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2. Reactive Epidermal Hyperplasia and Angiogenesis of the Rear (REAR): A Proposed Unifying Name for Senile Gluteal Dermatosis and Prurigiform Angiomatosis

Author

Michelle Weiting Liang, Joel H. L. Lim, Hui Yi Chia, Shang-Ian Tee, and Joyce S. S. Lee

Subjects
senile gluteal dermatosis, pressure dermatitis, prurigiform angiomatosis, sitter’s triangle, Dermatology, RL1-803
Abstract

Senile gluteal dermatosis (SGD) is a common but seldom recognized condition. It is characterized clinically by unilateral or bilateral hyperkeratotic, lichenified plaques on the gluteal area, being attributed to prolonged sitting, particularly in the elderly. SGD also encompasses the recently proposed entity of prurigiform angiomatosis. Histologically, there are features of lichenification, such as epidermal hyperplasia and a preserved granular layer, with prominent dermal angioproliferation. We report 4 cases of this condition as well as novel findings of variably increased mast cells and superficial lymphatic vessels in addition to the proliferation of dermal blood vessels. We propose a unifying name for Reactive Epidermal hyperplasia and Angiogenesis of the Rear (REAR) to encapsulate the characteristic clinical and histological features of this distinct entity.

Published
2022
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3. Keratin-Alginate Sponges Support Healing of Partial-Thickness Burns

Author

Zi Kuang Moay, Luong T. H. Nguyen, Pietradewi Hartrianti, Declan P. Lunny, David Leavesley, Yee Onn Kok, Si Jack Chong, Alvin Wen Choong Chua, Shang-Ian Tee, and Kee Woei Ng

Subjects
fibroblast, human hair keratin, sponge, wound healing, porcine burn wounds, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract

Deep partial-thickness burns damage most of the dermis and can cause severe pain, scarring, and mortality if left untreated. This study serves to evaluate the effectiveness of crosslinked keratin–alginate composite sponges as dermal substitutes for deep partial-thickness burns. Crosslinked keratin–alginate sponges were tested for the ability to support human dermal fibroblasts in vitro and to support the closure and healing of partial-thickness burn wounds in Sus scrofa pigs. Keratin–alginate composite sponges supported the enhanced proliferation of human dermal fibroblasts compared to alginate-only sponges and exhibited decreased contraction in vitro when compared to keratin only sponges. As dermal substitutes in vivo, the sponges supported the expression of keratin 14, alpha-smooth muscle actin, and collagen IV within wound sites, comparable to collagen sponges. Keratin–alginate composite sponges supported the regeneration of basement membranes in the wounds more than in collagen-treated wounds and non-grafted controls, suggesting the subsequent development of pathological scar tissues may be minimized. Results from this study indicate that crosslinked keratin–alginate sponges are suitable alternative dermal substitutes for clinical applications in wound healing and skin regeneration.

Published
2021
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4. Two episodes of cutaneous non-tuberculous mycobacterial infection in a patient with psoriasis

Author

Wai Sze Agnes Chan, Shang-Ian Tee, Nisha Su Yien Chandran, and Jiun Yit Pan

Subjects
Mycobacterium abscessus, Mycobacterium hemophilum, cutaneous, non tuberculous mycobacteria, psoriasis, Dermatology, RL1-803
Abstract

Non-tuberculous mycobacteria (NTM) are a group of environmental pathogens, which cause a broad spectrum of disease. The incidence of NTM infection is increasing, especially in immunocompromized patients. The past three decades also saw a rapid increase in the incidence of NTM infection involving otherwise healthy subjects. We report a case of cutaneous NTM infection in a 79-year-old Chinese woman, who was receiving methotrexate for psoriasis. Mycobacterial culture grew Mycobacterium abscessus, and the lesions cleared with a combination of oral clarithromycin, ciprofloxacin and doxycycline. Interestingly, she then developed a second episode of cutaneous NTM infection with Mycobacterium haemophilum over the same body region, five years after stoppage of methotrexate. Both episodes were separated in time and involved different species, indicating that they were independent from each other. We further discuss the risk factors for cutaneous NTM infection, treatment, and highlight the need for diagnostic vigilance.

Published
2015
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5. Efficacy and safety of ligelizumab in adults and adolescents with chronic spontaneous urticaria: results of two phase 3 randomised controlled trials

Author

Rosana, Agondi, Ahmed, Al Waily, Fabio, Almerigogna, Miguel Angel Tejedor, Alonso, Alfred, Ammoury, Eng Kim, Anne Goh, Robert, Anolik, Ledit, Ardusso, Petr, Arenberger, Nandini, AS, Mohammad, Asefi, Natalia, Astafieva, Anil, Badhwar, Esther Serra, Baldrich, Christine, Bangert, Annick, Barbaud, Zsuzsanna, Bata-Csorgo, Andrea, Bauer, Frederic, Berard, Beata, Bergler-Czop, Gary D, Berman, Jonathan, Bernstein, Subhash Chandra, Bharija, Ramesh M, Bhat, Isabelle, Boccon-Gibod, Ivan, Botev, Knut, Brockow, Philipp, Buck, Paula, Busse, Regis, Campos, Giorgio Walter, Canonica, Irani, Carla, Julia Maria Del, Carmen, Jaime Del, Carpio, Mamatha, Chadalavada, Yoon-Seok, Chang, Amarjit, Cheema, Yi Hsing, Chen, Yuko, Chinuki, Soyun, Cho, Jeong-Hee, Choi, Chia-Yu, Chu, Ronit, Confino, Jonathan, Corren, Roberta, Criado, Claudia De La, Cruz, David M, Cypcar, Pramila, Daftary, Inna, Danilycheva, Kenneth, Dawes, Michelle Joy, De Vera, James, Deangelo, Stefano, Del Giacco, Diana, Deleanu, John, Delgado, Richard, DeMera, Mohamed, Denguezli, Heinrich, Dickel, Le Huu, Doanh, Sinan, Dogan, Marie Sylvie, Doutre, Anne Sophie, Dupond, Anton, Edin, Kent, EDWARD, Swarna, Ekanayake-Bohling, Daniel, Elbirt, David, Elkayam, Anne, Ellis, Shaunagh, Emanuel, Alexander, Emeliyanov, Burhan, Engin, Luis Felipe, Ensina, Ignacio Antepara, Ercoreca, Safiye, Ergun, Jose Luis Lopez, Estebaranz, Rustem, Fassakhov, Daria, Fomina, Linda, Ford, Mariangela, Francomano, Todd, Funkhouser, Remi, Gagnon, Ricardo, Galimberti, Cesar Alberto, Galvan Calle, Clovis, Galvao, Gabriel, Gattolin, Pierre-Dominique, Ghislain, Ana Maria, Gimenez Arnau, Elliot, Ginchansky, Francoise, Giordano-Labadie, Stanislav, Givirovsky, Kiran, Godse, Shaila, Gogate, Alan, Goldsobel, Francisca, Gomez, Rene Maximiliano, Gomez, Erika, Gonzalez, Paula Ribo, Gonzalez, Dimitar, Gospodinov, Clive, Grattan, Martine, Grosber, Gary, Gross, Francisco Jose Gomez, Guimera Martin-Neda, Rolland, Gyulai, Svetlana, Hadvabova, Suzana Ljubojevic, Hadzavdic, Hadi, Hamam, Daniela, Hasicova, Koremasa, Hayama, Pravin, Hissaria, Anna, Hjerppe, Ivan, Hlinka, Moises Labrador, Horrillo, Connie, Hsu, Yu-Huei, Huang, Iftikhar, Hussain, Atsuyuki, Igarashi, Beata, IMKO-WALCZUK, Huseyin Serhat, Inaloz, Rossella, Intravaia, Neal, Jain, Sanjeev, Jain, Thilo, Jakob, Ruth Cerino, Javier, Antonio, João, Luiza Marek, Jozefowicz, Chang-Gyu, Jung, Martin, Kaatz, Nida, Kacar, Henry, Kanarek, Iva, Karlova, Alexander, Kastanayan, Jana, Kazandjieva, Johannes, Kern, Aharon, Kessel, Neena, Khanna, HeeJoo, Kim, Nancy, Kim, Sang-Ha, Kim, Tae-bum, Kim, Kulli, Kingo, Andreas, Kleinheinz, Janka, Komova, Evangelia, Kompoti, Tomas, Kopal, Peter, Kozub, Dorota, Krasowska, Beata, Krecisz, Burkhard, Kreft, Satsuki, Kubota, Hitoshi, Kudo, Teja, Kulkarni, Kanokvalai, Kulthanan, Akihiro, Kume, Maciej, Kupczyk, Edward, Lain, Bobby, Lanier, Hilde, Lapeere, Griselle Ortiz, Lasanta, Svetlana, Lazareva, Laura, Lazzeri, Dennis, Ledford, Donghun, Lee, Haur Yueh, Lee, Jeffrey, Leflein, Nicolas, Leitz, Nancy, Levin, Hermenio, Lima, Undine, Lippert, Brian, Lipson, Paula, Luna, Gabriel, Magarinos, Satyaprakash, Mahajan, Michail, Makris, Alejandro, Malbran, Ahmed Manjra, Manjra, Michael, Manning, Maria, Manrique, Adriana, Marcipar, Mariano, Marini, Veronique Del, Marmol, Jorge, Maspero, Tomoko, Matsuda, Jonathan, Matz, Marcus, Maurer, Wendy, McFalda, Anne, Mclaughlin, Iris, Medina, Rajesh Dutt, Mehta, Stephan, Meller, Steven, MELTZER, Raisa, Meshkova, Dorin, Mihalache, Francisco Javier, Miquel, Mourad, Mokni, J, Molhoek, Efrain, Montano, Sabine, Mueller, Javier Pedraz, Munoz, Toshikazu, Nagakura, Joanna, Narbutt, Ignasi Figueras, Nart, Ma. Lourdes M, Nebrida-Idea, Trong Hao, Nguyen, Johannes, Niesmann, Violeta Zaragoza, Ninet, Hiromitsu, Noguchi, Yuko Chinuki, Nomura, Roman, Nowicki, Tokuya, Omi, Robert, Onder, Ivan, Orojan, Francisco Javier, Ortiz de Frutos, Kim, Papp, Claudio, Parisi, Chun Wook, Park, Heungwoo, Park, Jungwon, Park, Young Min, Park, Viviana, Parra, Thierry, Passeron, Justine, Pasteur, Shivakumar, Patil, Vergil, Patrascu, Sylvia, Pauser, Anna Wojas, Pelc, Jonathan Grant, Peter, Wolfgang, Pfuetzner, Nicola, Pimpinelli, Andreas, Pinter, Cristian, Pizarro, Karel, Pizinger, Jarmila, Plutinska, Todor, Popov, Veronika, Popova, Marta Ferrer, Puga, Lara Ferrandiz, Pulido, Anca, Purcaru, Ulrike, Raap, Anna, Rajchel, John, Ramey, Ma Deanna Santos, Ramiscal, German Dario, Ramon, Syed, Rehman, Adam, Reich, Norbert, Reider, Krista, Ress, Dimitrios, Rigopoulos, Enrique, Rivas, Heike, Rockmann, Pierre-Paul, Roquet-Gravy, Menachem, Rottem, Vermen Verallo, Rowell, Franziska, Rueff, Juan Alberto Ruano, Ruiz, Juan, Russo, Ronald, Saff, Sarbjit, Saini, Maria, Salazar, Juan Francisco Silvestre, Salvador, Jorge, Sanchez, Florica, Sandru, Mark, Scarupa, Knut, Schaekel, Sibylle, Schliemann, Rik, Schrijvers, Beate, Schwarz, Andreas, Schwinn, Sudhir, Sekhsaria, Nilgun, Senturk, Seong Jun, Seo, Mercedes Rodriguez, Serna, Faradiba, Serpa, Paul A, Shapero, Eriko, Shinkawa, Jan-Christoph, Simon, Rodney, Sinclair, Ralfi, Singer, Dareen D, Siri, Karl, Sitz, Adam, Smialowski, Andrew, Smith, Morten, Soerensen, Wiebke, Sondermann, Haejun, Song, Dmitrii, Sonin, Weily, Soong, Daniel, Soteres, Maria, Staevska-Kotasheva, Petra, Staubach-Renz, Nisha Su Yien, Subash, Gordon, Sussman, Ake Svensson, Svensson, Ekaterini, Syrigou, Andrea, Szegedi, Jacek, Szepietowski, Shunsuke, Takahagi, Yuval, Tal, Neetu, Talreja, Wooi Chiang, Tan, Ricardo, Tan, Jyh Jong, Tang, Tonny, Tanus, Martha, Tarpay, Shang Ian, Tee, Craig, Teller, Florence, Tetart, Aurelie Du, Thanh, Suganthi, Thevarajah, Simon Francis, Thomsen, Carl, Thornblade, Milan, Tjioe, Alberto, Tolcachier, Celeste, Tolentino, Athanasios, Tsianakas, Ilia, Tsingov, Hamida, Turki, Olga, Ukhanova, Jens, Ulrich, Meltem, Uslu, Fernando, Valenzuela, Solange, Valle, Martijn, van Doorn, Jirina, Vankova, Suneel, Vartak, Christine, Vidouria, Sebastian, Volc, Gerald, Volcheck, Nicola, Wagner, Irena, Walecka-Herniczek, Penpun, Wattanakrai, Bettina, Wedi, Steven, Weinstein, Vesarat, Wessagowit, Hugh, Windom, Akiko, Yagami, Aisaku, Yamamoto, Shinichiro, Yasumoto, Young Min, Ye, Jose Cevallos, Yepez, Sang Woong, Youn, Hana, Zelenkova, Oleg, Ziganshin, Matthew, Zook, Maurer, Marcus, Ensina, Luis Felipe, Gimenez-Arnau, Ana Maria, Sussman, Gordon, Hide, Michihiro, Saini, Sarbjit, Grattan, Clive, Fomina, Daria, Rigopoulos, Dimitrios, Berard, Frederic, Canonica, Giorgio Walter, Rockmann, Heike, Szepietowski, Jacek C, Leflein, Jeffrey, Bernstein, Jonathan A, Peter, Jonny G, Kulthanan, Kanokvalai, Godse, Kiran, Ardusso, Ledit, Ukhanova, Olga, Staubach, Petra, Sinclair, Rodney, Gogate, Shaila, Thomsen, Simon Francis, Tanus, Tonny, Ye, Young Min, Burciu, Alis, Barve, Avantika, Modi, Darshna, Scosyrev, Emil, Hua, Eva, Letzelter, Kerstin, Varanasi, Vineeth, Patekar, Manmath, and Severin, Thomas

Published
2024
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6. Efficacy and safety of ligelizumab in adults and adolescents with chronic spontaneous urticaria: results of two phase 3 randomised controlled trials

Author

Maurer, Marcus, primary, Ensina, Luis Felipe, additional, Gimenez-Arnau, Ana Maria, additional, Sussman, Gordon, additional, Hide, Michihiro, additional, Saini, Sarbjit, additional, Grattan, Clive, additional, Fomina, Daria, additional, Rigopoulos, Dimitrios, additional, Berard, Frederic, additional, Canonica, Giorgio Walter, additional, Rockmann, Heike, additional, Irani, Carla, additional, Szepietowski, Jacek C, additional, Leflein, Jeffrey, additional, Bernstein, Jonathan A, additional, Peter, Jonny G, additional, Kulthanan, Kanokvalai, additional, Godse, Kiran, additional, Ardusso, Ledit, additional, Ukhanova, Olga, additional, Staubach, Petra, additional, Sinclair, Rodney, additional, Gogate, Shaila, additional, Thomsen, Simon Francis, additional, Tanus, Tonny, additional, Ye, Young Min, additional, Burciu, Alis, additional, Barve, Avantika, additional, Modi, Darshna, additional, Scosyrev, Emil, additional, Hua, Eva, additional, Letzelter, Kerstin, additional, Varanasi, Vineeth, additional, Patekar, Manmath, additional, Severin, Thomas, additional, Rosana, Agondi, additional, Ahmed, Al Waily, additional, Fabio, Almerigogna, additional, Miguel Angel Tejedor, Alonso, additional, Alfred, Ammoury, additional, Eng Kim, Anne Goh, additional, Robert, Anolik, additional, Ledit, Ardusso, additional, Petr, Arenberger, additional, Nandini, AS, additional, Mohammad, Asefi, additional, Natalia, Astafieva, additional, Anil, Badhwar, additional, Esther Serra, Baldrich, additional, Christine, Bangert, additional, Annick, Barbaud, additional, Zsuzsanna, Bata-Csorgo, additional, Andrea, Bauer, additional, Frederic, Berard, additional, Beata, Bergler-Czop, additional, Gary D, Berman, additional, Jonathan, Bernstein, additional, Subhash Chandra, Bharija, additional, Ramesh M, Bhat, additional, Isabelle, Boccon-Gibod, additional, Ivan, Botev, additional, Knut, Brockow, additional, Philipp, Buck, additional, Paula, Busse, additional, Regis, Campos, additional, Giorgio Walter, Canonica, additional, Julia Maria Del, Carmen, additional, Jaime Del, Carpio, additional, Mamatha, Chadalavada, additional, Yoon-Seok, Chang, additional, Amarjit, Cheema, additional, Yi Hsing, Chen, additional, Yuko, Chinuki, additional, Soyun, Cho, additional, Jeong-Hee, Choi, additional, Chia-Yu, Chu, additional, Ronit, Confino, additional, Jonathan, Corren, additional, Roberta, Criado, additional, Claudia De La, Cruz, additional, David M, Cypcar, additional, Pramila, Daftary, additional, Inna, Danilycheva, additional, Kenneth, Dawes, additional, Michelle Joy, De Vera, additional, James, Deangelo, additional, Stefano, Del Giacco, additional, Diana, Deleanu, additional, John, Delgado, additional, Richard, DeMera, additional, Mohamed, Denguezli, additional, Heinrich, Dickel, additional, Le Huu, Doanh, additional, Sinan, Dogan, additional, Marie Sylvie, Doutre, additional, Anne Sophie, Dupond, additional, Anton, Edin, additional, Kent, EDWARD, additional, Swarna, Ekanayake-Bohling, additional, Daniel, Elbirt, additional, David, Elkayam, additional, Anne, Ellis, additional, Shaunagh, Emanuel, additional, Alexander, Emeliyanov, additional, Burhan, Engin, additional, Luis Felipe, Ensina, additional, Ignacio Antepara, Ercoreca, additional, Safiye, Ergun, additional, Jose Luis Lopez, Estebaranz, additional, Rustem, Fassakhov, additional, Daria, Fomina, additional, Linda, Ford, additional, Mariangela, Francomano, additional, Todd, Funkhouser, additional, Remi, Gagnon, additional, Ricardo, Galimberti, additional, Cesar Alberto, Galvan Calle, additional, Clovis, Galvao, additional, Gabriel, Gattolin, additional, Pierre-Dominique, Ghislain, additional, Ana Maria, Gimenez Arnau, additional, Elliot, Ginchansky, additional, Francoise, Giordano-Labadie, additional, Stanislav, Givirovsky, additional, Kiran, Godse, additional, Shaila, Gogate, additional, Alan, Goldsobel, additional, Francisca, Gomez, additional, Rene Maximiliano, Gomez, additional, Erika, Gonzalez, additional, Paula Ribo, Gonzalez, additional, Dimitar, Gospodinov, additional, Clive, Grattan, additional, Martine, Grosber, additional, Gary, Gross, additional, Francisco Jose Gomez, Guimera Martin-Neda, additional, Rolland, Gyulai, additional, Svetlana, Hadvabova, additional, Suzana Ljubojevic, Hadzavdic, additional, Hadi, Hamam, additional, Daniela, Hasicova, additional, Koremasa, Hayama, additional, Pravin, Hissaria, additional, Anna, Hjerppe, additional, Ivan, Hlinka, additional, Moises Labrador, Horrillo, additional, Connie, Hsu, additional, Yu-Huei, Huang, additional, Iftikhar, Hussain, additional, Atsuyuki, Igarashi, additional, Beata, IMKO-WALCZUK, additional, Huseyin Serhat, Inaloz, additional, Rossella, Intravaia, additional, Neal, Jain, additional, Sanjeev, Jain, additional, Thilo, Jakob, additional, Ruth Cerino, Javier, additional, Antonio, João, additional, Luiza Marek, Jozefowicz, additional, Chang-Gyu, Jung, additional, Martin, Kaatz, additional, Nida, Kacar, additional, Henry, Kanarek, additional, Iva, Karlova, additional, Alexander, Kastanayan, additional, Jana, Kazandjieva, additional, Johannes, Kern, additional, Aharon, Kessel, additional, Neena, Khanna, additional, HeeJoo, Kim, additional, Nancy, Kim, additional, Sang-Ha, Kim, additional, Tae-bum, Kim, additional, Kulli, Kingo, additional, Andreas, Kleinheinz, additional, Janka, Komova, additional, Evangelia, Kompoti, additional, Tomas, Kopal, additional, Peter, Kozub, additional, Dorota, Krasowska, additional, Beata, Krecisz, additional, Burkhard, Kreft, additional, Satsuki, Kubota, additional, Hitoshi, Kudo, additional, Teja, Kulkarni, additional, Kanokvalai, Kulthanan, additional, Akihiro, Kume, additional, Maciej, Kupczyk, additional, Edward, Lain, additional, Bobby, Lanier, additional, Hilde, Lapeere, additional, Griselle Ortiz, Lasanta, additional, Svetlana, Lazareva, additional, Laura, Lazzeri, additional, Dennis, Ledford, additional, Donghun, Lee, additional, Haur Yueh, Lee, additional, Jeffrey, Leflein, additional, Nicolas, Leitz, additional, Nancy, Levin, additional, Hermenio, Lima, additional, Undine, Lippert, additional, Brian, Lipson, additional, Paula, Luna, additional, Gabriel, Magarinos, additional, Satyaprakash, Mahajan, additional, Michail, Makris, additional, Alejandro, Malbran, additional, Ahmed Manjra, Manjra, additional, Michael, Manning, additional, Maria, Manrique, additional, Adriana, Marcipar, additional, Mariano, Marini, additional, Veronique Del, Marmol, additional, Jorge, Maspero, additional, Tomoko, Matsuda, additional, Jonathan, Matz, additional, Marcus, Maurer, additional, Wendy, McFalda, additional, Anne, Mclaughlin, additional, Iris, Medina, additional, Rajesh Dutt, Mehta, additional, Stephan, Meller, additional, Steven, MELTZER, additional, Raisa, Meshkova, additional, Dorin, Mihalache, additional, Francisco Javier, Miquel, additional, Mourad, Mokni, additional, J, Molhoek, additional, Efrain, Montano, additional, Sabine, Mueller, additional, Javier Pedraz, Munoz, additional, Toshikazu, Nagakura, additional, Joanna, Narbutt, additional, Ignasi Figueras, Nart, additional, Ma. Lourdes M, Nebrida-Idea, additional, Trong Hao, Nguyen, additional, Johannes, Niesmann, additional, Violeta Zaragoza, Ninet, additional, Hiromitsu, Noguchi, additional, Yuko Chinuki, Nomura, additional, Roman, Nowicki, additional, Tokuya, Omi, additional, Robert, Onder, additional, Ivan, Orojan, additional, Francisco Javier, Ortiz de Frutos, additional, Kim, Papp, additional, Claudio, Parisi, additional, Chun Wook, Park, additional, Heungwoo, Park, additional, Jungwon, Park, additional, Young Min, Park, additional, Viviana, Parra, additional, Thierry, Passeron, additional, Justine, Pasteur, additional, Shivakumar, Patil, additional, Vergil, Patrascu, additional, Sylvia, Pauser, additional, Anna Wojas, Pelc, additional, Jonathan Grant, Peter, additional, Wolfgang, Pfuetzner, additional, Nicola, Pimpinelli, additional, Andreas, Pinter, additional, Cristian, Pizarro, additional, Karel, Pizinger, additional, Jarmila, Plutinska, additional, Todor, Popov, additional, Veronika, Popova, additional, Marta Ferrer, Puga, additional, Lara Ferrandiz, Pulido, additional, Anca, Purcaru, additional, Ulrike, Raap, additional, Anna, Rajchel, additional, John, Ramey, additional, Ma Deanna Santos, Ramiscal, additional, German Dario, Ramon, additional, Syed, Rehman, additional, Adam, Reich, additional, Norbert, Reider, additional, Krista, Ress, additional, Dimitrios, Rigopoulos, additional, Enrique, Rivas, additional, Heike, Rockmann, additional, Pierre-Paul, Roquet-Gravy, additional, Menachem, Rottem, additional, Vermen Verallo, Rowell, additional, Franziska, Rueff, additional, Juan Alberto Ruano, Ruiz, additional, Juan, Russo, additional, Ronald, Saff, additional, Sarbjit, Saini, additional, Maria, Salazar, additional, Juan Francisco Silvestre, Salvador, additional, Jorge, Sanchez, additional, Florica, Sandru, additional, Mark, Scarupa, additional, Knut, Schaekel, additional, Sibylle, Schliemann, additional, Rik, Schrijvers, additional, Beate, Schwarz, additional, Andreas, Schwinn, additional, Sudhir, Sekhsaria, additional, Nilgun, Senturk, additional, Seong Jun, Seo, additional, Mercedes Rodriguez, Serna, additional, Faradiba, Serpa, additional, Paul A, Shapero, additional, Eriko, Shinkawa, additional, Jan-Christoph, Simon, additional, Rodney, Sinclair, additional, Ralfi, Singer, additional, Dareen D, Siri, additional, Karl, Sitz, additional, Adam, Smialowski, additional, Andrew, Smith, additional, Morten, Soerensen, additional, Wiebke, Sondermann, additional, Haejun, Song, additional, Dmitrii, Sonin, additional, Weily, Soong, additional, Daniel, Soteres, additional, Maria, Staevska-Kotasheva, additional, Petra, Staubach-Renz, additional, Nisha Su Yien, Subash, additional, Gordon, Sussman, additional, Ake Svensson, Svensson, additional, Ekaterini, Syrigou, additional, Andrea, Szegedi, additional, Jacek, Szepietowski, additional, Shunsuke, Takahagi, additional, Yuval, Tal, additional, Neetu, Talreja, additional, Wooi Chiang, Tan, additional, Ricardo, Tan, additional, Jyh Jong, Tang, additional, Tonny, Tanus, additional, Martha, Tarpay, additional, Shang Ian, Tee, additional, Craig, Teller, additional, Florence, Tetart, additional, Aurelie Du, Thanh, additional, Suganthi, Thevarajah, additional, Simon Francis, Thomsen, additional, Carl, Thornblade, additional, Milan, Tjioe, additional, Alberto, Tolcachier, additional, Celeste, Tolentino, additional, Athanasios, Tsianakas, additional, Ilia, Tsingov, additional, Hamida, Turki, additional, Olga, Ukhanova, additional, Jens, Ulrich, additional, Meltem, Uslu, additional, Fernando, Valenzuela, additional, Solange, Valle, additional, Martijn, van Doorn, additional, Jirina, Vankova, additional, Suneel, Vartak, additional, Christine, Vidouria, additional, Sebastian, Volc, additional, Gerald, Volcheck, additional, Nicola, Wagner, additional, Irena, Walecka-Herniczek, additional, Penpun, Wattanakrai, additional, Bettina, Wedi, additional, Steven, Weinstein, additional, Vesarat, Wessagowit, additional, Hugh, Windom, additional, Akiko, Yagami, additional, Aisaku, Yamamoto, additional, Shinichiro, Yasumoto, additional, Young Min, Ye, additional, Jose Cevallos, Yepez, additional, Sang Woong, Youn, additional, Hana, Zelenkova, additional, Oleg, Ziganshin, additional, and Matthew, Zook, additional

Published
2023
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8. Morphoea following COVID-19 vaccination

Author

Yee Kiat Heng, Dawn Oh, and Shang-Ian Tee

Subjects
Dermatology
Abstract

We present a case of generalized morphoea developing after recent COVID-19 mRNA vaccination and suggest the plausible pathomechanisms.

Published
2022

9. Efficacy and safety of ligelizumab in adults and adolescents with chronic spontaneous urticaria: results of two phase 3 randomised controlled trials

Author

Maurer, Marcus, Ensina, Luis Felipe, Gimenez-Arnau, Ana Maria, Sussman, Gordon, Hide, Michihiro, Saini, Sarbjit, Grattan, Clive, Fomina, Daria, Rigopoulos, Dimitrios, Berard, Frederic, Canonica, Giorgio Walter, Rockmann, Heike, Irani, Carla, Szepietowski, Jacek C, Leflein, Jeffrey, Bernstein, Jonathan A, Peter, Jonny G, Kulthanan, Kanokvalai, Godse, Kiran, Ardusso, Ledit, Ukhanova, Olga, Staubach, Petra, Sinclair, Rodney, Gogate, Shaila, Thomsen, Simon Francis, Tanus, Tonny, Ye, Young Min, Burciu, Alis, Barve, Avantika, Modi, Darshna, Scosyrev, Emil, Hua, Eva, Letzelter, Kerstin, Varanasi, Vineeth, Patekar, Manmath, Severin, Thomas, Rosana, Agondi, Ahmed, Al Waily, Fabio, Almerigogna, Miguel Angel Tejedor, Alonso, Alfred, Ammoury, Eng Kim, Anne Goh, Robert, Anolik, Ledit, Ardusso, Petr, Arenberger, Nandini, AS, Mohammad, Asefi, Natalia, Astafieva, Anil, Badhwar, Esther Serra, Baldrich, Christine, Bangert, Annick, Barbaud, Zsuzsanna, Bata-Csorgo, Andrea, Bauer, Frederic, Berard, Beata, Bergler-Czop, Gary D, Berman, Jonathan, Bernstein, Subhash Chandra, Bharija, Ramesh M, Bhat, Isabelle, Boccon-Gibod, Ivan, Botev, Knut, Brockow, Philipp, Buck, Paula, Busse, Regis, Campos, Giorgio Walter, Canonica, Irani, Carla, Julia Maria Del, Carmen, Jaime Del, Carpio, Mamatha, Chadalavada, Yoon-Seok, Chang, Amarjit, Cheema, Yi Hsing, Chen, Yuko, Chinuki, Soyun, Cho, Jeong-Hee, Choi, Chia-Yu, Chu, Ronit, Confino, Jonathan, Corren, Roberta, Criado, Claudia De La, Cruz, David M, Cypcar, Pramila, Daftary, Inna, Danilycheva, Kenneth, Dawes, Michelle Joy, De Vera, James, Deangelo, Stefano, Del Giacco, Diana, Deleanu, John, Delgado, Richard, DeMera, Mohamed, Denguezli, Heinrich, Dickel, Le Huu, Doanh, Sinan, Dogan, Marie Sylvie, Doutre, Anne Sophie, Dupond, Anton, Edin, Kent, EDWARD, Swarna, Ekanayake-Bohling, Daniel, Elbirt, David, Elkayam, Anne, Ellis, Shaunagh, Emanuel, Alexander, Emeliyanov, Burhan, Engin, Luis Felipe, Ensina, Ignacio Antepara, Ercoreca, Safiye, Ergun, Jose Luis Lopez, Estebaranz, Rustem, Fassakhov, Daria, Fomina, Linda, Ford, Mariangela, Francomano, Todd, Funkhouser, Remi, Gagnon, Ricardo, Galimberti, Cesar Alberto, Galvan Calle, Clovis, Galvao, Gabriel, Gattolin, Pierre-Dominique, Ghislain, Ana Maria, Gimenez Arnau, Elliot, Ginchansky, Francoise, Giordano-Labadie, Stanislav, Givirovsky, Kiran, Godse, Shaila, Gogate, Alan, Goldsobel, Francisca, Gomez, Rene Maximiliano, Gomez, Erika, Gonzalez, Paula Ribo, Gonzalez, Dimitar, Gospodinov, Clive, Grattan, Martine, Grosber, Gary, Gross, Francisco Jose Gomez, Guimera Martin-Neda, Rolland, Gyulai, Svetlana, Hadvabova, Suzana Ljubojevic, Hadzavdic, Hadi, Hamam, Daniela, Hasicova, Koremasa, Hayama, Pravin, Hissaria, Anna, Hjerppe, Ivan, Hlinka, Moises Labrador, Horrillo, Connie, Hsu, Yu-Huei, Huang, Iftikhar, Hussain, Atsuyuki, Igarashi, Beata, IMKO-WALCZUK, Huseyin Serhat, Inaloz, Rossella, Intravaia, Neal, Jain, Sanjeev, Jain, Sanjeev, Jain, Thilo, Jakob, Ruth Cerino, Javier, Antonio, João, Luiza Marek, Jozefowicz, Chang-Gyu, Jung, Martin, Kaatz, Nida, Kacar, Henry, Kanarek, Iva, Karlova, Alexander, Kastanayan, Jana, Kazandjieva, Johannes, Kern, Aharon, Kessel, Neena, Khanna, HeeJoo, Kim, Nancy, Kim, Sang-Ha, Kim, Tae-bum, Kim, Kulli, Kingo, Andreas, Kleinheinz, Janka, Komova, Evangelia, Kompoti, Tomas, Kopal, Peter, Kozub, Dorota, Krasowska, Beata, Krecisz, Burkhard, Kreft, Satsuki, Kubota, Hitoshi, Kudo, Teja, Kulkarni, Kanokvalai, Kulthanan, Akihiro, Kume, Maciej, Kupczyk, Edward, Lain, Bobby, Lanier, Hilde, Lapeere, Griselle Ortiz, Lasanta, Svetlana, Lazareva, Laura, Lazzeri, Dennis, Ledford, Donghun, Lee, Haur Yueh, Lee, Jeffrey, Leflein, Nicolas, Leitz, Nancy, Levin, Hermenio, Lima, Undine, Lippert, Brian, Lipson, Paula, Luna, Gabriel, Magarinos, Satyaprakash, Mahajan, Michail, Makris, Alejandro, Malbran, Ahmed Manjra, Manjra, Michael, Manning, Maria, Manrique, Adriana, Marcipar, Mariano, Marini, Veronique Del, Marmol, Jorge, Maspero, Tomoko, Matsuda, Jonathan, Matz, Marcus, Maurer, Wendy, McFalda, Anne, Mclaughlin, Iris, Medina, Rajesh Dutt, Mehta, Stephan, Meller, Steven, MELTZER, Raisa, Meshkova, Dorin, Mihalache, Francisco Javier, Miquel, Mourad, Mokni, J, Molhoek, Efrain, Montano, Sabine, Mueller, Javier Pedraz, Munoz, Toshikazu, Nagakura, Joanna, Narbutt, Ignasi Figueras, Nart, Ma. Lourdes M, Nebrida-Idea, Trong Hao, Nguyen, Johannes, Niesmann, Violeta Zaragoza, Ninet, Hiromitsu, Noguchi, Yuko Chinuki, Nomura, Roman, Nowicki, Tokuya, Omi, Robert, Onder, Ivan, Orojan, Francisco Javier, Ortiz de Frutos, Kim, Papp, Claudio, Parisi, Chun Wook, Park, Heungwoo, Park, Jungwon, Park, Young Min, Park, Viviana, Parra, Thierry, Passeron, Justine, Pasteur, Shivakumar, Patil, Vergil, Patrascu, Sylvia, Pauser, Anna Wojas, Pelc, Jonathan Grant, Peter, Wolfgang, Pfuetzner, Nicola, Pimpinelli, Andreas, Pinter, Cristian, Pizarro, Karel, Pizinger, Jarmila, Plutinska, Todor, Popov, Veronika, Popova, Marta Ferrer, Puga, Lara Ferrandiz, Pulido, Anca, Purcaru, Ulrike, Raap, Anna, Rajchel, John, Ramey, Ma Deanna Santos, Ramiscal, German Dario, Ramon, Syed, Rehman, Adam, Reich, Norbert, Reider, Krista, Ress, Dimitrios, Rigopoulos, Enrique, Rivas, Heike, Rockmann, Pierre-Paul, Roquet-Gravy, Menachem, Rottem, Vermen Verallo, Rowell, Franziska, Rueff, Juan Alberto Ruano, Ruiz, Juan, Russo, Ronald, Saff, Sarbjit, Saini, Maria, Salazar, Juan Francisco Silvestre, Salvador, Jorge, Sanchez, Florica, Sandru, Mark, Scarupa, Knut, Schaekel, Sibylle, Schliemann, Rik, Schrijvers, Beate, Schwarz, Andreas, Schwinn, Sudhir, Sekhsaria, Nilgun, Senturk, Seong Jun, Seo, Mercedes Rodriguez, Serna, Faradiba, Serpa, Paul A, Shapero, Eriko, Shinkawa, Jan-Christoph, Simon, Rodney, Sinclair, Ralfi, Singer, Dareen D, Siri, Karl, Sitz, Adam, Smialowski, Andrew, Smith, Morten, Soerensen, Wiebke, Sondermann, Haejun, Song, Dmitrii, Sonin, Weily, Soong, Daniel, Soteres, Maria, Staevska-Kotasheva, Petra, Staubach-Renz, Nisha Su Yien, Subash, Gordon, Sussman, Ake Svensson, Svensson, Ekaterini, Syrigou, Andrea, Szegedi, Jacek, Szepietowski, Shunsuke, Takahagi, Yuval, Tal, Neetu, Talreja, Wooi Chiang, Tan, Ricardo, Tan, Jyh Jong, Tang, Tonny, Tanus, Martha, Tarpay, Shang Ian, Tee, Craig, Teller, Florence, Tetart, Aurelie Du, Thanh, Suganthi, Thevarajah, Simon Francis, Thomsen, Carl, Thornblade, Milan, Tjioe, Alberto, Tolcachier, Celeste, Tolentino, Athanasios, Tsianakas, Ilia, Tsingov, Hamida, Turki, Olga, Ukhanova, Jens, Ulrich, Meltem, Uslu, Fernando, Valenzuela, Solange, Valle, Martijn, van Doorn, Jirina, Vankova, Suneel, Vartak, Christine, Vidouria, Sebastian, Volc, Gerald, Volcheck, Nicola, Wagner, Irena, Walecka-Herniczek, Penpun, Wattanakrai, Bettina, Wedi, Steven, Weinstein, Vesarat, Wessagowit, Hugh, Windom, Akiko, Yagami, Aisaku, Yamamoto, Shinichiro, Yasumoto, Young Min, Ye, Jose Cevallos, Yepez, Sang Woong, Youn, Hana, Zelenkova, Oleg, Ziganshin, and Matthew, Zook

Abstract

Many patients with chronic spontaneous urticaria (CSU) do not achieve complete control of their symptoms with current available treatments. In a dose-finding phase 2b study, ligelizumab improved urticaria symptoms in patients with H1-antihistamine (H1-AH) refractory CSU. Here, we report the efficacy and safety outcomes from two ligelizumab phase 3 studies.

Published
2024
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12. Recurrent Papular Eruption: Answer

Author

Xuan Qi Koh, Raymond Yung Chien Kwah, and Shang-Ian Tee

Subjects
Humans, Dermatology, General Medicine, Exanthema, Pathology and Forensic Medicine, Skin
Published
2022

13. An intriguing case of persistent facial swelling

Author

Shang-Ian Tee, Hua-Liang Joel Lim, Chee Hian Tan, and Sheng Yao Chan

Subjects
Facial swelling, medicine.medical_specialty, Infectious Diseases, business.industry, Face, MEDLINE, Edema, Humans, Medicine, Dermatology, business
Published
2021

14. Keratin-Alginate Sponges Support Healing of Partial-Thickness Burns

Author

David I. Leavesley, Pietradewi Hartrianti, Kee Woei Ng, Si Jack Chong, Shang-Ian Tee, Alvin Wen Choong Chua, Declan P. Lunny, Luong T. H. Nguyen, Yee Onn Kok, Zi Kuang Moay, School of Materials Science and Engineering, Skin Research Institute of Singapore, Nanyang Environment and Water Research Institute, and Environmental Chemistry and Materials Centre

Subjects
Male, Human Hair Keratin, Pathology, Keratin 14, Swine, wound healing, Severity of Illness Index, fibroblast, sponge, Materials Testing, Keratin, Biology (General), Cells, Cultured, Spectroscopy, Skin, chemistry.chemical_classification, biology, integumentary system, Hydrogels, human hair keratin, Dermis, General Medicine, Computer Science Applications, Chemistry, medicine.anatomical_structure, Keratins, Fibroblast, Burns, medicine.medical_specialty, Alginates, QH301-705.5, Porcine Burn Wounds, macromolecular substances, Article, Catalysis, Inorganic Chemistry, In vivo, Sponge, medicine, Animals, Humans, Physical and Theoretical Chemistry, Materials::Biomaterials [Engineering], Molecular Biology, QD1-999, Wound Healing, Regeneration (biology), Organic Chemistry, biology.organism_classification, chemistry, porcine burn wounds, Wound healing, Bandages, Hydrocolloid
Abstract

Deep partial-thickness burns damage most of the dermis and can cause severe pain, scarring, and mortality if left untreated. This study serves to evaluate the effectiveness of crosslinked keratin-alginate composite sponges as dermal substitutes for deep partial-thickness burns. Crosslinked keratin-alginate sponges were tested for the ability to support human dermal fibroblasts in vitro and to support the closure and healing of partial-thickness burn wounds in Sus scrofa pigs. Keratin-alginate composite sponges supported the enhanced proliferation of human dermal fibroblasts compared to alginate-only sponges and exhibited decreased contraction in vitro when compared to keratin only sponges. As dermal substitutes in vivo, the sponges supported the expression of keratin 14, alpha-smooth muscle actin, and collagen IV within wound sites, comparable to collagen sponges. Keratin-alginate composite sponges supported the regeneration of basement membranes in the wounds more than in collagen-treated wounds and non-grafted controls, suggesting the subsequent development of pathological scar tissues may be minimized. Results from this study indicate that crosslinked keratin-alginate sponges are suitable alternative dermal substitutes for clinical applications in wound healing and skin regeneration. Agency for Science, Technology and Research (A*STAR) Published version This research is supported by the Agency for Science, Technology and Research (A*STAR) under its Wound Care Innovation for the Tropics program (IAF-PP; H17/01/a0/0L9).

Published
2021

16. A rapidly enlarging shoulder lump

Author

Yen Loo Lim, Felix Swee Then Kho, and Shang-Ian Tee

Subjects
Shoulder, medicine.medical_specialty, business.industry, General surgery, medicine, Humans, Dermatology, business
Published
2020

17. Mycosis fungoides associated with silicone injections

Author

Shang-Ian Tee, Wee Ping Tan, and Hui Mei Cheng

Subjects
medicine.medical_specialty, chemistry.chemical_compound, Mycosis fungoides, Silicone, chemistry, business.industry, Medicine, Dermatology, business, medicine.disease
Published
2020

18. Anxiety and Depression in Patients with Atopic Dermatitis in a Southeast Asian Tertiary Dermatological Centre

Author

Vanessa ZY Lim, Roger CM Ho, Shang-Ian Tee, Jiun Yit Pan, Yen Loo Lim, Mark BY Tang, Keen Loong Chan, and Yoke Chin Giam

Subjects
General Medicine
Abstract

Introduction: This study aimed to assess the frequency of anxiety and depression in a cohort of adult patients with atopic dermatitis (AD) in a tertiary dermatological centre, using the Hospital Anxiety and Depression Scale (HADS). We looked for any correlation between anxiety and depression with skin disease severity. Materials and Methods: Patients with AD were recruited from the National Skin Centre, Singapore, from 2008 to 2009 for a prospective cross-sectional study. The scoring atopic dermatitis (SCORAD) grade was determined and the HADS was administered via interviews. Results: A total of 100 patients (78 males, 22 females) were enrolled (92% Chinese, 4% Malays and 4% Indians). Their average age was 25.7 years. Sixty-five percent used topical steroids, 14% had previously taken oral prednisolone for the control of disease flares, and 20% were on concurrent systemic therapy. The mean SCORAD was 55.0, with 99% of patients having moderate or severe AD. The mean HADS anxiety score was 7.2 and the mean depression score was 5.0. The level of anxiety correlated well with that of depression (Spearman’s rank correlation coefficient, ρ = 0.59, P

Published
2016

20. Multiple Papules on the Penis: Challenge

Author

Stephanie Giao Yun Ho, Wai Leong Kok, and Shang-Ian Tee

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, medicine, Dermatology, General Medicine, business, Penis, Pathology and Forensic Medicine
Published
2018

21. A plaque under cover

Author

Shang-Ian Tee, Ling Yee Kuan, and Martin T. W. Chio

Subjects
Male, medicine.medical_specialty, Penile Diseases, medicine.diagnostic_test, business.industry, Biopsy, medicine.medical_treatment, Foreskin, MEDLINE, Amyloidosis, Dermatology, Middle Aged, Diabetes Mellitus, Type 2, Erythema, medicine, Humans, Cover (algebra), Watchful Waiting, business, Skin pathology, Watchful waiting, Skin
Published
2019

22. Reflectance confocal microscopy is a useful non-invasive tool in the in vivo diagnosis of pigmented basal cell carcinoma in Asians

Author

Siong See Joyce Lee, Wee Ping Tan, Sai Yee Chuah, Sze Hon Chua, Tien Guan Steven Thng, Shang Ian Tee, and See Ket Ng

Subjects
Reflectance confocal microscopy, medicine.medical_specialty, Pathology, Pigmented basal cell carcinoma, integumentary system, Seborrhoeic keratosis, business.industry, Non invasive, Dermatology, Lesion, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Imaging Tool, In vivo, 030220 oncology & carcinogenesis, Medicine, medicine.symptom, business, Histological examination
Abstract

Background The clinical differentiation between pigmented basal cell carcinoma (BCC) and other benign pigmented skin lesions can be challenging even with an additional dermoscopic evaluation, especially if the lesion is small. In vivo reflectance confocal microscopy (RCM) is an emerging, non-invasive imaging tool that allows near-microscopic evaluation of skin lesions. The features of RCM for pigmented BCC and seborrhoeic keratosis have previously been described. However, the use of RCM to differentiate between these clinically and dermoscopically challenging pigmented skin lesions among Asians has not yet been demonstrated. Objectives We aimed to evaluate the usefulness of non-invasive RCM to differentiate between clinically and dermoscopically challenging pigmented skin lesions among Asians in a series of 11 lesions. Methods Nine patients with 11 clinically and dermoscopically difficult to distinguish pigmented skin lesions were evaluated by RCM to differentiate between pigmented BCC and benign lesions. In all cases, a histological confirmation of the RCM diagnosis was obtained. Results The clinical or dermoscopical characteristics were non-specific in all 10 cases. RCM detected features of pigmented BCC in nine patients and seborrhoeic keratosis in one patient. These were all confirmed by histological examination. Conclusions This case series shows the value of non-invasive in vivo RCM imaging in the differentiation of malignant and benign pigmented lesions. Early diagnosis of small, pigmented BCC allows earlier excision with better prognosis. Future biopsies of benign lesions in cosmetic areas could also be avoided.

Published
2015

24. A challenging diagnosis of MPO-C-ANCA EGPA

Author

Sheryl Lim, Shang-Ian Tee, Chai Yiing Ling, and Gareth Lim

Subjects
Male, medicine.medical_specialty, C-ANCA, Churg-Strauss Syndrome, Antibodies, Antineutrophil Cytoplasmic, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Rare Disease, Internal medicine, Eosinophilic, medicine, Humans, Eosinophilia, 030212 general & internal medicine, Peroxidase, medicine.diagnostic_test, Mononeuritis Multiplex, business.industry, Granulomatosis with Polyangiitis, General Medicine, Middle Aged, medicine.disease, Dermatology, Asthma, Rheumatology, Skin biopsy, medicine.symptom, Vasculitis, Granulomatosis with polyangiitis, business, 030217 neurology & neurosurgery
Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystemic small-vessel vasculitic disease that can present with positive MPO-P-ANCA (myeloperoxidase–perinuclear–anti-neutrophil cytoplasmic antibody). It is a rare condition that is difficult to diagnose. We present the case of a 64-year-old man with late-onset adult asthma and treated nasopharyngeal carcinoma who initially presented to us with proximal myopathy. Thereafter, he developed a constellation of fleeting symptoms which included rhinosinusitis, mononeuritis multiplex, skin vasculitis and arthritis. Blood investigations showed that he had eosinophilia, and skin biopsy demonstrated dermal vasculitis with eosinophils. He was found to be MPO-C-ANCA positive, and although initially thought to have granulomatosis with polyangiitis, the diagnosis was later revised to EGPA. This case highlights the diagnostic challenges with atypical presentations of EGPA and also presents a rare case of positive MPO-C-ANCA that has never been described in EGPA before.

Published
2019

25. Hemorrhagic lip and oral mucosal blisters

Author

Shang-Ian Tee, Audrey Wei Hsia Tan, and Yee Leng Teoh

Subjects
medicine.medical_specialty, business.industry, medicine, Dermatology, business, Oral mucosal blisters
Published
2017

26. Necrobiosis Lipoidica With Elastophagocytosis on an Unusual Location

Author

Yen Loo Lim, Shang-Ian Tee, and Qi Ping Chen

Subjects
Male, Pathology, medicine.medical_specialty, Physical examination, Dermatology, Pathology and Forensic Medicine, Necrobiosis lipoidica, Phagocytosis, Dermis, medicine, Humans, Aged, 80 and over, Necrobiosis Lipoidica, integumentary system, medicine.diagnostic_test, business.industry, Macrophages, Histology, General Medicine, Elastic Tissue, medicine.disease, Actinic granuloma, medicine.anatomical_structure, Skin biopsy, Elastophagocytosis, Differential diagnosis, business
Abstract

Necrobiosis lipoidica (NL) is a granulomatous disease of collagen degeneration classically affecting the lower extremities. Elastophagocytosis is a histological finding, whereby multinucleate macrophages demonstrate phagocytosis of elastic fibers commonly associated with sun-damaged skin. Elastophagocytosis is not typically described in NL. The authors present a patient who presented with reddish-yellow plaques on both his forearms. Skin biopsy revealed extensive palisaded granulomas consistent with NL and features of elastophagocytosis in the upper dermis. The unusual site of presentation is a diagnostic pitfall, further complicated by the histological features of elastophagocytosis, for which the differential diagnosis of actinic granuloma needs to be considered. This case highlights the importance of clinicopathological correlation to arrive at a definitive diagnosis in situations where unexpected features on physical examination and histology may confound the clinical picture.

Published
2014

27. Cutaneous protothecosis in a patient with previously undiagnosed HIV infection

Author

Madeline S L Ho, Jiun Yit Pan, Shang-Ian Tee, and Kenneth Fong

Subjects
Protothecosis, Prototheca species, biology, Itraconazole, business.industry, medicine.medical_treatment, Human immunodeficiency virus (HIV), Immunosuppression, Dermatology, Prototheca, medicine.disease_cause, biology.organism_classification, medicine.disease, Immunology, medicine, Disseminated disease, business, medicine.drug
Abstract

Protothecosis is an uncommon condition resulting from infection by achlorophyllous algae of the Prototheca species. Immunocompromised individuals are generally most susceptible to protothecal infection and tend to develop severe and disseminated disease. However, the association between protothecosis and HIV-induced immunosuppression is not clear, with only a handful of cases having been described to date. Here we report a case of cutaneous protothecosis in a Chinese man with previously undiagnosed HIV infection that responded well to oral itraconazole.

Published
2014

28. Multiple Papules on the Penis: Answer

Author

Shang-Ian Tee, Stephanie Giao Yun Ho, and Wai Leong Kok

Subjects
Male, medicine.medical_specialty, business.industry, Penile Neoplasm, Syringoma, Sweat Gland Neoplasm, Dermatology, General Medicine, medicine.disease, Pathology and Forensic Medicine, Sweat Gland Neoplasms, Young Adult, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, medicine, Humans, business, Penile Neoplasms, Penis
Published
2018

29. Pegylated liposomal doxorubicin-induced miliaria crystallina and lichenoid follicular eruption

Author

Amelie Clementine Seghers, Shang-Ian Tee, Wei-Sheng Chong, Taige Cao, and Hong Liang Tey

Subjects
Liposome, business.industry, medicine.drug_class, Antibiotics, Dermatology, lcsh:RL1-803, Pharmacology, medicine.disease, Pegylated Liposomal Doxorubicin, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, 030220 oncology & carcinogenesis, Lichenoid eruption, Follicular phase, lcsh:Dermatology, Medicine, Doxorubicin, Miliaria crystallina, business, medicine.drug
Published
2018

30. Reflectance confocal microscopy is a useful non-invasive tool in the in vivo diagnosis of pigmented basal cell carcinoma in Asians

Author

Sai Yee, Chuah, Shang Ian, Tee, Wee Ping, Tan, Siong See Joyce, Lee, See Ket, Ng, Sze Hon, Chua, and Tien Guan Steven, Thng

Subjects
Aged, 80 and over, Diagnosis, Differential, Male, Microscopy, Confocal, Skin Neoplasms, Asian People, Intravital Microscopy, Carcinoma, Basal Cell, Humans, Female, Middle Aged, Keratosis, Seborrheic, Aged
Abstract

The clinical differentiation between pigmented basal cell carcinoma (BCC) and other benign pigmented skin lesions can be challenging even with an additional dermoscopic evaluation, especially if the lesion is small. In vivo reflectance confocal microscopy (RCM) is an emerging, non-invasive imaging tool that allows near-microscopic evaluation of skin lesions. The features of RCM for pigmented BCC and seborrhoeic keratosis have previously been described. However, the use of RCM to differentiate between these clinically and dermoscopically challenging pigmented skin lesions among Asians has not yet been demonstrated.We aimed to evaluate the usefulness of non-invasive RCM to differentiate between clinically and dermoscopically challenging pigmented skin lesions among Asians in a series of 11 lesions.Nine patients with 11 clinically and dermoscopically difficult to distinguish pigmented skin lesions were evaluated by RCM to differentiate between pigmented BCC and benign lesions. In all cases, a histological confirmation of the RCM diagnosis was obtained.The clinical or dermoscopical characteristics were non-specific in all 10 cases. RCM detected features of pigmented BCC in nine patients and seborrhoeic keratosis in one patient. These were all confirmed by histological examination.This case series shows the value of non-invasive in vivo RCM imaging in the differentiation of malignant and benign pigmented lesions. Early diagnosis of small, pigmented BCC allows earlier excision with better prognosis. Future biopsies of benign lesions in cosmetic areas could also be avoided.

Published
2015

31. Two episodes of cutaneous non-tuberculous mycobacterial infection in a patient with psoriasis

Author

Shang-Ian Tee, Nisha Su Yien Chandran, Wai Sze Agnes Chan, and Jiun Yit Pan

Subjects
Case Report, Dermatology, Disease, Mycobacterium abscessus, Clarithromycin, Psoriasis, medicine, lcsh:Dermatology, non tuberculous mycobacteria, Doxycycline, biology, business.industry, cutaneous, Mycobacterium hemophilum, psoriasis, lcsh:RL1-803, biology.organism_classification, medicine.disease, bacterial infections and mycoses, Mycobacterium haemophilum, Ciprofloxacin, Immunology, Body region, business, medicine.drug
Abstract

Non-tuberculous mycobacteria (NTM) are a group of environmental pathogens, which cause a broad spectrum of disease. The incidence of NTM infection is increasing, especially in immunocompromized patients. The past three decades also saw a rapid increase in the incidence of NTM infection involving otherwise healthy subjects. We report a case of cutaneous NTM infection in a 79-year-old Chinese woman, who was receiving methotrexate for psoriasis. Mycobacterial culture grew Mycobacterium abscessus, and the lesions cleared with a combination of oral clarithromycin, ciprofloxacin and doxycycline. Interestingly, she then developed a second episode of cutaneous NTM infection with Mycobacterium haemophilum over the same body region, five years after stoppage of methotrexate. Both episodes were separated in time and involved different species, indicating that they were independent from each other. We further discuss the risk factors for cutaneous NTM infection, treatment, and highlight the need for diagnostic vigilance.

Published
2015

32. A challenging diagnosis of MPO-C-ANCA EGPA.

Author

Gareth Lim, Sheryl Lim, Shang-Ian Tee, and Chai Yiing Ling

Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA ) is a multisystemic small-vessel vasculitic disease that can present with positive MPO-P-ANCA (myeloperoxidase– perinuclear–anti-neutrophil cytoplasmic antibody). It is a rare condition that is difficult to diagnose. We present the case of a 64-year-old man with late-onset adult asthma and treated nasopharyngeal carcinoma who initially presented to us with proximal myopathy. Thereafter, he developed a constellation of fleeting symptoms which included rhinosinusitis, mononeuritis multiplex, skin vasculitis and arthritis. Blood investigations showed that he had eosinophilia, and skin biopsy demonstrated dermal vasculitis with eosinophils. He was found to be MPO-C-ANCA positive, and although initially thought to have granulomatosis with polyangiitis, the diagnosis was later revised to EGPA . This case highlights the diagnostic challenges with atypical presentations of EGPA and also presents a rare case of positive MPO-C-ANCA that has never been described in EGPA before. [ABSTRACT FROM AUTHOR]

Published
2019
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33. Genetic study in a Singaporean patient with erythropoietic protoporphyria

Author

Colin Theng, Zacharias A.D. Pramono, Shang-Ian Tee, and Sai Yee Chuah

Subjects
Mutation, biology, business.industry, Immunology, Dermatology, General Medicine, Ferrochelatase, medicine.disease_cause, medicine.disease, Early infancy, chemistry.chemical_compound, Molecular level, chemistry, Haem biosynthesis, medicine, biology.protein, Immunology and Allergy, Radiology, Nuclear Medicine and imaging, Protoporphyrin, Erythropoietic protoporphyria, Allele, business
Abstract

Summary Erythropoietic protoporphyria (EPP) is a rare autosomal dominant disorder of haem biosynthesis resulting from a partial decrease in ferrochelatase (FECH) activity which leads to the excessive accumulation of protoporphyrin in blood, erythrocytes and tissues. Cutaneous manifestations of photosensitivity usually appear in early infancy upon the first sun exposures. This normally requires the co-inheritance of a common hypomorphic FECH allele and a deleterious FECH mutation. Here, we report the first Singaporean Chinese patient with EPP characterized at the molecular level.

Published
2012

34. Cutaneous protothecosis in a patient with previously undiagnosed HIV infection

Author

Kenneth, Fong, Shang-Ian, Tee, Madeline S L, Ho, and Jiun Yit, Pan

Subjects
Male, Immunocompromised Host, Humans, HIV Infections, Middle Aged, Prototheca, Skin Diseases, Infectious, Infections, Facial Dermatoses
Abstract

Protothecosis is an uncommon condition resulting from infection by achlorophyllous algae of the Prototheca species. Immunocompromised individuals are generally most susceptible to protothecal infection and tend to develop severe and disseminated disease. However, the association between protothecosis and HIV-induced immunosuppression is not clear, with only a handful of cases having been described to date. Here we report a case of cutaneous protothecosis in a Chinese man with previously undiagnosed HIV infection that responded well to oral itraconazole.

Published
2013

35. Mammographic and sonographic findings of steatocystoma multiplex presenting as breast lumps

Author

John Mun Chin, Wan, Jill Su Lin, Wong, and Shang-Ian, Tee

Subjects
Diagnosis, Differential, Breast Diseases, Humans, Female, Ultrasonography, Mammary, Middle Aged, Steatocystoma Multiplex, Mammography
Abstract

Steatocystoma multiplex (SM) is an uncommon cutaneous disorder characterised by multiple intradermal cysts distributed over the trunk and proximal extremities. This condition affects both genders and is often inherited as an autosomal dominant trait, although sporadic cases have been described. This report describes the mammographic and sonographic features of the cysts, which presented as breast lumps, for evaluation. The cysts appeared as numerous well-circumscribed, radiolucent nodules with thin radiodense rims on mammography. On sonography, the cysts could be hypoechoic, isoechoic or demonstrate mixed echoes containing debris-fluid levels, depending on the amount of clear oily liquid and keratinous material. SM can be diagnosed based on a clinical setting of multiple asymptomatic small intradermal nodules over the trunk and proximal extremities, positive family history and imaging findings.

Published
2012

36. Cutaneous infiltrates of acute myelogenous leukemia simulating inflammatory dermatoses

Author

Daniel Zuriel, Cesare Massone, Shang-Ian Tee, Lorenzo Cerroni, Isabella Fried, and Marcela Martínez-Escanamé

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Myeloid, Adolescent, Biopsy, Dermatitis, Dermatology, Pathology and Forensic Medicine, Diagnosis, Differential, Myelogenous, Young Adult, Leukemic Infiltration, Predictive Value of Tests, Recurrence, medicine, Biomarkers, Tumor, Humans, Histiocyte, Aged, Skin, Aged, 80 and over, medicine.diagnostic_test, business.industry, CD68, Bone Marrow Examination, General Medicine, Middle Aged, medicine.disease, Immunohistochemistry, Bone marrow examination, Leukemia, Leukemia, Myeloid, Acute, medicine.anatomical_structure, Female, Drug Eruptions, business
Abstract

Some cases of specific cutaneous manifestations of acute myelogenous leukemia (AML) may mimic inflammatory dermatoses both clinically and histopathologically, presenting with an inconspicuous maculopapular eruption and with only sparse dermal infiltrates. The authors studied the histopathological and immunohistochemical features of 17 biopsies from 16 patients (11 men and 5 women, age range 15-85 years) presenting with minimal skin infiltrates as the first manifestation of AML or as first sign of recurrence after complete remission of the disease. In all cases, the diagnosis of leukemia has been confirmed by bone marrow examination. Two of these cases had been sent to one of us for second expert consultation. Patients presented with generalized, exanthematic maculopapular eruptions, sometimes with a hemorrhagic note, that were mostly interpreted clinically as drug reactions. Histopathologically, the lesions showed sparse, superficial, and mid-dermal infiltrates with minimal perivascular and periadnexal accentuation. Infiltrating cells consisted mostly of neoplastic monocytoid elements with only few reactive lymphocytes and histiocytes. Immunohistochemical stainings revealed in the majority of cases positivity for CD68 (14 of 16 patients), naphthol chloroacetate esterase (NaSDCl) (7 of 10 patients), and myeloperoxidase (6 of 9 patients). Other markers tested were positive only in a minority of cases. These cases represent a pitfall both in the clinical and in the histopathological diagnosis of cutaneous AML. Accurate morphologic and phenotypic correlation together with a high index of suspicion allows a precise diagnosis in these unconventional cases.

Published
2012

37. Acrodermatitis chronica atrophicans with pseudolymphomatous infiltrates

Author

Daniel Zuriel, Ingrid H. Wolf, Shang-Ian Tee, Lorenzo Cerroni, Isabella Fried, Marcela Martínez-Escanamé, and Cesare Massone

Subjects
DNA, Bacterial, Male, Pathology, medicine.medical_specialty, Biopsy, Plasma Cells, Context (language use), Dermatology, Gene Rearrangement, T-Lymphocyte, Cutaneous lymphoma, Pathology and Forensic Medicine, Lymphocytic Infiltrate, Diagnosis, Differential, Immunoglobulin kappa-Chains, Immunoglobulin lambda-Chains, Pseudolymphoma, Predictive Value of Tests, medicine, Humans, Lymphocytes, Aged, Skin, Aged, 80 and over, Mycosis fungoides, medicine.diagnostic_test, business.industry, Papillary dermis, Borrelia, Acrodermatitis, General Medicine, Gene rearrangement, Middle Aged, medicine.disease, Immunohistochemistry, Female, business, Borrelia Infections, Acrodermatitis chronica atrophicans, Biomarkers
Abstract

In this study, we describe the clinicopathologic features of pseudolymphomatous infiltrates found within lesions of acrodermatitis chronica atrophicans (ACA). We studied 11 patients (10 females, 1 male, age range 60-88 years). The diagnosis of ACA in all cases was confirmed by clinicopathologic correlation and positive serology for Borrelia. Histopathologic examination revealed prominent, pseudolymphomatous inflammatory cell infiltrates in all cases, with 2 distinct patterns. Eight of 11 cases showed a band-like lymphocytic infiltrate, exocytosis of lymphocytes and a fibrotic papillary dermis, similar to features seen in mycosis fungoides. The other 3 cases showed dense, nodular-diffuse dermal infiltrates with many plasma cells and without germinal centers. The plasma cells expressed both kappa and lambda immunoglobulin light chains with a polyclonal pattern in all 3 cases. In conclusion, ACA may present with pseudolymphomatous infiltrates showing both a T-cell and, less frequently, a B-cell pattern. These lesions need to be distinguished from a cutaneous lymphoma. In the context of the knowledge of Borrelia-associated cutaneous lymphomas, follow-up seems advisable in these cases.

Published
2012

38. Genetic study in a Singaporean patient with erythropoietic protoporphyria

Author

Sai Yee, Chuah, Shang-Ian, Tee, Zacharias Aloysius Dwi, Pramono, and Colin Thiam Seng, Theng

Subjects
Adult, Male, Singapore, Asian People, Protoporphyria, Erythropoietic, Sunlight, Humans, Protoporphyrins, Heme, Photosensitivity Disorders, Alleles, Ferrochelatase
Abstract

Erythropoietic protoporphyria (EPP) is a rare autosomal dominant disorder of haem biosynthesis resulting from a partial decrease in ferrochelatase (FECH) activity which leads to the excessive accumulation of protoporphyrin in blood, erythrocytes and tissues. Cutaneous manifestations of photosensitivity usually appear in early infancy upon the first sun exposures. This normally requires the co-inheritance of a common hypomorphic FECH allele and a deleterious FECH mutation. Here, we report the first Singaporean Chinese patient with EPP characterized at the molecular level.

Published
2012

39. Prevention of glucocorticoid-induced osteoporosis in immunobullous diseases with alendronate: a randomized, double-blind, placebo-controlled study

Author

Ian Yu Yan Tsou, Susanna Soo See Tan, Suat Hoon Tan, Ee Tzun Koh, Gil Yosipovitch, Yiong Huak Chan, Yuin Chew Chan, Shang Ian Tee, and Sze Hon Chua

Subjects
musculoskeletal diseases, Adult, Male, medicine.medical_specialty, Prednisolone, Osteoporosis, Pemphigoid, Benign Mucous Membrane, Placebo-controlled study, Urology, Anti-Inflammatory Agents, Administration, Oral, Dermatology, Lumbar vertebrae, Epidermolysis Bullosa Acquisita, Placebo, Drug Administration Schedule, Article, law.invention, Autoimmune Diseases, Randomized controlled trial, Double-Blind Method, law, Bone Density, Pemphigoid, Bullous, medicine, Humans, Prospective Studies, Vitamin D, Femoral neck, Singapore, Alendronate, Bone Density Conservation Agents, Skin Diseases, Vesiculobullous, business.industry, General Medicine, Middle Aged, medicine.disease, Surgery, Osteopenia, Alendronate Sodium, medicine.anatomical_structure, Calcium, Drug Therapy, Combination, Female, business, Pemphigus
Abstract

To evaluate the efficacy and safety of oral alendronate sodium therapy once daily in preventing glucocorticoid-induced bone loss in patients with immunobullous skin diseases treated with long-term glucocorticoid therapy.A 12-month randomized, double-blind, placebo-controlled trial.A tertiary referral dermatology center in Singapore.Patients newly diagnosed as having an immunobullous disease and deemed to require at least 6 months of systemic glucocorticoid therapy.The patients were randomized to receive either oral alendronate sodium (10 mg/d) or a matching placebo for 12 months. All patients also received concurrent calcium with vitamin D, 2 tablets daily.Percent change in bone mineral density (BMD) at the lumbar spine and the femoral neck at 12 months.A total of 29 patients (alendronate [n = 15], placebo [n = 14]) were evaluated. The percent change in BMD in the alendronate group was +3.7% and +3.5% at the lumbar spine and the femoral neck, respectively, whereas in the placebo group, it was -1.4% and -0.7% at the lumbar spine and the femoral neck, respectively. The increase in BMD observed in the alendronate group compared with the placebo group was statistically significant at both the lumbar spine (P = .01) and the femoral neck (P = .01). There was also a statistically significant decrease in serum heat-labile alkaline phosphatase levels after 12 months (-32.6%, P.01) in the alendronate group but not in the placebo group. Adverse events were generally minor, and the frequency of occurrence did not differ significantly between both treatment groups (P = .59).There were statistically significant increases in BMD at both the lumbar spine (P = .01) and the femoral neck (P = .01) with alendronate therapy. It is imperative to use bisphophonate therapy in patients with immunobullous disorders who are receiving oral corticosteroids because it largely prevents the morbidity associated with low BMD.

Published
2011

40. A predominant pelvic gastrointestinal stromal tumor (GIST) mass observed on Tc-99m red blood cell gastrointestinal bleeding scintigraphy

Author

Ravi Sood and Shang Ian Tee

Subjects
medicine.medical_specialty, Gastrointestinal bleeding, Erythrocytes, Gastrointestinal Stromal Tumors, Rectum, Hemorrhage, Scintigraphy, Gastroenterology, Pelvis, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Stromal tumor, Radionuclide Imaging, medicine.diagnostic_test, GiST, business.industry, General Medicine, Organotechnetium Compounds, Middle Aged, medicine.disease, medicine.anatomical_structure, Angiography, Abdomen, Female, Radiology, business
Abstract

A 51-year-old woman presented with recurrent bleeding per rectum. Her earlier endoscopies were negative. Tc-99m RBC GI bleeding scintigraphy was performed. It demonstrated an apparent hypervascular pelvic mass, and active small bowel bleeding. Based on scintigraphic finding of a predominant pelvic mass indicating tumor, CT of the abdomen and pelvis was performed for further gastrointestinal bleeding localization work up instead of an invasive angiography or endoscopy, which detected a small bowel tumor in the pelvis. A small bowel gastrointestinal stromal tumor was resected subsequently.

Published
2011

41. Pegylated liposomal doxorubicin-induced miliaria crystallina and lichenoid follicular eruption.

Author

Seghers, Amelie Clementine, Hong Liang Tey, Shang-Ian Tee, Taige Cao, Wei-Sheng Chong, Tey, Hong Liang, Tee, Shang-Ian, Cao, Taige, and Chong, Wei-Sheng

Subjects
SKIN disease diagnosis, ANTINEOPLASTIC antibiotics, DOXORUBICIN, ARTIFICIAL membranes, POLYETHYLENE glycol, SKIN diseases, DISEASE complications, SWEAT gland diseases, DIAGNOSIS
Abstract

The article presents a case study of a 24-year-old woman, who had developed pruritic eruption on the trunk while taking pegylated liposomal doxorubicin for stage IV primary peritoneal carcinoma. The patient underwent skin biopsy that showed the location of vesicle within the stratum corneum. The patient had treated with emollients and steroids for the rashes.

Published
2018
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42. Eruptive pruritic papular porokeratosis

Author

Shang-Ian Tee and Wei-Sheng Chong

Subjects
Infectious Diseases, Chronic disease, business.industry, Adrenal cortex hormones, Histamine antagonists, Immunology, lcsh:Dermatology, Medicine, Dermatology, lcsh:RL1-803, business, medicine.disease, Porokeratosis
Published
2012

43. Two episodes of cutaneous non-tuberculous mycobacterial infection in a patient with psoriasis.

Author

Chan, Wai Sze Agnes, Shang-Ian Tee, Nisha Su Yien Chandran, and Jiun Yit Pan

Subjects
*MYCOBACTERIAL diseases, *PSORIASIS treatment, *CIPROFLOXACIN, *DOXYCYCLINE, *THERAPEUTICS, ETIOLOGY of tuberculosis
Abstract

Non-tuberculous mycobacteria (NTM) are a group of environmental pathogens, which cause a broad spectrum of disease. The incidence of NTM infection is increasing, especially in immunocompromized patients. The past three decades also saw a rapid increase in the incidence of NTM infection involving otherwise healthy subjects. We report a case of cutaneous NTM infection in a 79-year-old Chinese woman, who was receiving methotrexate for psoriasis. Mycobacterial culture grew Mycobacterium abscessus, and the lesions cleared with a combination of oral clarithromycin, ciprofloxacin and doxycycline. Interestingly, she then developed a second episode of cutaneous NTM infection with Mycobacterium haemophilum over the same body region, five years after stoppage of methotrexate. Both episodes were separated in time and involved different species, indicating that they were independent from each other. We further discuss the risk factors for cutaneous NTM infection, treatment, and highlight the need for diagnostic vigilance. [ABSTRACT FROM AUTHOR]

Published
2015
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44. Painless nodules on legs: The location of the nodules and the patient's history were important diagnostic clues. The punch biopsy confirmed our suspicions.

Author

En Qi Toh, Juay, Lester, Shang-Ian Tee, and Ziying Vanessa Lim

Subjects
*DIFFUSE large B-cell lymphomas, *THYROID diseases, *ANAPLASTIC large-cell lymphoma, *BIOPSY, *GRAVES' disease
Abstract

The article explores the case of a 34-year-old man with pretibial myxedema, a rare late manifestation of Graves disease. The patient presented with progressively enlarging subcutaneous nodules on his lower legs, and the diagnosis was confirmed through a punch biopsy, highlighting the dermatological implications of thyroid disorders.

Published
2023
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45. Prevention of Glucocorticoid-Induced Osteoporosis in Immunobullous Diseases With Alendronate.

Author

Shang-Ian Tee, Gil Yosipovitch, Yuin Chew Chan, Sze Hon Chua, Ee Tzun Koh, Yiong Huak Chan, Susanna Soo See Tan, Ian Yu Yan Tsou, and Suat Hoon Tan

Abstract

Objective: To evaluate the efficacy and safety of oral alendronate sodium therapy once daily in preventing glucocorticoid- induced bone loss in patients with immunobullous skin diseases treated with long-term glucocorticoid therapy. Design: A 12-month randomized, double-blind, placebocontrolled trial. Setting:Atertiary referraldermatologycenter in Singapore. Participants: Patients newly diagnosed as having an immunobullous disease and deemed to require at least 6 months of systemic glucocorticoid therapy. Interventions: The patients were randomized to receive either oral alendronate sodium (10 mg/d) or amatching placebo for 12 months. All patients also received concurrent calcium with vitamin D, 2 tablets daily. Main Outcome Measures: Percent change in bone mineral density (BMD) at the lumbar spine and the femoral neck at 12 months. Results: A total of 29 patients (alendronate [n=15], placebo [n=14]) were evaluated. The percent change in BMD in the alendronate group was -3.7% and -3.5% at the lumbar spine and the femoral neck, respectively, whereas in the placebo group, it was -1.4% and -0.7% at the lumbar spine and the femoral neck, respectively. The increase in BMD observed in the alendronate group compared with the placebo group was statistically significant at both the lumbar spine (P=.01) and the femoral neck (P=.01). There was also a statistically significant decrease in serum heat-labile alkaline phosphatase levels after 12 months (-32.6%, P< .01) in the alendronate group but not in the placebo group. Adverse events were generally minor, and the frequency of occurrence did not differ significantly between both treatment groups (P=.59). Conclusions: There were statistically significant increases in BMD at both the lumbar spine (P=.01) and the femoral neck (P=.01) with alendronate therapy. It is imperative to use bisphophonate therapy in patients with immunobullous disorders who are receiving oral corticosteroids because it largely prevents themorbidity associated with low BMD. [ABSTRACT FROM AUTHOR]

Published
2012
Full Text
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