Adawiyah Jamil

University Kebangsaan Malaysia Medical Center · Dermatology Unit Department of Medicine

The skin is the largest organ in the integumentary system, protecting against various external threats, including ultraviolet exposure, heat, infections, dehydration and mechanical injuries. Skin disorders can arise from various causes, including allergic reactions or breaches in the skin barrier, which allow microorganisms or chemicals to penetrat...

Introduction Skin barrier dysfunction is an important component of atopic dermatitis (AD) pathophysiology. Topical corticosteroids (TCSs) are the mainstay therapy, but steroid phobia is emerging due to potential side effects. We aimed to determine the short-term effect of clobetasone butyrate on patients with AD. Methods This investigator-blinded,...

Background Vitiligo is characterized by depigmentation due to melanocyte destruction. Itch is an under-recognized symptom; its pathophysiology is unclear. Aims To compare epidermal biophysical characteristics of the vitiligous skin and normal skin and to determine the association with thyroid auto-immunity and itch. Methods A cross-sectional stud...

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced wit...

Background Systemic Lupus erythematous (SLE) is an autoimmune disease which is characterized by remission and flares. Experimental studies demonstrate that sun exposure can trigger immunomodulatory response, however, there is lacking of strong epidemiologic data regarding its role in triggering SLE flare. Malaysia has a tropical climate and hence g...

Skin exposure to ultraviolet (UV) rays in the sun causes premature ageing and may predispose to skin cancers. UV radiation generates excessive free radical species, resulting in oxidative stress, which is responsible for cellular and DNA damage. There is growing evidence that phytonutrients such as flavonoids and carotenoids may impede oxidative st...

Antihistamine is standard chronic spontaneous urticaria (CSU) therapy. Weight gain is a side effect of concern as prolonged high dose therapy is common. We investigated the effects of 12-weeks loratadine therapy on weight, appetite and parameters of metabolic syndrome (MetS). A cohort study was performed involving CSU patients aged ≥18 years. Patie...

Context: Acitretin increases serum lipids. Data on its effects on insulin resistance and glucose metabolism are sparse and contradicting. Aims: The aim of this study is to investigate the effects of acitretin on insulin resistance, glucose metabolism, and lipids. Methods: Dermatology clinic in a public tertiary hospital. A cross sectional stud...

Lichen striatus (LS) is a rare self-limiting inflammatory dermatosis characterized by Blaschkoid distribution. We report a 34-year-old woman with a 1-year history of asymptomatic unilateral rashes on her left trunk and limbs. Physical examination revealed light to dark brown papules, macules, patches and plaques with some erythematous areas in a Bl...

Background Autologous serum (ASST) and plasma (APST) skin testing confirm autoreactivity in chronic spontaneous urticaria (CSU). Whole blood autohemotherapy has been used. Plasma and even whole blood may be used instead of serum with relatively quicker preparation and cheaper method especially using the latter in centers with limited resources. Pu...

Methotrexate (MTX) is a first line systemic psoriasis therapy with risk of liver fibrosis. Non-invasive tools for liver fibrosis screening are Fibroscan®, Fibrosis-4 (FIB-4) index, and aspartate aminotransferase-to-platelet ratio (APRI) index. To compare Fibroscan®, FIB-4, and APRI in detecting fibrosis, determine association of fibrosis with MTX c...

Introduction: Studies on nutrition among adult AD, a chronic inflammatory skin condition, are lacking. The objective of this cross-sectional study was to investigate the energy, micro and macro nutrient intakes. Methods: Sixty two adult participants defined by the Hanifin-Rajka criteria were included. AD severity was determined using SCORAD index a...

Introduction: The atopic march consists of atopic dermatitis (AD), allergic rhinitis or sinusitis (AR), allergic conjunctivitis (AC) and bronchial asthma (BA). The influence of concomitant atopic diseases on AD is under-explored. We determined the relationship between personal and family history of atopic diseases with AD severity and persistence....

Cryotherapy is a standard treatment for warts. Tuberculin immunotherapy is a novel therapeutic option. We compared the efficacy and safety of cryotherapy versus tuberculin immunotherapy in a randomized, assessor-blinded study. Fifteen patients were treated with intralesional tuberculin and 15 patients received cryotherapy every two weeks until comp...

This article provides information on allergy testing and serves as a simple guide for physicians who are considering using allergy testing as a step in patient management. Basic principles of allergy testing, indications for testing, and how and when to choose a suitable allergy test are discussed. Allergy testing in general refers to evaluation of...

Combinational therapy of hydrocortisone (HC), a topical steroid with an antioxidant hydroxytyrosol (HT) was used by co-loading into chitosan nanoparticles (CSNPs) for its clinical efficacy and safety against atopic dermatitis (AD). NPs were characterized while the complexation of drugs with CS was investigated by exploiting molecular docking and mo...

Cutaneous sporotrichosis (CS) presents as asymptomatic lesions of varied morphology. The most common variant is the lymphocutaneous type which typically progresses from a papule to an ulcer and then forms nodules along the superficial lymphatic channels. Diagnosis CS may be challenging when the lesion presents at an uncommon site where the superfic...

Background Systemic Lupus Erythematosus (SLE) patients are at risk of Herpes Zoster (HZ) infection due to the underlying immunosuppressed state. The reported incidence of HZ in SLE is 6 to 10-times higher than the general population. Objectives To determine the clinical characteristics of SLE patients who develop Herpes Zoster (HZ) infection and t...

Background: Human immunodeficiency virus (HIV) infection is frequently associated with cutaneous infections. Objective: To determine the spectrum of dermatological infections among HIV positive patients, identify the causative microorganisms and CD4 count. Methods: This is a retrospective study conducted in a tertiary center. HIV-positive patients...

Introduction: Psoriasis is a chronic, immune mediated, hyperproliferative skin disease that has substantial impact on the sexual functions. This study aimed to determine the prevalence and associated factors of female sexual dysfunction (FSD) in patients with psoriasis. Methods: A cross-sectional study involving 79 women with psoriasis attending tw...

Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin disease. Biological therapy has revolutionized it's the treatment. Paradoxical HS occur with various biological and targeted agents. We report a patient with juvenile rheumatoid arthritis who developed HS after 6 months of tofacitinib therapy. A comprehensive literature revie...

Background Allergy towards systemic corticosteroid is rare. This case report discusses the investigations to confirm diagnosis and alternative treatments. Case presentation A 51-year-old asthmatic woman developed severe anaphylactic reaction following administration of systemic hydrocortisone. Skin prick, intradermal, and intravenous provocation t...

Introduction: Merkel cell carcinoma (MCC) is a rare and aggressive malignancy of the skin, with poor clinical outcomes. Typical conditions include a rapidly growing, solitary dome-shaped, violaceous nodule. Several root causes have been identified - sun exposure, age, lighter skin, immunocompromised state, and polyomavirus infection. Wide local ex...

Background Pruritus among patients with diabetes mellitus is common and may lead to complex dermatological conditions if left untreated. Pruritus can be caused by increased transepidermal water loss (TEWL) and reduced skin hydration. Aims To compare the TEWL and skin hydration in diabetic with non‐diabetic patients. To investigate the association...

Introduction: Lower limb cellulitis is a common superficial skin infection that leads to morbidity and mortality. Cellulitis risk factors have been well studied in many countries, but to date, not in Malaysia. Geographical and climate variables may affect risk factors. Early identification of the preventable risk factors is vital to prevent cellul...

Background: Higher skin pH in atopic dermatitis contributes to impaired epidermal barrier. A moisturizer compatible with physiological pH could improve atopic dermatitis. Objective: To determine the effect of a physiologically compatible pH moisturizer in atopic dermatitis. Methods: A randomized half body, double blind, controlled trial involv...

Introduction: Atopic dermatitis (AD) and its severity has been inconsistently associated with lower vitamin D levels as multiple other factors that influence vitamin D status were not always assessed. Methods: A case control study involving AD patients and controls ≥18 years old was performed. Exclusion criteria were systemic immunosuppres-sion ≤ 4...

ABSTRACT Drug reaction with eosinophilia and systemic symptom (DRESS) is a severe adverse drug reaction characterized by rash, fever, lymphadenopathy and internal organ involvement. Levetiracetam, a non-aromatic anti-epileptic drug is generally considered to be safe. Levetiracetam induced DRESS is rare. We report a 62-year-old male treated with le...

Background: Multiple factors affect growth in children with atopic dermatitis (AD). We investigated food restriction practice, nutrition, and growth in children with AD. Food restriction is defined as restriction ≥3 types of food due to AD or food allergy. Methods: A cross-sectional study was performed in 150 children aged 12-36 months. Exclusi...

Background: Defective skin's acidic mantle is a component of atopic dermatitis (AD) pathophysiology. We mapped the skin pH and determine its relationship with transepidermal water loss (TEWL), hydration and disease severity. Materials and methods: A cross-sectional study involving patients aged ≥18 years. Eczema Area and Severity Index (EASI) wa...

Prurigo pigmentosa is an inflammatory dermatosis characterized by a pruritic, symmetrically distributed erythematous papular or papulo-vesicular eruption on the trunk arranged in a reticulated pattern that resolves with hyperpigmentation. It is typically non-responsive to topical or systemic steroid therapy. The exact etiology is unknown, but it is...

Introduction: The pH of normal skin is in the acidic range. Higher pH observed in atopic dermatitis (AD) contributes to the skin barrier defect. This study aimed to assess the effect and tolerability of low pH skin cleanser in children with AD. Methods: A prospective open label study was performed involving AD children aged 4-12 years old. Patients...

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease which predominantly affects females. The disease characteristics in male SLE patients are reported to be distinct and may vary across ethnicities and geographical regions. Objective: To determine and compare the clinical phenotype and organ damage between male and female pat...

Introduction: Sun exposure is a risk for skin cancer but is beneficial for multiple other diseases. Recommendations for photoprotection are well defined, guidelines for optimal sun exposure is not clear. We determined sun exposure in healthy adults, considering their skin phototype and amount of skin exposed. Methods: A cross sectional study was pe...

Background Ethnicity, skin phototype and colour influenced minimal erythema dose (MED). Sun exposure has been postulated to increase MED. We determined immediate pigment darkening dose to UVA (IPDDA), MED and minimal melanogenic dose (MMD) for UVB and UVA, and investigated factors affecting these doses. Methods Skin phototype was determined using...

Introduction: Basal cell carcinoma (BCC) of the skin is common. The genitalia is rarely affected as it is naturally protected from ultraviolet light (UV) exposure. Predisposing factors and clinical features of BCC affecting the genitalia still require further description. Observation: We present an elderly man with a scrotal lesion of 31 years dura...

Objective The objective of this paper is to determine photoprotection awareness, knowledge, practices, and its relationship with disease activity and damage in patients with systemic lupus erythematosus (SLE). Methods A cross-sectional study was performed. Data were acquired from in-person interviews and medical records. Results A total of 199 (8...

A 59-year-old man presented with proximal myopathy, myalgia, and weight loss, with the initial markedly elevated serum creatine kinase at 11,000 U/L. Due to his refusal for muscle biopsy, he was initially treated as inflammatory myositis and responded well with the corticosteroids. However, he subsequently had a relapse of the symptoms with more ex...

Hydrocortisone (HC), topical glucocorticoid along with hydroxytyrosol (HT), and anti-microbial- and anti-oxidant-loaded chitosan nanoparticles (CSNPs) were prepared in large scale and analyzed for their adverse effects on healthy human skin followed by repeated applications. Ten subjects were randomized to receive test (HC-HT CSNPs) and vehicle sam...

Introduction: Psoriasis is a chronic, immune mediated, hyperproliferative skin disease that has substantial impact on the sexual functions. This study aimed to determine the prevalence and associated factors of female sexual dysfunction (FSD) in patients with psoriasis. Methods: A cross-sectional study involving 79 women with psoriasis attending tw...

Introduction: Psoriasis is considered an independent cardiovascular risk factor. This study aims to determine and describe the cardiac abnormalities using echocardiography and electrocardiography in patients with plaque psoriasis. Methods: This is a case control study of psoriasis patients with no previous history of cardiac disease. One hundred an...

Elephantiasis nostras verrucosa occurs due to chronic lymphedema, characterized by cutaneous changes consisting of papillomatous, verrucous, and hyperkerototic lesions. Treatment of elephantiasis nostras verrucosa is challenging and results are often disappointing. We report our experience with a patient who was successfully treated with oral acitr...

Leprosy reactions are a major cause of nerve damage, morbidity and disability. We present case of lepromatous leprosy with T1R and pulmonary tuberculosis. We reviewed the literature to determine the relationship between co infection and tuberculosis therapy with leprosy reactions. Case report A 69 year old man with type II diabetes mellitus and hyp...

Introduction: Our country is fast becoming a developed country with improved life expectancy. The healthcare system should be prepared to manage medical conditions which are prevalent in the older age group. Skin diseases are commonly observed in the geriatric population. We seek to characterize the dermatological conditions affecting patients at t...

Background and objective: Keloid is conventionally treated with intra-lesional (IL) triamcinolone, which is highly operator dependent and has its own adverse effects. Topical steroid and silicone dressings are a patient friendly and non-invasive treatment alternative. We therefore sought to determine the efficacy and safety of topical clobetasol p...

The objective of this study was to investigate the in-vivo behavior of topically applied cationic polymeric chitosan nanoparticles (CSNPs) loaded with anti-inflammatory (hydrocortisone, HC) and antimicrobial (hydroxytyrosol, HT) drugs, to elucidate their skin targeting potential for the treatment of atopic dermatitis (AD). Compared to the commercia...

Background: Dermatology is a minor module in internal medicine undergraduate curriculum. Limited time is allocated for its teaching. Most graduates are inadequately prepared to diagnose and manage skin diseases. We aimed to identify the core content of a more effective dermatology module. Methods: A modified Delphi method was used to reach a con...

Hydrocortisone (HC) is a topical glucocorticoid for the treatment of atopic dermatitis (AD); the local as well as systemic side effects limit its use. Hydroxytyrosol (HT) is a polyphenol present in olive oil that has strong antimicrobial and antioxidant activities. HC-HT coloaded chitosan nanoparticles (HC-HT CSNPs) were therefore developed to impr...

Psoriasis is a genetically determined, systemic immune-mediated chronic inflammatory disease that affects primarily the skin and joints. It has been estimated to affect 1-3% of the general population worldwide. There are several distinctive clinical sub-types of psoriasis. Psoriasis vulgaris (Figure 1), the most common type, is seen in 89% of the 6...

Animal inflicted wounds, left untreated may result in chronic bacterial or fungal infection. Clinical features of these infections may overlap leading to a delay in diagnosis and treatment. We report a case of chronic non-healing cat bite wound treated with several antibiotics without improvement. Later patient developed the classical "sporotrichoi...

Ulcer wound refers to a wound with underlying medical conditions that prevent healing. The ability to measure objectively early therapeutic response is important for wound management. Early therapeutic efficacy is best assessed by measurement of wound depth and volume. This study presents a non-invasive technique for assessing ulcer wound volume fr...

In medical applications, 3D information of ulcer wounds are very crucial in measuring the volume of the ulcer cavity. Volume measurement is the most significant criterion in ulcer wound assessment as reduction in wound volume is an indicator of wound healing. Treatment efficacy can be improved and healing period can be shorten if changes in wound p...

Wounds that do not follow a predictable course of healing within a specified period of time develop into ulcers causing severe pain and discomfort to the patients. One of the most prominent changes during wound healing is the colour of the tissues. Describing the tissues in terms of percentages of each tissue colour is an approved clinical method o...

Angiogenesis has been reported to be one of the contributory factors to the pathogenesis of psoriasis vulgaris. This study aims to compare the expression of different angiogenesis growth factors namely (1) the vascular endothelial growth factor (VEGF) subfamily: A, B, C, D and placenta growth factor (PlGF); (2) nerve growth factor (NGF) and (3) von...

The methylenetetrahydrofolate reductase (MTHFR) enzyme catalyzes the reduction of 5, 10-methylenetetrahydrofolate to 5-methyltetrahydrofolate and methyl donors. The methyl donors are required for the conversion of homocysteine to methionine. Mutation of MTHFR 677 C > T disrupts its thermostability therefore leads to defective enzyme activities and...

Imaging is defined as the process of obtaining geometric images, either in two or three dimensions by digitizing an existing object. In this research, 3D information of the human skin surface is retrieved and analysed to determine volume of leg ulcers for medical purposes. Volume determination is an important criterion in clinical assessment of leg...

Ulcers are chronic wounds that cause severe pain and discomfort to the patients. Describing the ulcer tissues in terms of percentages of each tissue colour is an approved method of wound healing assessment. The first indication of ulcer healing is the growth of the red granulation tissue from the base of ulcers. Granulation tissue appears red in co...

This paper presents a comprehensive review of acne grading and measurement. Acne is a chronic disorder of the pilosebaceous units, with excess sebum production, follicular epidermal hyperproliferation, inflammation and Propionibacterium acnes activity. Most patients are affected with acne vulgaris, which is the prevalent type of acne. Acne vulgaris...

Chromoblastomycosis is a chronic subcutaneous mycosis seen mainly in tropical regions. While malignant transformation rarely occurs, the present report describes a 69-year-old man with a 21-year history of chromoblastomycosis complicated by invasive squamous cell carcinoma requiring amputation of the affected limb. A review of previous reported cas...

The ability to measure objectively wound healing is important for an effective wound management. Describing wound tissues in terms of percentages of each tissue colour is an approved clinical method of wound assessment. Wound healing is indicated by the growth of the red granulation tissue, which is rich in small blood capillaries that contain haem...

Ulcers are chronic wounds that do not heal within a predictable amount of time causing severe pain and discomfort to the patients. Describing the proportion of tissue types is a part of the approved clinical method of wound assessment. Many imaging techniques segment and classify different types of tissues of chronic skin wounds according to the ti...

Antibiotic resistant P. acnes have influenced acne therapy worldwide resulting in increased use of topical and systemic retinoids. Judicious use of oral antibiotic is important for effective therapeutic outcome. To determine the response and side effects of oral antibiotic treatment in acne vulgaris. To determine the type of antibiotic used, therap...

A 24-year-old lady presented with four days history of fever, non-pruritic rash, ankle pain and swelling. She had consumed herbal supplement five days before the onset of symptoms. Examinations revealed erythematous maculo-papular lesions of varying sizes on sun exposed areas. Patient was suspected to have Drug Induced Lupus Erythematosus (DILE) an...

Introduction The non-thyroidal illness syndrome (NTIS) or the sick euthyroid syndrome refers to abnormal changes in circulating thyroid hormones due to systemic illnesses. Thyroid hormones are pivotal in the regulation of normal cardiac functions. However, the effects of the NTIS on the heart in acute coronary syndrome (ACS) are still unclear. Met...

Measuring changes in ulcer during treatment can indicate the effectiveness of a treatment regime. Identifying appropriate treatment regime will reduce healing time. Current methods for measuring wound size are subjective and require manual contact with the wound. With the availability of techniques which can provide accurate depth measurement and s...

In this work 3D surface scans of wounds are used to obtain several measurement including wound top area, true surface area (rue area), depth, and volume for the purpose of assessing the progress of ulcer wounds throughout treatment. KONICA MINOLTA 910 laser scanner is used to obtain the surface scans. The algorithm for estimating top area and true...