[show abstract][hide abstract] ABSTRACT: Skin lesions in pregnant women could be caused by physiologic or pathologic changes. Polymorphic eruption of pregnancy (PEP), which manifests as various types of skin lesions, is the most common pregnancy dermatosis. Thus, PEP could mimic other skin diseases related to unfavorable maternal and fetal outcomes.
Two PEP patients with targetoid lesions are presented here. One of them was a primigravida, whereas the other was a secundigravida. Both patients had singleton pregnancies and skin rash which started during the third trimester. The lesions began on the abdomen and then spread to the trunk and extremities. The face, palms, soles, and mucosa were not affected. Pruritus was observed but no other systemic symptoms were reported. Both patients delivered healthy, term infants without complications.
Targetoid lesions in PEP are an uncommon presentation, and the differential diagnosis of PEP along with other dermatoses should be considered. However, the prognosis for this type of PEP is not different from that for classic PEP.
[show abstract][hide abstract] ABSTRACT: To reveal the clinical manifestations, aggravating factors, factor associated with severity, and treatment of psoriasis in Thai patients.
The data of psoriasis patients who had been visited Dermatologic outpatient clinic, Siriraj Hospital between July 2002 and July 2008 were retrospectively reviewed.
One thousand eighty two patients were studied. The male to female ratio was 1.2:1 and the peak age of onset was in the 40 to 49 year-old age group. The most common aggravating factor was stress (50%), followed by trauma (39%) and weather condition (35%). The majority of patients had plaque type (72.8%). Male gender, smoking, alcohol intake, and nail abnormalities were related to severe psoriasis (PASI > 10).
The present study demonstrated the demographic data of Thai psoriasis patients in a large number of population. These data would be beneficial for national public health development of Thailand in order to provide the better care for Thai psoriasis patients.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 06/2012; 95(6):795-801.
[show abstract][hide abstract] ABSTRACT: Pemphigus is a rare, organ-specific autoimmune disease. The epidemiology and clinical course vary between reports from different countries.
To evaluate clinical manifestations, investigation and clinical course of Thai patients with pemphigus.
Demographic data, clinical presentations, laboratory investigations and treatment outcomes in 124 pemphigus patients who had attended the specialized autoimmune skin clinic at Siriraj Hospital during the period from January 1991 to December 2009 were retrospectively studied.
Of the 124 pemphigus patients, 79% were diagnosed with pemphigus vulgaris (PV) and 15.3% with pemphigus foliaceus (PF). The male to female ratio was approximately 1:2 in both groups. The mean age of onset was 45.4 years in PV patients and 57.4 years in PF patients. Oral mucosal involvement at the onset of disease was presented in 37.8% of PV patients. The sensitivity and specificity of DIF in the diagnosis of pemphigus was 97.8% and 98.3% while that of IIF was 94.7% and 98.4%. Disease control was achieved in 93.9% of PV patients and 94.7% of PF patients. Remission (off therapy) was achieved in 31.6% of patients in both groups.
PV is the most common subtype of pemphigus in Thailand and usually affects females more than males. The disease usually occurs in the fifth decade of life and mucosal involvement is common. Immunofluorescence studies yields very high sensitivity and specificity. Corticosteroids are the mainstay of treatment. The majority of patients attain disease control and one-third of them achieve remission (off therapy).
Asian Pacific journal of allergy and immunology / launched by the Allergy and Immunology Society of Thailand 06/2011; 29(2):161-8. · 0.79 Impact Factor
[show abstract][hide abstract] ABSTRACT: Bullous pemphigoid (BP) is a rare, subepidermal autoimmune blistering disease. Studies from different regions show discrepancies in clinical features and courses.
To reveal clinical characteristics, investigations and clinical outcomes of Thai patients with BP and to evaluate the association of BP with malignancy, diabetes mellitus and neurologic diseases.
Patients diagnosed as BP who had visited the autoimmune skin clinic at Siriraj Hospital between 1991 and 2009 were retrospectively studied.
Fifty-eight patients were enrolled. Mean age of onset was 69.3 years. The female to male ratio was 2.7:1. Fifteen percent of the patients had mucosal involvement and 38.9% showed peripheral blood eosinophilia. The sensitivity of the direct and indirect immunofluorescence test in the diagnosis of BP was 95.7% and 73.5%, respectively. The frequency of diabetes mellitus in BP patients was significantly higher than that in the general population (p < 0.001). BP patients had a significantly higher chance of having neurologic diseases compared with other autoimmune vesiculobullous disease patients (adjusted odd ratios 4, 95% confidence interval 1.2-13.3). Disease control was achieved in 89.7% of the patients. One-year and three-year 6.4% remission rate was and 66.3%, respectively.
BP usually occurred in the seventh and eighth decade of life and affected females more than males. BP is associated with diabetes mellitus and neurologic diseases. Corticosteroids are the mainstay of the treatment. Two-thirds of patients are likely to be in remission within three years.
Asian Pacific journal of allergy and immunology / launched by the Allergy and Immunology Society of Thailand 03/2011; 29(1):66-72. · 0.79 Impact Factor