MyMedR

Fulltext Nevus lipomatosus superficialis

Yap FB

Singapore Med J, 2009 May;50(5):e161-2.

PMID: 19495497

Nevus lipomatosus superficialis is a rare benign skin malformation characterised by ectopic adipocytes in the upper dermis. It is classified into two types: a classical Hoffman-Zurhelle type and the solitary type. A case of the classical type with multiple soft, non-tender, pedunculated, cerebriform, skin-coloured papules and nodules over the right lower back is presented in a 21-year-old Malay woman. She had a rare occurrence of ulceration and necrosis of the lesions.

Fulltext The Role of Combination Calcipotriol plus Betamethasone Dipropionate Gel in the Treatment of Moderate-to-Severe Scalp Seborrhoeic Dermatitis

Yap FB

Sultan Qaboos Univ Med J, 2018 Nov;18(4):e520-e523.

PMID: 30988973 DOI: 10.18295/squmj.2018.18.04.015

Objectives: This study aimed to investigate the off-label use of a combination calcipotriol plus betamethasone dipropionate (CBD) gel in the treatment of moderate-to-severe scalp seborrhoeic dermatitis (SSD).

Methods: This retrospective study involved 32 patients with SSD who were prescribed CBD gel at the Subang Jaya Medical Centre, Selangor, Malaysia, between January 2016 and December 2017. The Physician Global Assessment Scale was used to assess disease severity. Itching/discomfort was evaluated using a visual analogue scale.

Results: The mean age was 35.8 ± 6.9 years. Severe disease was seen in 53.1%. Complete clearance was recorded in 15.6%, 40.6% and 59.4% of patients at weeks two, six and 10, respectively. By week 10, 87.5% had achieved marked improvement. Both mean itching and discomfort scores significantly improved at weeks two, six and 10 (P <0.001). Better outcomes were significantly associated with disease duration and itching intensity and discomfort at presentation (P <0.050).

Conclusion: CBD gel should be considered as an option for SSD cases not adequately controlled by prior conventional treatment.

Cutaneous larva migrans in Hospital Kuala Lumpur, Malaysia: rate of correct diagnosis made by the referring primary care doctors

Yap FB

Trans R Soc Trop Med Hyg, 2011 Jul;105(7):405-8.

PMID: 21600621 DOI: 10.1016/j.trstmh.2011.04.002

A retrospective study was undertaken to determine the clinical features of cutaneous larva migrans (CLM) seen in the Department of Dermatology, Hospital Kuala Lumpur (Kuala Lumpur, Malaysia) and to assess the rate of correct diagnosis made by the referring primary care doctors. Clinical records of all 31 patients with CLM seen between January 2006 and June 2010 were retrieved. The majority of patients were male. The mean age was 32.2 years. Pruritus was reported in 83.9% of cases and serpiginous tracts in 100%. The mean lesion count was 4.4 and the mean duration of disease before presentation was 3.1 weeks. The majority of skin lesions were on the buttock and lower extremities. Only 45.2% of patients had the correct diagnosis made by the referring primary care doctors. Older age of patients and lower number of lesions were associated with a higher rate of correct diagnosis. The low rate of correct diagnosis made by the referring primary care doctors to the dermatologists in this study warrants the need for education of not only primary care doctors but also future primary care providers, consisting of medical students, house officers and junior medical officers.

Study site: Department of Dermatology, Hospital Kuala Lumpur

Fulltext Disseminated cutaneous sporotrichosis in an immunocompetent individual

Yap FB

Int J Infect Dis, 2011 Oct;15(10):e727-9.

PMID: 21719337 DOI: 10.1016/j.ijid.2011.05.005

Sporotrichosis is a subacute or chronic fungal infection caused by the ubiquitous fungus Sporothrix schenckii. Disseminated cutaneous sporotrichosis is an uncommon entity and is usually present in the immunosuppressed. Here, a case of disseminated cutaneous sporotrichosis in an immunocompetent patient is reported. This 70-year-old healthy woman presented with multiple painful ulcerated nodules on her face and upper and lower extremities of 6-month duration, associated with low-grade fever, night sweats, loss of appetite, and loss of weight. Histopathological examination of the skin biopsy revealed epidermal hyperplasia and granulomatous inflammation in the dermis, with budding yeast. Fungal culture identified S. schenckii. She had total resolution of the lesions after 2 weeks of intravenous amphotericin B and 8 months of oral itraconazole. All investigations for underlying immunosuppression and internal organ involvement were negative. This case reiterates that disseminated cutaneous sporotrichosis, although common in the immunosuppressed, can also be seen in immunocompetent patients.

Nonvenereal sclerosing lymphangitis of the penis

Yap FB

South. Med. J., 2009 Dec;102(12):1269-71.

PMID: 20016439 DOI: 10.1097/SMJ.0b013e3181bf27f6

A 30-year-old man presented to the genitourinary medicine clinic with the sudden appearance of an asymptomatic, 2 mm wide, flesh-colored, firm, and cord-like lesion encircling the coronal sulcus circumferentially following vigorous sexual intercourse with his wife. An initial diagnosis of sexually transmitted disease-associated penile swelling was entertained. He was given antibiotics for this condition. Failure of resolution and negative screening tests for sexually transmitted diseases prompted a skin biopsy and extensive literature search, with an ultimate diagnosis of nonvenereal sclerosing lymphangitis of the penis, a rare, self-limiting condition. Reassurance and abstinence of sexual intercourse for a few weeks led to complete recovery.

Chromoblastomycosis in Sarawak, East malaysian Borneo

Yap FB

Trans R Soc Trop Med Hyg, 2010 Feb;104(2):168-9.

PMID: 19766279 DOI: 10.1016/j.trstmh.2009.05.016

A retrospective study was conducted to determine the clinical characteristics and treatment outcomes of 11 new patients with a histological diagnosis of chromoblastomycosis at Sarawak General Hospital, Malaysia, between 1996 and 2008. The majority (81.8%) were males, and the median age at presentation was 40 years. Over half the patients were farmers. All the patients had irregular verrucous lesions, mostly on the lower limbs (90.9%), and had initially been misdiagnosed. The mean duration of the lesions was 13.8 years. Oral terbinafine and itraconazole were administered to all the patients; clinical cure was seen in 54.5%, and partial response in 18.2%. Concomitant electrocautery and cryotherapy were only effective for small lesions.

Fulltext Angiokeratoma corporis diffusum

Yap FB, Pubalan M

Med J Malaysia, 2008 Oct;63(4):329-30.

PMID: 19385495 MyJurnal

Angiokeratoma is a dark violaceous keratotic papule which can be solitary or multiple. Generalised systemic angiokeratoma constitute angiokeratoma corporis diffusum, a rare X-linked recessive inborn error of glycosphingolipid metabolism due to deficiency of alpha galactosidase A. Patients with this disease have premature death due to the vascular complications. A case of possible Fabry's disease is presented.

Fulltext Creeping eruption

Yap FB

Int J Infect Dis, 2010 Jun;14(6):e545.

PMID: 19889564 DOI: 10.1016/j.ijid.2009.07.006

Fulltext Chromoblastomycosis

Yap FB

Int J Infect Dis, 2010 Jun;14(6):e543-4.

PMID: 19889559 DOI: 10.1016/j.ijid.2009.07.005

Leprosy in sarawak, East malaysian borneo

Yap FB

Scand. J. Infect. Dis., 2009;41(4):320.

PMID: 19117243 DOI: 10.1080/00365540802680409

Pediatric leprosy in Sarawak, Malaysia

Bin Yap FB

Pediatr Infect Dis J, 2009 Oct;28(10):933-4.

PMID: 20118691 DOI: 10.1097/INF.0b013e3181b48f76

Safety and efficacy of fixed-dose 10 mg daily isotretinoin treatment for acne vulgaris in Malaysia

Yap FB

J Cosmet Dermatol, 2017 Sep;16(3):348-352.

PMID: 27539948 DOI: 10.1111/jocd.12268

INTRODUCTION: Low-dose isotretinoin is used to reduce side effects albeit higher relapse. This study aimed to determine the efficacy and safety of fixed-dose 10 mg daily isotretinoin for the treatment of acne.

METHODS: This prospective study was performed between 2011 and 2015. All 150 patients were given 10 mg daily isotretinoin until a cumulative dose of 90-110 mg/kg.

RESULTS: The mean age was 26.6 years with 64.7% moderate acne, 29.3% severe, and 6% very severe. The mean cumulative dose was 98.8 ± 6.05 mg/kg. All 150 patients had total clearance with a mean time to clearance of 24.0 weeks. Patients with severe/very severe acne had higher cumulative dosage (102.1 vs. 97.0, P

Erythema nodosum-like lesions in a renal transplant recipient

Yap FB, Lee BR

Arch Dermatol, 2011 Jun;147(6):735-40.

PMID: 21690541 DOI: 10.1001/archdermatol.2011.128-a

Fulltext Pattern and clinical characteristics of patients with nail psoriasis in Sarawak General Hospital, Malaysia

Yap FB, Pubalan M

Indian J Dermatol Venereol Leprol, 2010 Nov-Dec;76(6):703-4.

PMID: 21079320 DOI: 10.4103/0378-6323.72447

Study site: Skin Clinic, Sarawak General Hospital, Malaysia

Novel techniques for enhancement and segmentation of acne vulgaris lesions

Malik AS, Humayun J, Kamel N, Yap FB

Skin Res Technol, 2014 Aug;20(3):322-31.

PMID: 24329769 DOI: 10.1111/srt.12122

BACKGROUND: More than 99% acne patients suffer from acne vulgaris. While diagnosing the severity of acne vulgaris lesions, dermatologists have observed inter-rater and intra-rater variability in diagnosis results. This is because during assessment, identifying lesion types and their counting is a tedious job for dermatologists. To make the assessment job objective and easier for dermatologists, an automated system based on image processing methods is proposed in this study.
OBJECTIVES: There are two main objectives: (i) to develop an algorithm for the enhancement of various acne vulgaris lesions; and (ii) to develop a method for the segmentation of enhanced acne vulgaris lesions.
METHODS: For the first objective, an algorithm is developed based on the theory of high dynamic range (HDR) images. The proposed algorithm uses local rank transform to generate the HDR images from a single acne image followed by the log transformation. Then, segmentation is performed by clustering the pixels based on Mahalanobis distance of each pixel from spectral models of acne vulgaris lesions.
RESULTS: Two metrics are used to evaluate the enhancement of acne vulgaris lesions, i.e., contrast improvement factor (CIF) and image contrast normalization (ICN). The proposed algorithm is compared with two other methods. The proposed enhancement algorithm shows better result than both the other methods based on CIF and ICN. In addition, sensitivity and specificity are calculated for the segmentation results. The proposed segmentation method shows higher sensitivity and specificity than other methods.
CONCLUSION: This article specifically discusses the contrast enhancement and segmentation for automated diagnosis system of acne vulgaris lesions. The results are promising that can be used for further classification of acne vulgaris lesions for final grading of the lesions.
KEYWORDS: acne grading; acne lesions; acne vulgaris; enhancement; segmentation

Syringocystadenoma papilliferum in an unusual location beyond the head and neck region: a case report and review of literature

Yap FB, Lee BR, Baba R

Dermatol. Online J., 2010;16(10):4.

PMID: 21062598

A case of syringocystadenoma papilliferum with multiple papulonodules in a linear fashion located in an unusual location of the right lower abdomen is presented. The presence of a large tumor at the inferior pole raised the suspicion of malignant transformation and the presence of discharge from the lesions raised the possibility of necrosis. However, histopathological examination showed the classical features of syringocystadenoma papilliferum without malignant transformation or tumor necrosis. The patient refused to undergo surgical excision of the nodules and subsequently was lost to follow-up. This case illustrates the atypical location of a rare disease and adds to the differential diagnosis of linear verrucous lesions on the abdomen. Review of all the cases with syringocystadenoma papilliferum outside the head and neck region in the English literature showed only one case of syringocystadenoma papilliferum arising on the abdomen; our patient is the second reported case with the unique feature of linear arrangement of lesions.

Penicillium marneffei infection in an African man

Yap FB, Thevarajah S, Asmah J

Dermatol. Online J., 2010;16(7):2.

PMID: 20673530

Penicilliosis is a systemic fungal infection caused by Penicillium marneffei. The infection is most commonly seen in Southeast Asia, Southern China, Hong Kong, and Taiwan. It is rarely seen among individuals of African descent. Here, we report a case of penicilliosis in an African man from Namibia who was studying in Malaysia. He presented with multiple umbilicated papules associated with cough, fever, loss of appetite, and weight. He also had urethral discharge and admitted to unprotected sexual intercourse with multiple partners. Histopathological examination of a skin papule showed the presence of multiple 2 to 4 microm intracellular yeast cells. Culture of the papule revealed Penicillium marneffei. The serology for human immunodeficiency virus (HIV) was positive. This case illustrates the need to recognize penicilliosis in any individuals staying or travelling to Southeast Asia and the need to look for underlying HIV infection in adults with umbilicated papules.

Quality of life in patients with erythema nodosum leprosum in Kuala Lumpur, Malaysia

Yap FB, Kiung ST, Yap JB

Indian Dermatol Online J, 2016 Jul-Aug;7(4):255-8.

PMID: 27559497 DOI: 10.4103/2229-5178.185495

There is a paucity of data on quality of life issues in patients with leprosy suffering from erythema nodosum leprosum (ENL). Thus, we aim to study the effect of ENL on quality of life.

Prevalence of scabies and head lice among students of secondary boarding schools in Kuching, Sarawak, Malaysia

Yap FB, Elena EM, Pubalan M

Pediatr Infect Dis J, 2010 Jul;29(7):682-3.

PMID: 20574407 DOI: 10.1097/INF.0b013e3181df61dd

Fulltext Using Patient Profiles To Guide The Choice Of Antihistamines In The Primary Care Setting In Malaysia: Expert Consensus And Recommendations

Baharudin A, Abdul Latiff AH, Woo K, Yap FB, Tang IP, Leong KF, et al.

Ther Clin Risk Manag, 2019;15:1267-1275.

PMID: 31802877 DOI: 10.2147/TCRM.S221059

H1-antihistamines are recognized to be effective for conditions such as allergic rhinitis and chronic spontaneous urticaria. However, management of such conditions in the real-world primary care setting may be challenging due to diverse patient-specific considerations, the wide range of antihistamines available, choice of other treatment modalities, and the complexity of interpreting specialist treatment algorithms. Despite regular updates to international guidelines, regional/national surveys of healthcare professionals show a clear gap between guidelines and real-world practice, particularly at the primary care level. This article thus presents the consensus opinion of experts from relevant specialties in Malaysia - allergology, pediatrics, otorhinolaryngology, and dermtology - on harmonizing the use and choice of antihistamines in primary care. Patient profiling is recommended as a tool to guide primary care practitioners in prescribing the appropriate antihistamine for each patient. Patient profiling is a three-step approach that involves 1) identifying the individual's needs; 2) reviewing patient-specific considerations; and 3) monitoring treatment response and referral to specialists in more severe or difficult-to-treat cases. Concurrently, guidelct 3ines should be reviewed and updated periodically to include recommendations that are easily actionable for primary care practitioners.

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