoot base, maroon stem, stalk, and leaf) of the CP and CPA plants. Five major chromatographic peaks, namely, alpinetin, pinocembrin, pinostrobin, 4-hydroxypanduratin A, and panduratin A, were consistently observed by high performance liquid chromatography. Nonaerial organs had higher levels of flavonoids than the aerial ones for all types of samples. Among the compounds detected, pinostrobin and 4-hydroxypanduratin A were the most abundant flavonoid and cyclohexenyl chalcone derivative, respectively. The distribution and abundance of the bioactive compounds suggested that the shoot base could be more potentially useful for medicinal application than other organs of the plant and may be the site of storage or occurrence of biosynthetic enzymatic activities.
  14. Yong SS, Robinson S, Kwan Z, Khoo EM, Han WH, Tan LL, et al.
    Psychol Health Med, 2023 Feb;28(2):324-335.
    PMID: 35057684 DOI: 10.1080/13548506.2022.2029914
    Patients with chronic spontaneous urticaria (CSU) have an increased risk of psychological distress. This cross-sectional study aimed to determine factors associated with psychological burden, quality of life (QoL) and patient satisfaction among adults living with CSU. Participants completed the self-administered Urticaria Activity Score-7 (UAS-7), Depression Anxiety Stress Scale (DASS 21), Dermatology Life Quality Index (DLQI), and Short Assessment Patient Satisfaction (SAPS) questionnaires. Multivariate logistic regression was used to determine the independent predictors of depression, anxiety, stress, QoL and patient satisfaction. From a total of 115 subjects with a median age of 42.6 years, range (19-89 years). 60.9% subjects reported moderate-to-severe CSU, 26.1% reported symptoms of depression, 54.8% had anxiety, 40.0% had stress, and 36.5% reported severely impaired QoL. The median UAS-7 score was 20 (IQR 11-27) while the median score of DLQI was 8 (IQR 4-13). The median score of SAPS was 20 (IQR 17-21). Low-income and severe disease were the significant predictors for depression while severe disease was predictive of impaired QoL and depression. Subjects who were diagnosed at older ages and those who required medical leave due to flares of CSU were less likely to be satisfied with their care. (192 words).
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