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Biomedical subjects

S N Tham

Publications and source records attributed to S N Tham.

At least 37 records · Page 2Linked to original sources

Pityriasis rubra pilaris in Singapore.

Fourteen patients with pityriasis rubra pilaris seen between 1981 and 1989 were evaluated retrospectively. There were nine male and five female patients. There was a bimodal age of onset in early childhood and in adulthood. All the patients had either follicular hyperkeratosis or hyperkeratosis of the palms and soles. Nine patients had erythroderma. The classical forms, either in the children or in the adult patients, were more likely to recover. Several treatment modalities were used and these included steroids, Vitamin A, etretinate, retinoic acid and ultraviolet light (UBV). Nine patients had complete recovery. Four of these patients received only steroids, two cleared while on vitamin A, two cleared while on etretinate and one cleared with methotrexate.

Adolescent↗

Secondary syphilis with framboesiform lesions.

An unusual case of secondary syphilis is presented. A 40 year old Chinese male presented with a one-month history of a scaly scalp with purulent discharge, and crusted papules and nodules on the face, body and genitals. A diagnosis of secondary syphilis was confirmed, and he responded rapidly to treatment.

Adult↗

Comparative double-blinded study between mupirocin and tetracycline ointments for treating skin infections.

A double-blinded study was conducted to compare the effects of mupirocin and tetracycline ointments in the treatment of skin infections. 111 patients were available for clinical assessment, of which 53 were treated with mupirocin and 58 treated with tetracycline. Clinically, both groups were improved, and there was no significant difference. Bacteriological assessment however revealed a better response to mupirocin. Staphylococcus aureus and Streptococcus pyogenes were the most common organisms isolated. 99% of Staphylococci were sensitive to mupirocin compared with 61% to tetracycline and 29% to penicillin G. 57% of Group A beta haemolytic Streptococci were resistant to tetracycline compared to 14% to mupirocin. Gram-negative organisms were mostly resistant to both preparations. No side effects were observed in both treatment groups. This study suggests that mupirocin is a safe and effective topical preparation for treating most of our common skin infections.

Adolescent↗

Fixed drug eruptions--a Singapore study.

This study documents 62 patients with fixed drug eruptions (FDE) proven by provocative testing. Of these 39 (63%) were caused by tetracycline hydrochloride and 12 (19%) caused by Saridon (R). Fifty-eight (94%) of the patients had 10 or less lesions and 50 (81%) had 5 or less lesions. The lips and genitalia were preferential sites being involved in 28 (45%) and 22 (36%) instances. In 6 instances each a solitary lesion occurred on the lower lip or the glans penis. At presentation, 43 (69%) patients were unaware of the drug-induced nature of their condition. Compared with previous reports the causative drugs varied from place to place and from decade to decade. This may be due to differences in prescription patterns.

Adult↗

Generalised exfoliative dermatitis--a clinical study of 108 patients.

This study was to investigate the epidermiological, etiological, clinical and prognostic aspects of patients with Generalised Exfoliative Dermatitis in Singapore. From 1981 to 1985, all patients with exfoliative dermatitis or erythroderma admitted to our dermatology wards were included into this study. A standard protocol was filled in for each patient, and they were subsequently followed up at our out-patient clinics. There were 79 male and 29 female patients (sex ratio 2.7:1). The average age was 61.5 years. Most of the patients were from low social income groups. Apart from scaling and erythema, peripherial oedema was the most common finding (44%), followed by hair loss (25%) and lymphadenopathy (22%), 15% of patients had haemoglobin level 10G/dl. The main etiological groups were eczema/dermatitis, psoriasis, drug reactions and those with unknown causes. Two patients were suffering from congenital dermatoses. None of our patients was casually related to malignancy. This study suggested that GED was not a fatal disease among our patients, and they often had a good prognosis.

Adolescent↗

Clinical observations on nail changes in psoriasis.

410 cases of psoriasis [282 males (68%) and 127 females (31%)] were interviewed and examined to study the nail changes. The prevalence of nail changes was 78.0% (males = females). Common changes were pitting (67.5%) and onycholysis (67.2%). Dystrophy of varying degrees occurred in 35.0%, subungual hyperkeratosis in 24.7%, discoloration in 18.4%, loss of nails in 2.8% and pustulation in 1.3%. Pitting and onycholysis was the most common combination (45.6%). Nail changes were significantly more common in patients who have moderate to severe psoriasis as compared with patients with mild psoriasis; in patients who have psoriasis for greater than 5 years as compared with patients who have psoriasis for less than 5 years; and in patients older than age 50 as compared with those aged less than 50. A definite correlation was found between the prevalence of nail changes and the presence of scalp and periungual psoriasis, and the presence of joint involvement.

Arthritis↗

Initial experience with CO2 laser in treating dermatological conditions.

CO2 laser was first used in the treatment of melanomas in animals. Since then, it has been successfully used in treating many dermatological conditions. A total of 47 patients were treated once as outpatients in Middle Road Hospital by using Model 720 Sharplan CO2 Laser System and Yoshida Opelaser-01 CO2 Laser System to determine the usefulness of CO2 laser in the treatment of various dermatological conditions. The laser was used mainly in the defocused mode at 10 watts. Local anaesthetic with 1% lignocaine HCL was employed in all cases. 3 patients defaulted follow-up. Of the 30 patients with warts, most of which were recalcitrant, 14 were cured and the remaining 16 showed marked improvement. 4 of the 5 patients with lichen simplex chronicus were cured. 1 patient each of the following conditions were also treated; prurigo nodularis, psoriasis, solar keratosis, ingrowing toe nail, Bowen's disease, infected callosity and lichen amyloidosis; cure was achieved in the former 4 conditions. The laser failed to cure 2 patients with pyogenic granuloma. Side effects included hypopigmentation (62%), mild post-operative pain (11%), scarring (11%), excess granulation tissue (11%), and infection (2%). CO2 laser is a potentially useful, effective and safe treatment modality for many dermatological conditions.

Adolescent↗

Single dose cefoxitin in treating uncomplicated gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG strains.

A total of 136 patients with uncomplicated gonorrhoea were treated with intramuscular cefoxitin 2 g (25 patients) or 1 g (111 patients) and oral probenecid 1 g. Cefoxitin 1 g cured 95% (42 out of 45 men and all of 14 women) with infections caused by penicillinase producing Neisseria gonorrhoeae (PPNG) strains and 98% (all of 38 men and 13 out of 14 women) with non-PPNG infections, giving an overall cure rate of 96%. The rate of postgonococcal urethritis (PGU) in men treated with 1 g cefoxitin was 28%. No serious side effects of treatment were observed in patients treated with either dose. The failure rate of 7% in men infected with PPNG strains who were treated with the 1 g dose is, however, disturbing. We therefore recommend that intramuscular cefoxitin 2 g and oral probenecid 1 g may be used to treat uncomplicated gonorrhoea, especially in areas where PPNG strains are common.

Cefoxitin↗

Drug eruptions from phenylbutazone in Jamu.

Drug eruptions from indeginous medicine is often difficult to diagnosis and confirm. It is known that a number of these now supplied by bomohs and Chinese sinsehs contain known drugs and are dispensed as tablets and capsules. We report 3 cases of adverse drug eruption to "Jamu", a Malay herb. A particular brand, "Jamu Indonesia, Toko Air Pancur", from Johor Bahru, Malaysia, is especially recommended for "sakit pinggang" or backache. The cases occurred between January and February 1985, and all had taken brown kidney shaped tablets. The adverse reactions were moderately severe. Two had erythroderma with hepatitis, and one, Steven Johnson Syndrome. Analysis of this jamu for analgesics led to the discovery of adulteration with phenylbutazone and diazepam. Records from local cases from 1974-1984 showed that 8 other patients, all Chinese had adverse cutaneous eruptions from phenylbutazone, oxybutazone and propyphenazone. The skin manifestations were erythroderma (2 cases), vasculitis (2 cases) and toxic epidermal necrolysis (4 cases). Those with toxic epidermal necrolysis had 100% mortality.

Adult↗

Liver biopsies from psoriatics treated with methotrexate.

To study the effects of Methotrexate (MTX) on the liver, light microscopic examination of liver biopsies from 18 consecutive patients with moderate to severe psoriasis receiving MTX seen between 1981-1985, were carried out. All patients received MTX (mean dosage of 1808 gm, mean duration of 88 months) prior to biopsy. There were 12 males, 6 females, with mean age of 55.1 yrs (range 39-77 yrs). All patients were HBsAg negative, non diabetic, and with no significant drug history or alcohol intake. Twenty liver biopsies were examined. Attempts to correlate severity of histological changes to dosage and duration of MTX therapy; and to the levels of raised SGPT at biopsy, failed to show any definite relationship. A variety of histological changes were seen in liver biopsies of MTX treated psoriatics, with 2 patients showing progression of histological changes following repeat biopsy.

Adult↗