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Biomedical subjects

C L Goh

Publications and source records attributed to C L Goh.

At least 127 records · Page 7Linked to original sources
PubMed1994

A study of occupational skin disease in the metal industry (1986-1990).

A retrospective study of the epidemiology of occupational skin disease among metal workers showed that irritant contact dermatitis (75%) prevailed over allergic contact dermatitis. Most workers belonged to the age group 20 to 29 years. There was a slight preponderance of Malays and Indians compared to the working population of Singapore. Most presented for treatment within 10 days of their dermatitis. Ninety-five percent presented with dermatitis on the hands and arms. There was no significant difference in the prevalence of atopy between workers with irritant and allergic contact dermatitis. In most cases of allergic contact dermatitis from cutting fluid, the causative allergen in the cutting fluid cannot be identified.

Adolescent↗
PubMed1994

Common industrial processes and occupational irritants and allergens--an update.

This paper reviews the recent development of the industrial processes in the construction, electronics and metal industries which are the predominant industries in developing countries. Common occupational irritants and allergens are presented. The information is essential for occupational dermatologists and physicians managing patients with occupational skin diseases. In the construction industry, the prefabrication construction methods are now widely used. The commonest irritant is cement and the allergens are chromate, rubber chemicals and epoxy resins. In the electronics industry, the commonest irritants include soldering flux, solvent and fibreglass, and allergens include resins and metals, rubber chemicals and amines and colophony. Cutting fluid is the commonest occupational irritant in the metal industry. Biocides and metals in The electro-discharge machining process now widely used in the metal industry for precision engineering uses the electrodischarge machining fluids (EDM fluids) which are a strong skin irritant. Preventive measures including health education are most effective against occupational dermatitis.

Allergens↗
PubMed1994

Pattern of skin diseases in the elderly seen at the National Skin Centre (Singapore) 1990.

A retrospective study was conducted at the National Skin Centre (Singapore) for the period 1st January 1990 to 31st December 1990 to determine the pattern of skin disorders in the elderly. A total of 2,571 patients aged 65 years and above were studied. This constituted 6.4% (2,571/39,941) of patients seen at the Centre for that year. 38.1% of the elderly patients were aged 75 years or older. The male to female ratio was 1.3 to 1. There were differences in the pattern of skin problems when compared with the young. Xerosis and asteatotic eczema were distinctly common in the elderly. The most common dermatosis in the elderly was eczema. Endogenous eczema (including seborrhoeic dermatitis, lichen simplex chronicus, hand/feet eczema, stasis eczema, generalised exfoliative dermatitis), exogenous eczema (ie contact dermatitis) and dermatitis (not otherwise specified) formed 35.3% (907/2,571) of the skin disorders encountered at the National Skin Centre. Eczema, fungal, viral infections and psoriasis were on the whole less common in the elderly compared with the general population. Common skin infestations and infections were scabies, viral warts, monilial and bacterial intertrigo and tinea corporis. Urticaria, alopecia, insect bite reactions and post-inflammatory pigmentation were uncommon referral problems in the elderly.

Aged↗
PubMed1994

Lasers used in dermatology.

This review introduces the various lasers available for the treatment of dermatological conditions. The applications of various lasers used in dermatology, including the carbon dioxide, argon, Q-switch Nd:YAG, ruby, dye and metal vapour lasers are discussed. We present our experience with the use of the carbon dioxide laser, flashlamp pulse-dye laser and Q-switch Nd:YAG laser in the National Skin Centre, Singapore. Our experience indicated that the lasers if used selectively are useful tools in the management of numerous skin disorders. The carbon dioxide laser is a versatile tool, useful for vaporizing or destroying skin lesions. The treatment of vascular or pigmented (melanin) lesions requires lasers that emit wavelengths corresponding to the absorption spectrum of haemoglobin or melanin respectively. Choosing the right laser gives optimal cosmetic result whereas the wrong lasers can lead to a less satisfactory result and even severe scarring. It is important to note that there is no single laser system that is versatile enough to be used to treat all skin disorders. To provide full coverage in the treatment of skin disorders, a laser centre has to be equipped with many different laser systems. This makes using lasers in the treatment of skin disorders very expensive.

Humans↗
PubMed1993

Etretinate therapy for psoriasis and other keratinizing disorders: a 10-year retrospective study in Singapore.

BACKGROUND: Etretinate, a second generation retinoic acid, has been reported to be useful in the treatment of psoriasis and other keratinizing disorders. The effectiveness of etretinate for these disorders are studied in a 10-year retrospective study of all patients treated with etretinate in a skin clinic in Singapore. METHODS: The case records of 190 cases of psoriasis and other keratinizing disorders treated with etretinate were analyzed. Information collected included demographic data, dosage of etretinate taken, response and side effects, clinical follow-up, and relapse. RESULTS: Most of the cases (72.6%) had psoriasis (138/190). The others had different keratinizing disorders. The dose of etretinate used was 0.15 to 1 mg/kg/day (median 0.36 mg/kg/day), and the duration of the treatment varied from 1 to 120 months (median 6 months). Etretinate was coadministered with UVB (ReUVB) or PUVA (RePUVA) in 89 (46.8%) patients. In psoriasis, the response to treatment was excellent in 41.3% (57/138), good in 36.2% (50/138), fair in 15.9% (22/138), and poor in 6.5% (9/138) of the cases. Patients with plaque-type psoriasis did better with combination therapy than with monotherapy. Those with keratinizing disorders showed excellent, good, fair, and poor responses in 32.7% (17/52), 32.7% (17/52), 25.0% (13/52), and 9.6% (5/52) respectively. Adverse effects were noted in 102 (53.7%) cases and were generally mild and tolerable. Etretinate was discontinued in 24 (12.6%) patients due to significant toxicity. CONCLUSIONS: Etretinate is effective for treating psoriasis and other keratinizing disorders. Combination therapy is preferred in chronic plaque psoriasis. Adverse effects are common, but mild and tolerable.

Adolescent↗
PubMed1993

Contact dermatitis from dielectric fluids in electrodischarge machining.

We report an outbreak of irritant contact dermatitis in the aerospace industry from electrodischarge machining (EDM). 20 workers doing EDM developed irritant contact dermatitis from the dielectric fluid used in EDM, a form of precision metal machining that is widely used in mould making and precision engineering. Dielectric fluid contains hydrocarbons that are aromatic, paraffinic or naphthenic and are skin irritants. Irritant contact dermatitis from dielectric fluid has not been reported previously. EDM will become more widespread and occupational dermatitis from dielectric fluid is likely to become more prevalent in the future. Our experience was that irritant contact dermatitis from dielectric fluid can be prevented by simple preventive measures such as personal hygiene and health education.

Adult↗
PubMed1993

A descriptive profile of eczema in a tertiary dermatological referral centre in Singapore.

A retrospective study of 25,448 new cases of patients with various types of eczemas seen over a two-year period (1989-1990) was conducted. This represented 34.1% of new cases (74,589) seen at the Centre. The M:F ratio was 1:1. Occupational and ethnic distribution did not differ from that of the total outpatient population. 67% were endogenous eczema. Among the endogenous eczema, the majority (70%) were either non-specified endogenous eczema, hand and feet eczema or atopic dermatitis. 13.7% were contact dermatitis. Of these, 50% were non-specified contact dermatitis, 39% were irritant contact dermatitis and 11% were allergic contact dermatitis. Unskilled workers (19.1%) and housewives (12%) had the highest proportion for contact dermatitis. Exfoliative dermatitis (0.5% of all eczemas) was commonest among the elderly (68.3%) and Malays (19.7%). The prevalence of endogenous eczema had increased sharply from 31% in 1973 to 67% in 1989/90. In contrast, the proportion of exogenous eczemas over all eczemas seen has decreased from 48% to 15.4% (1973 to 1989/90).

Adolescent↗
PubMed1993

Cutaneous cryptococcosis successfully treated with itraconazole.

I report on a patient with primary cryptococcosis that was successfully treated with oral itraconazole. A seventy-year-old laborer with primary cutaneous cryptococcosis presented with a large verrucous plaque with abscess on his right forearm. His infection was probably due to direct inoculation of the fungus from trauma. This patient was probably immunosuppressed by long-term treatment with systemic steroids, which he took for treatment of chronic obstructive airway disease. His cryptococcosis cleared with a six-month course of oral itraconazole 200 mg daily. The patient experienced no side effects during treatment.

Administration, Oral↗
PubMed1992

Pattern of skin diseases at the National Skin Centre (Singapore) from 1989-1990.

At the National Skin Centre, 74,589 new attendances were seen from 1989 to 1990. The M:F ratio was 1:1. The majority of the patients belonged to the 20-39 year age groups (40%). Frequencies of psoriasis (20.4%) and alopecia (17.2%) were higher among Indians; exfoliative dermatitis was higher among Malays (19.72%); and insect bites were higher among Chinese (87%) [P less than 0.05] compared with ethnic distribution (9.9%, 7.6%, and 77.2% respectively) of NSC patient population. Dermatitis (34.2%) and acne (10.9%) were the most common skin disorders seen. The more common dermatoses seen in 1989/90 differ slightly from those reported in 1950s and 1980s; however, the frequencies of contact dermatitis, fungal infection, and insect bite reactions of 5.8%, 10.9%, and 7.6%, respectively, in 1980 have decreased to 4.7%, 5.4%, and 2.3%, respectively, in 1989/90. There was no seasonal variation in the frequency of various dermatoses except for psoriasis, which was more prevalent during the first quarters of 1989 and 1990. Our results showed that the pattern of skin diseases in Singapore is slowly approximating that of developed countries. The changes in the pattern of skin diseases are probably due to improved economic status, better education and hygiene, ready availability of dermatology services, as well as changes in occupational and environmental contactants over the last decade.

Adult↗
PubMed1992

Carbon dioxide laser treatment of periungual and subungual viral warts.

This is a retrospective study of the cure rates of forty patients with subungual and periungual viral warts treated with carbon dioxide laser vapourisation (total of 69 lesions). 70.6% (48/68) lesions had failed treatment with cryotherapy and/or electrocautery treatment previously. 20/68 were treated with CO2 laser vapourisation as a first line treatment. The overall cure rate over 10 months follow-up period was 57.4% (39/68). Most recurrences (24/25) occurred within the first 3 months of vapourisation. The carbon dioxide laser vapourisation cure rate for warts in which previous cryotherapy and/or electrocautery had failed was 47.9% whereas those treated with carbon dioxide laser vapourisation as a first line treatment had a cure rate of 80% (p = 0.043). Subungual warts responded slightly better with a cure rate of 64.7% compared with periungual warts (54.9%) (n.s.). The carbon dioxide laser vapourisation cure rate for recurrent subungual and periungual warts (which failed previous carbon dioxide laser vapourisation) was 73.3% (11/15). Our findings appeared to indicate that periungual and subungual warts can be eradicated by CO2 laser vapourisation. Recurrent warts can be effectively eradicated by further vapourisation. Recalcitrant periungual and subungual warts which have previously failed to respond to cryotherapy and/or electrocautery can be effectively eradicated with CO2 laser vapourisation.

Adolescent↗
PubMed1992

Dermatophyte and non-dermatophyte onychomycosis in Singapore.

Onychomycosis is caused by dermatophytes, moulds and yeasts. It is important to identify the non-dermatophyte moulds as they are resistant to the usual anti-fungals. A prospective study was undertaken in the National Skin Centre, Singapore to study the pattern of dermatophyte and non-dermatophyte onychomycosis. 53 male and 47 female patients seen between June 1990 and June 1991 were entered into the study. Direct microscopy was done and the nail clippings were cultured. Toe and finger nails were equally infected. Dermatophytes were isolated from 21 patients namely, T. rubrum (12/21), T. interdigitale (5/21), T. mentagrophytes (3/21) and T. violaceum (1/21). Candida onychomycosis occurred in 39 patients and was caused by C. albicans (38/39) and C. parapsilosis (1/39). 37/39 patients had associated paronychia. 5 types of moulds were isolated from 12 patients, namely Fusarium species (6/12), Aspergillus species (3/12), S. brevicaulis (1/12), Aureobasilium species (1/12) and Penicillium species (1/12). Although the clinical pattern and microscopy may predict the type of organisms, in practice this is difficult. Only cultures were confirmatory. 28% (28/100) had negative cultures despite a positive microscopy, and moulds (12/100) grown might be contaminants rather than pathogens.

Adolescent↗
PubMed1992

Changing trends in the epidemiology of contact dermatitis in Singapore.

All patients seen in the Contact Dermatitis Clinic of the National Skin Centre, Singapore (and the former Middle Road Hospital) between January 1986 and December 1990 were analysed retrospectively. 5557 patients comprising 2634 (47.4%) males and 2923 (52.6%) females were patch tested. 3154 (56.8%) patients had 1 or more positive reactions. The majority of the patients were Chinese (78.0%), followed by Malays (11.5%), Indians (8.1%) and other minority races (2.4%). The majority of positive reactions belonged to the 21-40 age group. The incidence of positivity decreased after 60 years. The commonest allergens responsible were nickel (17.7%), fragrance (13.3%), neomycin (6.9%), colophony (6.6%) and proflavine (6.5%). Both neomycin and proflavine were commonly used as over-the-counter medicaments. Compared to an earlier report in 1988, there were differences in the incidence of contact sensitivity to some allergens. Potassium dichromate, which used to be a common allergen, was less common. Some allergens (carba-mix, naphthyl-mix, caine-mix and PCMX) have been removed from our standard series as they were uncommon causes of contact allergy. Thimerosal and Amerchol L-101 were added in their place.

Adult↗
PubMed1992

Comparative study of TRUE Test and Finn Chamber patch test techniques in Singapore.

This is a report on a comparative study of the reactivity of TRUE Test and Finn Chamber patch test techniques. 413 patients attending a contact dermatitis clinic in Singapore were simultaneously patch tested with panels 1 and 2 of the TRUE Test standard series and with corresponding allergens (Hermal, Hamburg) using Finn Chambers. The left/right application of the TRUE Test and Finn Chambers was randomized. The concordance of positive patch test reactions to the 2 test techniques was studied. The number of patient with positive reactions was 38% and 42% for TRUE Test and Finn Chamber techniques, respectively (n.s.). The overall concordance of positive patch test reactions was 64% (209/328). 13% (42/328) of positive reactions appeared on TRUE Test only and 24% (77/328) on Finn Chamber only. When only relevant positive reactions were considered, the concordance rate was 67%; 11.6% of positive reactions appeared on TRUE Test only and 21% on Finn Chamber only. Positive reactions to p-phenylenediamine (PPD) and neomycin were more frequent with the Finn Chamber technique than with TRUE Test, i.e., false negative reactions to PPD and neomycin were more likely to occur with TRUE Test. It appeared that the TRUE Test and Finn Chamber techniques were comparable when used for patch testing. However false negative and false positive patch test reactions can occur when using either technique.

Adolescent↗