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Biomedical subjects

Y K Tay

Publications and source records attributed to Y K Tay.

At least 55 records · Page 3Linked to original sources
PubMed1997

Patterns of psoriatic arthritis in Orientals.

OBJECTIVE: To determine the clinical features of psoriatic arthritis (PsA) in a multiethnic Oriental population and to study the effect of ethnicity on disease patterns. METHODS: A retrospective study of 80 patients with PsA seen at either a rheumatology or dermatology referral center. Patients and case records were reviewed and data abstracted according to a standard protocol. Eighty consecutive patients with psoriasis without PsA seen at the dermatology center were recruited as controls. RESULTS: Asymmetric polyarthritis developing in the 4th decade with an equal male to female ratio was the commonest pattern of arthritis among Chinese, Indians, and Malays. Clinically apparent lumbar spondylitis was significantly more common in Indians than Chinese (10/11 vs 11/20, respectively; p = 0.046), although the prevalence of lumbar spondylitis was similar in all ethnic groups. Eighty-nine percent of subjects required nonsteroidal antiinflammatory drugs and 51% required disease modifying antirheumatic drugs at some time for control of joint disease. PsA was significantly more common among Indians compared to the ethnic distribution of the Singapore population (p < 0.000001). Multiple logistic regression identified Indian ethnicity as a risk factor for the development of PsA (OR 2.39, 95% confidence interval 1.02 to 5.60). CONCLUSION: The commonest pattern of PsA in all ethnic groups was asymmetric polyarthritis. Ethnicity affected the development and presentation of PsA in our series: Indians with psoriasis had double the risk of developing PsA compared to Chinese with psoriasis, and lumbar spondylitis when present in Chinese subjects was asymptomatic in 45%, being detectable only on radiological examination.

Adult↗
PubMed1997

Familial aplasia cutis congenita of the scalp: a case report and review.

We report three cases of aplasia cutis congenita of the scalp affecting two siblings and their mother, suggesting group 1, or autosomal dominant aplasia cutis congenita not associated with multiple abnormalities. A review of the clinical features and literature concerning this heterogenous and rare condition is presented.

Alopecia↗
PubMed1996

Inflammatory nuchal-occipital port-wine stains.

A port-wine stain is a congenital vascular anomaly caused by a malformation of the papillary dermal capillaries. We observed three children with an unusual appearance of their port-wine stains. All had a prominent inflammatory component consisting of scaling, excoriations, oozing, and crusting, resembling a dermatitis. In two patients, the port-wine stain occurred on the nape of the neck; in the third, it occurred over the occipital area of the scalp. Treatment with topical steroids helped to decrease the scaling and crusting, but when the steroids were stopped the inflammatory component returned. In tow patients, the lesions were treated with the flashlamp-pumped pulsed dye laser with almost total clearing of the port-wine stains and complete absence of the inflammatory component after one treatment. The recognition of this inflammatory manifestation of port-wine stains will enable earlier diagnosis and allow for effective treatment with the pulsed dye laser.

Dermatitis↗
PubMed1996

Epidermal nevus syndrome: association with central precocious puberty and woolly hair nevus.

The epidermal nevus syndrome is characterized by the association of epidermal nevi with abnormalities of the skin, skeletal system, central nervous system, eyes, and cardiovascular system, as well as with malignant conditions. We describe a 2-year-old girl with an extensive epidermal nevus involving the left side of the body (nevus unius lateris) and associated with a woolly hair nevus on the left parietal area of the scalp and multiple acquired melanocytic nevi. Idiopathic central precocious puberty characterized by premature breast and public hair development and advanced bone age developed at the age of 20 months. A sharp increase in serum gonadotropins after a luteinizing hormone releasing hormone (LHRH) stimulation test confirmed the presence of central precocious puberty. This is the third reported case of precocious puberty associated with the epidermal nevus syndrome.

Child, Preschool↗
PubMed1996

Mycoplasma pneumoniae infection is associated with Stevens-Johnson syndrome, not erythema multiforme (von Hebra).

A review of the English-language medical literature revealed at least 70 cases of well-documented Mycoplasma pneumoniae infections associated with the Stevens-Johnson syndrome. There were no cases associated with erythema multiforme (von Hebra). Most of the patients were children and young adults, and male patients were more commonly affected. Most patients had prodromal symptoms of an upper respiratory tract infection before the onset of the eruption and an underlying pneumonia. Although the clinical course may be severe and prolonged, the prognosis is uniformly good with complete recovery in nearly all patients. Treatment is largely supportive and the use of antibiotics or steroids (or both) appears to have little effect on the course of the illness. We conclude that M. pneumoniae is the most common infectious agent associated with the Stevens-Johnson syndrome. It is not associated with erythema multiforme of von Hebra.

Adult↗
PubMed1996

Photodermatoses in a Singapore skin referral centre.

The inducing or exacerbating effect of sunlight on skin diseases is often not appreciated in tropical countries, perhaps because of the perennial presence of sunlight, and a retrospective review of photodermatoses seen in a referral skin clinic was therefore carried out. The photodermatoses seen were secondary photoaggravation of primary skin diseases (32.2%), systemic drug photosensitivity (11.3%), polymorphic light eruption (13%), chronic actinic dermatitis (5.3%), solar urticaria (5.3%), actinic prurigo (4%), photoallergic contact dermatitis (2.6%), porphyria (1.3%) and xeroderma pigmentosum (1.3%). Compared with the results of Western studies, there were more photoaggravated underlying skin diseases and systemic drug photosensitivity, and fewer idiopathic photodermatoses and photoallergic contact dermatitis; the common photoallergens were chlorpromazine, promethazine and musk ambrette, very similar to those seen in the West.

Adolescent↗
PubMed1996

Localized vulvar syringomas--an unusual cause of pruritus vulvae.

Genital syringomas are rare and usually asymptomatic. We report 2 young women who presented with pruritus vulvae. Examination revealed multiple bilateral skin-coloured papules over the labia majora. Histology showed syringoma. Syringomas should be considered in the differential diagnosis of pruritic papular lesions of the vulva.

Adult↗
PubMed1996

A case of adult onset Still's disease presenting with fever and a rash.

Adult onset Still's disease is a rare condition presenting with high spiking fever, transient maculopapular rash, myalgias, polyarthralgias or arthritis, lymphadenopathy, hepatosplenomegaly and a sore throat, associated with leucocytosis and neutrophilia. Early diagnosis is difficult because clinical features are non-specific. We report a 33-year-old Chinese female with this condition who presented with recurrent high spiking fever and rash over a 4-month period. We highlight the sequence of events leading to this diagnosis with emphasis on the cutaneous changes.

Adult↗
PubMed1996

Focal facial dermal dysplasia: report of a case with associated cardiac defects.

Focal facial dermal dysplasia is characterized by congenital scar-like depressions on both temples and a wide spectrum of associated facial abnormalities. We report a 2-month-old white boy who presented with bitemporal defects, laterally deficient eyebrows, absent lower eyelashes, periorbital puffiness, a bulbous nasal tip with prominent sebaceous hyperplasia, and down-turned corners of the mouth. In addition, he had tetralogy of Fallot, an association which previously has not been described.

Abnormalities, Multiple↗
PubMed1995

A questionnaire-based survey of patients' knowledge of psoriasis at the National Skin Centre.

Psoriasis is a chronic disease, which while potentially controllable, cannot be cured. Treatment is long term and requires continuous effort by the patient. Patient education is important for a chronic disease like psoriasis and this involves acquiring knowledge about the disease. With knowledge gained, the patient will be better able to cope, improve decision-making and comply with treatment. The aim was to determine the level of knowledge of psoriasis among four groups of patients attending the National Skin Centre. The study population consisted of 120 patients divided into four groups with 30 patients each from the general clinic, psoriasis clinic, private clinic and phototherapy clinic. The patients were asked to fill up a questionnaire. For those who were Chinese educated, a Mandarin translation of the questionnaire was made. The patients' age ranged from 13 to 83 years with a mean of 39 years. The mean duration of psoriasis was 9 years. Patients from the phototherapy clinic scored significantly higher than patients from the other clinics. There were, however, gaps in the knowledge of psoriasis among the various groups. No correlation was noted between age, sex, duration of psoriasis, number of consultations or phototherapy session with correct scores to the questionnaire. The most common treatment prescribed for the general and private clinics was a combination of topical steroids and tar (67% and 44% respectively). For the psoriasis clinic, the most common treatment prescribed was methotrexate (60%). For the phototherapy clinic, the most common modality used was ultraviolet B light (60%). Education is important in the overall treatment of psoriasis patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Evaluation of enzyme immunoassay for the detection of anogenital infections caused by Chlamydia trachomatis.

BACKGROUND--Infection caused by Chlamydia trachomatis is now recognised as the most prevalent sexually transmitted disease in many parts of the world. Anorectal infections caused by C. trachomatis is not uncommon. Enzyme-linked immunoassay (EIA) detects an antigen lipopolysaccharide (LPS) of C. trachomatis directly in clinical specimens. OBJECTIVE--Our aim was to compare an enzyme immunoassay, Wellcozyme Chlamydia (WZ04) with cell culture for the diagnosis of chlamydial infection of the anogenital tract. METHOD--Rectal swabs were taken from 100 prostitutes (80 females and 20 males) for chlamydia culture, WZ04 and direct immunofluorescence (DIF). In addition, endocervical specimens were obtained from the females for the above three tests. MAIN FINDINGS--All the positive rectal specimens were from females. Nine patients had a positive chlamydia culture from the rectum but negative WZ04 and DIF. Two patients had false positive results by WZ04 but negative culture and DIF. For cervical specimens, WZ04 identified 43% (3/7) of the culture positive cases. Specificity was 98.6%. WZ04 identified an additional specimen as positive which was also confirmed as positive by DIF. CONCLUSION--Our study shows that in our hands enzyme-linked immunoassays such as Wellcozyme Chlamydia are neither sensitive nor specific in detecting C. trachomatis infection of the rectum. For cervical infections, the sensitivity of WZ04 was 43% and the specificity 98.6% as compared to culture, with a positive predictive value of 75% and a negative predictive value of 94.7%.

Adult↗
PubMed1995

Bullous systemic lupus erythematosus--a case report and review.

We report a case of a 20-year-old Chinese woman who presented with an 8-month history of a widespread pruritic blistering eruption. Histology, direct immunofluorescence and indirect immunofluorescence studies were consistent with bullous systemic lupus erythematosus (SLE). The lesions responded dramatically to dapsone 100 mg daily. Bullous SLE is a rare blistering condition with a distinctive combination of clinical, histologic and immunopathologic features that together constitute a unique bullous disease phenotype. The differential diagnoses and in particular the association between bullous SLE and epidermolysis bullosa acquisita are emphasized.

Adult↗
PubMed1995

Dual therapy with doxycycline and ketoprofen compared to doxycycline in the treatment of uncomplicated non-gonococcal urethritis.

The aim of this study was to compare a combination of doxycyline and ketoprofen, and doxycycline alone in treating non-gonococcal urethritis (NGU), with particular emphasis on reducing recurrent or persistent disease. Sixty-five men with first episode acute NGU were enrolled between November 1992 and November 1994. The men were randomly assigned to either the doxycycline plus ketoprofen group, group A (doxycycline 100 mg twice daily for 10 days plus ketoprofen 200 mg daily for 10 days, n = 34), or the doxycycline group, group B (100 mg twice daily for 10 days, n = 31). Out of the 65 patients studied, Chlamydia trachomatis was isolated from 9 patients (13.8%), Ureaplasma urealyticum from 6 patients (9.2%) and Mycoplasma hominis from 2 patients (3.1%). At 6 weeks in group A, 16 patients (47%) were cured, one patient had a recurrence (2.9%), and 4 patients had persistent infection (11.8%). Eleven patients defaulted follow-up (32.4%) and 2 patients were dropped from the trial. In contrast, for group B, 13 patients (42%) were cured, 5 patients (16%) had a recurrence, 2 patients (6.5%) had persistent infection and 3 patients (9.7%) were reinfected. Eight patients (25.8%) defaulted follow-up. At 12 weeks, for group A, 14 patients (41.2%) remained cured, one patient (2.9%) had a recurrence, 4 patients (11.8%) had persistent infection and one patient (2.9%) was reinfected. Twelve patients (35.3%) defaulted follow-up. For group B, 8 patients (25.8%) remained cured, 6 patients (19.4%) had recurrence, 2 patients (6.5%) had persistent infection and 5 patients (16.1%) were reinfected. Ten patients (32.2%) defaulted follow-up. There were no statistically significant differences between the two groups except for patients with recurrent NGU where the difference (1 versus 6 patients) was statistically significant (P = 0.019).

Anti-Bacterial Agents↗
PubMed1994

Papuloerythroderma of Ofuji: a report of three cases and review of the literature.

Papuloerythroderma of Ofuji is a rare, distinctive entity featuring widespread erythematous, flat-topped papules, with a striking sparing of body folds (the so-called 'deck-chair' sign), and peripheral eosinophilia. We report three elderly men who showed the typical features of this disease, and who responded to corticosteroid therapy. Immunohistochemical studies with anti-S-100 and UCHL-1 (CD45 RO) antibodies indicated the presence of abundant dendritic cells and mature T cells in the dermis. In addition, one patient had concomitant tinea corporis. Treatment with griseofulvin alone resulted in clearing of the fungal infection and improvement of his papuloerythroderma, and, worsening of his papuloerythroderma occurred when the tinea relapsed.

Aged↗
PubMed1994

In vitro evaluation of griseofulvin, ketoconazole, and itraconazole against various dermatophytes in Singapore.

BACKGROUND: Superficial cutaneous fungal infection, principally dermatophytosis, is an extremely common skin disease. Various in vitro test systems have been developed in recent years to determine the antifungal activity of various drugs. The minimum inhibitory concentration (MIC) obtained may give an indication of the in vivo potency of the drugs. METHODS: One hundred patients (69 men and 31 women) with a clinical diagnosis of dermatophytosis were entered into the study. Direct microscopy and culture were done on all patients. The MICS were determined using the broth dilution method. RESULTS: The age range was 1-76 years. The most common diagnosis was tinea corporis (36%), followed by tinea cruris (22%), and tinea pedis (19%). The most common fungus isolated was T. rubrum (58%), followed by E. floccosum (14%), and T. mentagrophytes (10%). The majority of the isolates was sensitive to the three drugs tested (griseofulvin, ketoconazole, and itraconazole). Of the isolates, 82% were sensitive to griseofulvin, 78% to ketoconazole, and 81% to itraconazole, all at a concentration of < 0.25 micrograms/mL. For T. rubrum, there were four isolates that had an MIC of > or = 64 micrograms/mL to griseofulvin, seven isolates and nine isolates with an MIC > or = 64 micrograms/mL to ketoconazole and itraconazole, respectively. T. interdigitale was relatively resistant to the three drugs in vitro with four of seven isolates having an MIC > or = 4 micrograms/mL with griseofulvin, one of seven isolate with an MIC > or = 64 micrograms/mL with ketoconazole, and three of seven isolates with an MIC > or = 32 micrograms/mL with itraconazole. CONCLUSIONS: The in vitro antifungal activity of griseofulvin, ketoconazole, and itraconazole are similar against dermatophytes in Singapore. Griseofulvin may be given as the first-line drug for treating such infections in Singapore.

Adolescent↗
PubMed1993

An unusual case of localised pemphigoid.

We describe an 85-year-old man with a one-year history of right hemiplegia presenting with bullous pemphigoid affecting only the paralysed side. The diagnosis was confirmed by histology and indirect immunofluorescence. Direct immunofluorescence study was negative. He responded to low dose prednisolone therapy, 30 mg daily. To our knowledge, this is the second case report of bullous pemphigoid affecting only the hemiplegic side.

Aged↗
PubMed1993

Pachydermoperiostosis (idiopathic hypertrophic osteoarthropathy)--a case report and review.

We report a Chinese patient with the complete form of pachydermoperiostosis. He presented with typical features consisting of palmoplantar hyperhidrosis, clubbing with spade-like enlargement of the hands and feet, cutis verticis gyrata, thickening and furrowing of the facial and forehead skin, and irregular thickening of the cortical bone with subperiosteal new bone formation involving the radii, ulnae. tibiae and fibulae. Classically, pachydermoperiostosis is characterised by a triad of finger clubbing, periosteal new bone formation, skin and soft tissue changes, giving an acromaegaloid look. Although rare, it is important to recognise this condition as misdiagnosis may subject the patient to unnecessary investigations and worry. The typical features and the self-limiting nature of this entity are emphasised.

Adult↗