Biomedical subjects

Kanokvalai Kulthanan

Publications and source records attributed to Kanokvalai Kulthanan.

9 recordsLinked to original sources

PubMed2006

Assessment of dermographism at different anatomical regions by dermographometer.

OBJECTIVE: Classic dermographism refers to the ability of the skin to produce a linear wheal with a scratch pressure of 4,900 gm/cm2. The authors manufactured a dermographometer to have precise and consistent measurement and tested it on different body regions to find the best location. MATERIAL AND METHOD: Twenty two patients with dermographism were enrolled. The pressure was applied to the volar aspect of the left forearm using the dermographometer and to the right forearm by the pen head. Then the pressure was applied to the upper back, abdomen, and shin using the dermographometer. The time onset and size of wheal, erythema and flare were recorded. RESULT: The positive yield at the left forearm by the dermographometer was 72.7% and the positive yield at the right forearm by the pen head was 68.2%. The positive yield of back, abdomen and shin were 68.2%, 68.2% and 13.6%, respectively. CONCLUSION: The dermographometer gave a comparable positive yield in diagnosing dermographism with the pen head and the dermographometer. The volar forearm, back and abdomen are the sensitive areas to produce dermographism while the shin is the least sensitive area. The site of the body that is most appropriate in testing is the forearm as it is easy to approach.

Adolescent↗

PubMed2006

Direct immunofluorescence study in Thai patients with scleroderma.

OBJECTIVE: Previous reports of direct immunofluorescence (DIF) studies of the skin biopsies in scleroderma were either negative or positive at various percentages and patterns. The present study was designed to evaluate the positive yield and pattern of DIF in Thai patients with scleroderma and its possible clinical correlation. MATERIAL AND METHOD: Twenty-two patients with localized or systemic sclerosis, who attended the Department of Dermatology, Siriraj Hospital, from 1996 to 2002, were enrolled in the present study. Skin biopsy was performed for DIF studies. RESULTS: Nine out of 22 patients were diagnosed with systemic sclerosis (SS), eleven with morphea, and two with overlapping syndrome. Fifteen of 22 patients (68%) had positive DIF findings; seven of nine (78%) patients with SS, six of eleven (55%) patients with morphea and two of two (100%) with overlapping syndrome. The common sites of deposit in SS, morphea and overlapping syndrome were dermo-epidermal junction and epidermal nuclei. The common immunoreactant deposit in all groups was IgM. There was no significant difference in the comparison of DIF findings with duration of biopsy lesion, clinical correlation, and the positive result of serum antinuclear antibody (ANA) in the three groups of patients. CONCLUSION: Positive DIF yield in the present study was higher than previous reports from Western countries. Similar to the study reported from Western country, there was no statistical significant difference in comparison of DIF findings with the duration of lesion, clinical correlation, and the positive result ofserum ANA in our three groups of patients. However; patients with SS had a tendency to give more frequently positive ENS and DEJ deposits than those with morphea.

Adolescent↗

PubMed2005

Drug eruptions at five institutes in Bangkok.

The study was performed in five hospitals in Bangkok for a period of one year. All in- and outpatients who developed drug eruption from January to December 2001 were enrolled into the study. Physical examinations and complete history-taking were performed by one of the authors. A skin biopsy was done to confirm the diagnosis in every suspected case. Oral challenge test was performed to obtain a definite diagnosis only in some patients with informed consent. Among 212 patients, the most common causative drugs were antimicrobial agents with cephalosporin group in the highest rank. Maculopapular rash was the most common type of drug eruption followed by urticaria and photosensitivity reaction. It was concluded that antimicrobial agents were the predominant causative agents and maculopapular eruption was the most frequent clinical manifestation. New kinds of antimicrobial agents, anti-inflammatory drugs and lipid lowering agents could cause various patterns of drug eruption.

Adolescent↗

PubMed2004

Cutaneous leukocytoclastic vasculitis: the yield of direct immunofluorescence study.

BACKGROUND: Leukocytoclastic vasculitis (LCV) is a clinico-pathological entity. Previous direct immunofluorescence study (DIF) studies of vasculitis showed positive findings mainly in the early stage of the disease. OBJECTIVE: To study the positive yield and patterns of DIF in patients with various stages of LCV. DESIGN: One hundred patients with LCV who attended the Department of Dermatology, Siriraj Hospital from 1997 to 2000 were enrolled in the study. RESULTS: The study showed immunoreactive deposits in blood vessel walls in 76 cases (76%). Forty seven per cent of patients showed immunoreactant deposit only in superficial blood vessel walls, 3% had deposits only in deep blood vessel walls. Superficial and deep blood vessel wall deposits were seen in 26%. Dermo-epidermal deposit in addition to blood vessel wall deposit was found in 39%. The most common immunoreactive deposit was C3 (71%), followed by IgM (35%), IgA (12%) and IgG (8%) respectively. The age of the skin lesions at the time of biopsy ranged from 1 to 7 days. 82% of patients with one day old lesions showed immunoreactive deposits in the blood vessel walls and 74% of the group with lesions aged 2-7 days at the time of biopsy showed immunoreactive deposits in the blood vessel walls. CONCLUSION: The present study showed a 76% positive yield for DIF study in patients with LCV when biopsies were performed within one week of onset. There was a tendency for the percentage of positive DIF results to decline when the biopsy was performed on lesions that were more than 1 day old.

Adolescent↗

PubMed2003

Extracellular matrix protein 1 gene (ECM1) mutations in lipoid proteinosis and genotype-phenotype correlation.

The autosomal recessive disorder lipoid proteinosis results from mutations in extracellular matrix protein 1 (ECM1), a glycoprotein expressed in several tissues (including skin) and composed of two alternatively spliced isoforms, ECM1a and ECM1b, the latter lacking exon 7 of this 10-exon gene (ECM1). To date, mutations that either affect ECM1a alone or perturb both ECM1 transcripts have been demonstrated in six cases. However, lipoid proteinosis is clinically heterogeneous with affected individuals displaying differing degrees of skin scarring and infiltration, variable signs of hoarseness and respiratory distress, and in some cases neurological abnormalities such as temporal lobe epilepsy. In this study, we sequenced ECM1 in 10 further unrelated patients with lipoid proteinosis to extend genotype-phenotype correlation and to add to the mutation database. We identified seven new homozygous nonsense or frameshift mutations: R53X (exon 3); 243delG (exon 4); 507delT (exon 6); 735delTG (exon 7); 785delA (exon 7); 892delC (exon 7) and 1190insC (exon 8), as well as two new compound heterozygous mutations: W160X/F167I (exon 6) and 542insAA/R243X (exons 6/7), none of which were found in controls. The mutation 507delT occurred in two unrelated subjects on different ECM1 haplotypes and may therefore represent a recurrent mutation in lipoid proteinosis. Taken with the previously documented mutations in ECM1, this study supports the view that exons 6 and 7 are the most common sites for ECM1 mutations in lipoid proteinosis. Clinically, it appears that mutations outside exon 7 are usually associated with a slightly more severe mucocutaneous lipoid proteinosis phenotype, but neurological features do not show any specific genotype-phenotype correlation.

Adolescent↗

PubMed2003

Urticaria and angioedema in Siriraj medical students.

The present study aimed to investigate the current prevalence of urticaria with or without angioedema among Siriraj medical students, the possible causative agent(s), the association between a history of atopy, behavior of patients seeking treatment and natural course. A cross-sectional study was conducted among 428 Siriraj medical students, Mahidol University in October, 2001. The study showed the prevalence of urticaria and angioedema to be 51.6 per cent and 19.6 per cent respectively, coexisting in 13.6 per cent but urticaria alone occurred in 38 per cent and angioedema alone in 6 per cent. There was an equal sex distribution. Acute urticaria (93.2%) was more prevalent than chronic urticaria (5.4%), and the acute intermittent type was the most common. Heat, inhalants, and contactants were more often suspected causes than food or drug allergy identified in both forms. More than half the urticaria subjects treated themselves by buying over-the-counter drugs (66%) and the remainder waited for spontaneous remission (49%) with a low percentage seeking medical advice (24% from a general practitioner, 14% from a dermatologist). An atopic history was not a major underlying factor for urticaria. Most patients with acute urticaria were free of symptoms after 3 weeks. Cases with chronic urticaria who were completely healed had a mean disease duration of 14.2 weeks. However, cases with chronic urticaria who had never had a long hive free period since the onset of the disease until the time of the study had a mean disease duration of 6 years. These findings may be useful to help educate affected persons and improve public awareness in order to prevent and manage this disease.

Adolescent↗

PubMed2003

Clinical characteristics and mycology of onychomycosis in autoimmune patients.

Onychomycosis is the most common nail disorder in adults. Predisposing factors are immunosuppression, poor peripheral circulation, diabetes mellitus, increasing age, nail trauma, and tinea pedis. Autoimmune patients, who carry many of these predisposing factors, have never been studied. Autoimmune patients, with underlying autoimmune skin diseases; pemphigus, systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD), scleroderma, dermatomyositis and cutaneous vasculitis, as well as having abnormal-appearing nail(s) with suspicion of fungal nail infection were included. Clinical information was obtained. The causative organisms were identified by potassium hydroxide preparation and cultured. Duration of onychomycosis in autoimmune patients was twice longer than in non-autoimmune patients. Of those with mycological proven onychomycosis, the autoimmune patients had significantly more affected nails (p < 0.05; chi2, two-sided) compared to the non-autoimmune patients but there was no difference in the affected fingernails or toenails and clinical type of onychomycosis. Candida spp was the most frequently found in autoimmune subjects compared to dermatophytes, Trichophyton rubrum. However, dermatophytes especially Trichophyton rubrum was the most common causative organism in non-autoimmune samples, followed by Candida spp. The causative organisms were more frequently discovered in autoimmune patients, whether by potassium hydroxide (KOH) or culture, than in non-autoimmune patients (p < 0.05; chi2, two-sided).

Adult↗

PubMed2002

Autoimmune and rheumatic manifestations and antinuclear antibody study in HIV-infected Thai patients.

BACKGROUND: There have been reports concerning an association between human immunodeficiency virus (HIV) infection and autoimmune and rheumatic diseases. OBJECTIVE: The purpose of this study was to examine autoimmune and rheumatic manifestations in HIV-infected patients and their correlation with antinuclear antibody (ANA) tests. METHODS: The clinical and laboratory results of HIV-infected patients attending the Department of Dermatology, Siriraj Hospital, Bangkok, Thailand, from February 1999 to January 2000, were analyzed. Laboratory studies included serum CD4 lymphocyte count and ANA tests. RESULTS: Sixty-two patients were enrolled prospectively in the study. Myalgia was the most common clinical presentation (50%). Others included photosensitivity (on history) (39%), arthralgia (26%), vasculitis (18%), sicca complex (10%), arthritis (7%), and Reiter's syndrome (2%). A history of hair loss was given by 23% of patients. A positive ANA test was detected in 3%. No cases of systemic lupus erythematosus, scleroderma, or dermatomyositis were seen. CONCLUSIONS: Autoimmune and rheumatic manifestations were not uncommonly detected in patients with HIV infection. HIV infection may sometimes mimic systemic lupus erythematosus clinically.

Adolescent↗

PubMed2002

Comparative study of the efficacy of topical corticosteroid: five locally made and one brand name creams.

The aim of this study was to evaluate the efficacy of 5 locally made clobetasol propionate creams compared with a brand name product. The study was divided into 3 parts 1) pharmacological study, 2) vasoconstriction test, and 3) double blind clinical trial. The results showed that the pharmacological properties of the locally made products were not different from the brand name product. Product C and D could diffuse through cellulose acetate membrane 3 fold more than the brand name product. Product D and E caused less vasoconstriction than the brand name product. This double blind study showed that all locally made products could improve psoriasis to the same extent as the brand name product, but there was more recurrence of psoriasis while using all the locally made products. It was concluded that locally made products were as effective as the brand name product in the treatment of psoriasis evaluated over a 2 week peroid, but more recurrence was observed with locally made products.

Administration, Topical↗