19th Regional Conference of Dermatology 2010

The 19th RCD presents a unique opportunity for the dermatological profession in Asia to come together in fraternity and fellowship. This conference will also pave way for enhanced regional and international cooperation in the field of dermatology.

This conference will look at innovative medical technology - particularly new
drugs, therapeutic devices and biologics. It will also examine developments
in subspecialties dealing with gene therapy, immunodermatology,
paediatric dermatology, dermatopathology, dermatologic and laser surgery.
An impressive regional and international faculty will be assembled to make
this conference.

You will find Kota Kinabalu, on the mystic island of Borneo a truly exciting
destination full of things to do and to discover, from crystal clear seas to
majestic mountains. Come and enjoy the warm hospitality and the unique
culture of the people. Come and be fascinated by the fauna, the rain forest,
the orang utans, proboscis monkeys and other creatures that you will not see anywhere else in this world.

Malaysia welcomes you.

http://www.asianderm.org/

ECG refresher course 2010

Dear colleagues,

The Cardiology Society of Hospital Pulau Pinang is organising an ECG refresher course on the 1st Jul 2010 venued at ACC. It is a one-day event with lectures and discussions detailing right from the very fundamental technical issues with ECG, to the complex tracings pertaining to day to day practice.

Please feel free to forward this email and program brochure to your colleagues in your mailing list, who are currently practicing in the northern region ie Penang, Perak, Kedah and Perlis.

Kindly take note that the "Stump the cardiologist" session is held with the main purpose of stimulating discussions between the "frontline" ECG interpreters and us. Please feel free to post ECGs during the day.

We'll see you all during the meeting!

Sincerely,
Dr SK Ma
MD, MRCP(UK)
Clinical Cardiologist,
Dept of Cardiology
Hospital Pulau Pinang
sootkeng@gmail.com

4TH PENANG MRCP PACES PREPARATORY COURSE

This preparartory course is jointly organized by Penang Medical College, MOH Penang General Hospital and Seberang Jaya Hospital.

It is a 2 day intensive and examination orientated course.

Date : 31 July - 1 Aug 2010
Venue : ACC,Hospital Pulau Pinang

THE INSIDER'S GUIDE TO PASSING MRCP(UK) PACES

Dear all,

Please forward to those who are sitting for the PACES exam soon. I think it is useful since it is a Saturday and it is free.

Folliculitis Decalvans

Folliculitis decalvans is a rare inflammatory scarring scalp disorder.

It is characterized by follicular pustules, lack of ostia, diffuse perifollicular erythema, follicular tufting and sometimes, hemorrhagic crusts and erosions.

It is believed that this type of scarring alopecia is the end stage of various inflammatory processes resulting in fibrosis and constriction of multiple hair follicles within a common trajectory.

It is also known as cicatricial alopecia or tufted folliculitis.

Treatment is mainly focused on the eradication of S. aureus and the anti-inflammatory agents.

Combination of antibiotic (Oral Rifampicin and Oral Clindamycin) is useful for this rare inflammatory scarring scalp disorder. But patient might need to be on antibiotic for long term.

The scarring, alopecia and tufting persisted but there was no further active inflammation.

Early aggressive treatment should be instituted to prevent scarring.

Please find the poster presentation during Regional Conference of Dermatology 2010 for the details.

Cutaneous Effects of Epidermal Growth Factor Receptor Inhibitors

The use of TKI is associated with unique and dramatic dermatologic side effects.

1. Abnormal scalp, face hair, and/or eyelash growth (Isolated reports)

2. Anaphylactic infusion reaction (cetuximab)

3. Papulopustular eruption 60%-80%

4. Paronychia with/without pyogenic granulomas 6%-12%

5. Telangiectasias

6. Xerosis 4%-35%

Although these new targeted therapies have low systemic toxicity, cutaneous side effects are common and may be serious.

Proper pre-treatment counseling and management will improve the treatment compliance and avoid unnecessary interruption of the TKI use.

TKI induced skin rash appears to be a visible marker of anti-tumor activity and therapeutic efficacy.

Cross-sensitivity of skin rashes with antiepileptic drug use

NEUROLOGY 2008;71:1527-1534
© 2008 American Academy of Neurology

Cross-sensitivity of skin rashes with antiepileptic drug use

L. J. Hirsch, MD, H. Arif, MD, E. A. Nahm, BA, R. Buchsbaum, S. R. Resor, Jr, MD and C. W. Bazil, MD, PhD

Objective:

To determine rates of cross-sensitivity of rash among commonly used antiepileptic drugs (AEDs) in patients with epilepsy.

Methods:

The incidence of AED-related rash was determined in 1875 outpatients (12 years), taking carbamazepine (CBZ), clobazam (CLB), felbamate (FBM), gabapentin (GBP), levetiracetam (LEV), lamotrigine (LTG), oxcarbazepine (OXC), phenobarbital (PB), phenytoin (PHT), primidone (PRM), tiagabine (TGB), topiramate (TPM), vigabatrin (VGB), valproic acid (VPA), or zonisamide (ZNS).

We compared rates of rash for each AED in patients with vs those without a rash to 1) another specific AED; 2) any other AED; 3) any two other AEDs; and 4) any non-epilepsy medication.

Results:

A total of 14.3% (269/1,875) of patients had a rash attributed to at least one AED; 2.8% had a rash to two or more AEDs.

Of patients who had a rash to CBZ and were also prescribed PHT (n = 59), 57.6% had a rash to PHT (abbreviated as CBZ PHT: 57.6%); of patients who had a rash to PHT and were also prescribed CBZ (n = 81), rate of rash was 42% (i.e., PHT CBZ: 42%). Other results: CBZ LTG: 20% (n = 50); LTG CBZ: 26.3% (n = 38); CBZ OXC: 33% (n = 15); OXC CBZ: 71.4% (n = 7); CBZ PB: 26.7% (n = 30); PB CBZ: 66.7% (n = 12); LTG PHT: 38.9% (n = 36); PHT LTG: 18.9% (n = 74); PB PHT: 53.3% (n = 15); PHT PB: 19.5% (n = 41); OXC LTG: 37.5% (n = 8); LTG OXC: 20% (n = 15).

There was evidence of specific cross-sensitivity between CBZ and PHT, and between CBZ and PB.

Conclusion:

Cross-sensitivity rates between certain antiepileptic drugs (AEDs) are high, especially when involving carbamazepine and phenytoin.

Specific cross-sensitivity rates provided here may be useful for AED selection and counseling in individual patients.

Abbreviations: AED = antiepileptic drug; CBZ = carbamazepine; CLB = clobazam; FBM = felbamate; GBP = gabapentin; LEV = levetiracetam; LTG = lamotrigine; OXC = oxcarbazepine; PB = phenobarbital; PHT = phenytoin; PRM = primidone; TGB = tiagabine; TPM = topiramate; VGB = vigabatrin; VPA = valproic acid; ZNS = zonisamide.