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Biomedical subjects

H L Chan

Publications and source records attributed to H L Chan.

At least 127 records · Page 7Linked to original sources
PubMed1988

Acute disseminated cutaneous candidiasis.

Acute disseminated candidiasis is a serious and difficult problem often seen in immunocompromised states. Appearance of a characteristic skin eruption is helpful in the diagnostic. We report below a case report of an eight year old girl with aplastic anemia who had received multiple courses of antibiotics. A profuse monomorphic papular nodular eruption subsequently appeared on the face, palms and soles. Candida tropicalis was identified from the skin biopsy taken from one such lesion.

Acute Disease↗
PubMed1987

Clear cell papulosis of the skin. A new entity with histogenetic implications for cutaneous Paget's disease.

A new skin condition characterized by multiple white papular eruptions was observed in two young brothers. Histologic study revealed many benign pagetoid clear cells in the basal layer of the acanthotic epidermis with decreased pigmentation. These cells contained cytoplasmic mucin and were positive for keratin AE1/AE3, carcinoembryonic antigen, and epithelial membrane antigen. The staining pattern was identical to that of extramammary Paget's disease. The presence of mucin granules and cytoplasmic filaments corresponding to AE1/AE3 were confirmed ultrastructurally. Comparative histochemical and immunohistochemical studies with normal eccrine sweat glands, Toker's nipple clear cells, and Paget cells of mammary and extramammary Paget's disease suggest that these clear cells are an aberrant derivative of sweat-gland epithelial cells in the epidermis. AE1/AE3 is an excellent marker for the "clear cells" of both the condition described and the cells in the nipple. The term "clear cell papulosis" is proposed for this new entity. The clear cell identified provides evidence for the existence of potential precursor cells in the epidermis for cutaneous Paget's disease.

Child, Preschool↗
PubMed1987

Severe reactional state in lepromatous leprosy simulating Sweet's syndrome.

A male patient with underlying lepromatous leprosy mimicked Sweet's syndrome clinically. He was believed to be in an atypical reactional state recognized as a variant form of erythema nodosum leprosum. In addition to the antileprosy treatment, steroid hormone was required to control the systemic symptoms.

Diagnosis, Differential↗
PubMed1986

Tinea infection histologically simulating eosinophilic pustular folliculitis.

A biopsy taken from an annular eruption on the thigh of an infant boy showed features of Ofuji's eosinophilic pustular folliculitis, yet fungal hyphae were demonstrated in the lesion. This case is reported to illustrate that tinea infection can stimulate eosinophilic pustular folliculitis histologically.

Diagnosis, Differential↗
PubMed1986

Wilson's disease revisited in the tropics.

The clinical features and investigations of 17 patients were analysed. Thirteen of them were Chinese and the rest Indians. Their ages at presentation ranged from 8 to 63 years (mean 18.35 years). Thirteen patients (76%) were symptomatic; 8 with predominantly hepatic manifestations and 5 with neurological features. Four were asymptomatic siblings. At diagnosis, however, 10(59%) had features of liver involvement singly, 3 (18%) had neurological involvement alone and 4 (27%) had mixed presentations. Family histories were available in 15 patients; 26.9% of siblings had Wilson's Disease. Serum ceruloplasmin was low in 82% of the patients. 24-hour urinary copper was measured in 16 patients and was raised in all of them. About half the patients (41%) had evidence of concomittant renal tubular dysfunction with hypouricaemia and aminoaciduria. Three patients (18%) had joint involvement at presentation. All 17 patients were treated with Penicillamine. Complications due to therapy included pemphigus in one and toxic epidermal necrolysis and later a lupus like syndrome in another. The features of clinical improvement included fading of K-F rings, improvement of neurological signs and the normalisation of serum transaminases. One patient developed primary hepatocellular carcinoma 5 years after presentation. Delay in diagnosis was encountered in half of the patients reviewed. Being a treatable condition, Wilson's Disease, although rare, should always be thought of in patients with haemolysis, liver diseases or extrapyramidal disorders.

Adolescent↗
PubMed1985

Adult T-cell leukemia/lymphoma in Taiwan. A clinicopathologic observation.

The retrovirus-associated adult T-cell leukemia/lymphoma (ATL) has not been previously documented in Taiwan. Five cases identified recently by the authors are reported. Three of the patients were women, and their ages ranged from 36 to 60 years. The most important diagnostic clue was the observation of polylobated lymphoid cells in the peripheral blood. Other variably observed significant features included hypercalcemia, cutaneous eruptions, osteolytic bone lesion, hepatomegaly, and lymphadenopathy. Surface marker studies revealed that the leukemic or lymphoma cells were T-helper cells. Histopathologic examination revealed one case of pleomorphic type and three cases of medium-sized cell type. No tissue was available for study in one case. The diagnosis of ATL was confirmed by the indirect immunofluorescence test on MT-1 cell for antibodies to adult T-cell leukemia virus-associated antigen (ATLA). Three patients were dead within 6 months, and two patients had been in clinical remission for 7 and 10 months, respectively. These two latter cases were similar to the so-called smoldering type of ATL. Two descendents among nine relatives of the patients were also positive for anti-ATLA (22%). Two husbands were negative. Four of the five patients lived in the same county in northeastern coastal Taiwan, which suggested a possible clustering of ATL in that region.

Adult↗
PubMed1985

Serological survey of antibodies to the adult T-cell leukemia virus-associated antigen (HTLV-A) in Taiwan.

A serological survey of antibodies to the adult T-cell leukemia virus-associated antigen (HTLV-A) conducted in Taiwan revealed II seropositive individuals among 2,565 serum donors tested, which included 1,187 hospital or free clinic patients, 1,065 blood donors and 313 aborigines. The overall prevalence rate was 0.43% and was 0.90% (9/995) for adults aged 40 years or over, which was similar to the rates observed in the non-endemic areas in Japan. No highly prevalent area was demonstrated. The II seropositive individuals identified were 8 hospital or clinic patients, 1 blood donor and 2 aborigines. Among 108 various leukemia/lymphoma patients also studied, 7 were positive. These 7 anti-HTLV-A-positive patients also had clinicopathologic features of adult T-cell leukemia/lymphoma (ATL). Among 21 relatives of 3 seropositive individuals in the epidemiologic study, 2 were positive; and among 25 relatives of 5 ATL patients, 6 were positive. Our data support the contention that horizontal familial transmission of human T-cell leukemia virus (HTLV-I) is an important route and HTLV-I infection can occur on a different genetic background. Furthermore, the antibody titer did not correlate with the manifestation or the state of the disease.

Adolescent↗
PubMed1985

Cutaneous manifestations of adult T cell leukemia/lymphoma. Report of three different forms.

The clinical and pathologic features of cutaneous lesions observed in three adult T cell leukemia/lymphoma (ATL) patients identified in Taiwan are described. They represent one classical case of ATL and two "smoldering" variants. The classical ATL patient when first seen had numerous erythematous or purpuric papules, nodules, and plaques with or without ulceration. The two "smoldering" cases developed encrusted purpuric plaques with subcutaneous erythematous nodules in one patient and pompholyx-like vesicular eruptions with tumor masses in another patient. The pompholyx-like eruptions have not been described before. Pruritus was the major complaint in two patients. Histopathologic studies revealed pleomorphic infiltration in the classical case and monomorphic infiltration with medium-sized cells in the two "smoldering" variants. Therefore, the cutaneous lesions of ATL are diverse and not pathognomonic. The diagnosis requires a high index of suspicion, detection of circulating characteristic multilobated lymphoid cells with T helper/inducer cell marker, and demonstration of serum antibody against the adult T cell leukemia virus-associated antigen.

Adult↗
PubMed1985

Dermatomyositis and cancer in Singapore.

Of 12 patients with adult dermatomyositis studied, 5 (41%) had associated malignancies, of which 3 were nasopharyngeal carcinomas. The youngest was a 23-year-old woman. In view of the high incidence of cancer and the predominance of nasopharyngeal carcinoma, malignancy evaluation in Chinese patients from the Far East, 20 years of age or older with dermatomyositis should have extended workups for postnasal cancer. Two patients who had positive antinuclear not have associated cancers. Three patients died of acute myocardial infarction.

Adult↗
PubMed1985

Ampicillin-induced interstitial nephritis with generalised exfoliative dermatitis.

Drug induced renal failure is a serious, potentially, fatal illness that is preventable. Hypersensitivity reactions involving the kidneys can occur with any of the penicillin groups. However, there are few reports in the literature of ampicillin as a cause of acute interstitial nephritis. In the following case report, a patient developed acute interstitial nephritis with renal failure and exfoliative dermatitis following ampicillin therapy. The diagnosis was based on the rapid onset of renal failure, presence of eosinophilia, skin rash, and characteristic renal biopsy finding, following the administration of ampicillin. Renal function returned to normal eventually, but she continued to have relapses of exfoliative dermatitis up to a year later.

Acute Kidney Injury↗
PubMed1985

The glucagonoma syndrome in a Chinese man.

The glucagonoma syndrome is a rare clinical condition. In this syndrome there is a pancreatic islet cell tumour which secretes glucagon, associated with a distinctive skin eruption--migratory necrolytic erythema. We describe a 79 year old Chinese man who presented with the typical skin features of this condition and on investigation had a pancreatic islet cell tumour. Serum glucagon levels were markedly elevated. He had a partial pancreatectomy and the skin rash improved dramatically. However he had liver metastases and responded poorly to streptozotocin. The skin features recurred and the patient died 9 months after diagnosis. As far as we are aware, this is the first report of a Glucagonoma syndrome in a Chinese.

Adenoma, Islet Cell↗
PubMed1985

Insulin dependent diabetes and goitre in a case of hypomelanosis of Ito (Incontinentia Pigmenti Achromians).

Incontinentia Pigmenti Achromians (IPA) or, more aptly, Hypomelanosis of Ito is now largely accepted as a Neurocutaneous Disorder. Studies, so far, have focussed on the ultrastructural abnormalities and to our knowledge, there have been no attempts to ascertain if there is a particular HLA pattern. We describe an interesting case where IPA occurred in association with Insulin Dependent Diabetes as well as a goitre, suggesting that HLA studies may well be worthwhile. The literature is also reviewed.

Adult↗
PubMed1985

A case of pneumonia presenting with the acute respiratory distress syndrome.

Adult respiratory distress syndrome (ARDS) or high permeability pulmonary oedema (HPPE) is an uncommon presentation of a viral pneumonia and usually occurs in the setting of a fulminant or severe viral pneumonia. High permeability pulmonary oedema (HPPE) can be loosely defined as those forms of pulmonary oedema with normal cardiac function associated with the accumulation of protein-rich fluid in the interstitial or intraalveolar spaces. Through the years, a number of phrases have been used to describe this entity: white lung, shock lung, wet lung, adult hyaline membrane disease, ARDS and others. The aetiology is varied but the clinical, radiologic and pathologic pictures are similar. In fact the pathologic picture is so consistent from patient to patient regardless of aetiology that it has been suggested that the term HPPE be used in place of the other commonly used ones. A case of HPPE of possible viral aetiology who responded to prompt intervention with a successful outcome, is described here.

Acute Disease↗
PubMed1984

Observations on drug-induced toxic epidermal necrolysis in Singapore.

Fifteen patients with toxic epidermal necrolysis (TEN) were studied. In all of them the TEN was related to drug ingestion and believed to be drug-induced. The drugs implicated include pyrazolone derivatives, allopurinol, barbiturates, tetracycline, phenytoin, and penicillamine. Possible etiologic co-factors are infections, cancer, and the systemic lupus erythematosus diathesis. The extent of skin loss varied from 25% to almost 100% involvement of the total body surface. Seven of the fifteen patients had more than 75% epidermal loss. Three deaths were recorded (20%). From observations on these fifteen patients it was found that a single drug can cause two "reaction" patterns, namely, Stevens-Johnson syndrome (or erythema multiforme) and TEN, at the same time or at different times in one and the same patient. It is stressed that from the prognostic and therapeutic viewpoints patients with TEN may be equated to patients with extensive partial-thickness burns and should be treated in a burn unit.

Adult↗