Publications by authors named "Khang Tran Hau"

33 Publications

Successful Treatment of Intralesional Bleomycin in Keloids of Vietnamese Population.

Open Access Maced J Med Sci 2019 Jan 29;7(2):298-299. Epub 2019 Jan 29.

University of Rome G. Marconi, Rome, Italy.

Background: Keloid is an overactive condition of the skin tissue to early lesions characterised by proliferation of fibroblasts, excessive collagen production in the lesion. Treatment of keloids is a big challenge because of the poor response rate and high risk of recurrence after treatment. We found that bleomycin offers promise in the treatment of keloids.

Aim: To evaluate the efficacy of bleomycin injected in the injury for keloids treatment.

Methods: The treatment was carried out in 55 patients having 120 keloids of different sizes and locations. Average treatments were 4 times.

Results: Complete flattening was 70.8%, highly significant flattening was 8.3%, no patient of minimal flattening. Systemic side-effects of bleomycin were not evaluated, but local side-effects were mainly pains (100%), blisters (78.3%), ulceration (5.8%), and hyperpigmentation (56.7%).

Conclusion: The percentage of patients recurring 6, 12, 15, 18 months after the last treatment were 3.8, 15.4, 45.5, 50%, respectively.
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http://dx.doi.org/10.3889/oamjms.2019.099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364735PMC
January 2019

Microneedling Therapy for Atrophic Acne Scar: Effectiveness and Safety in Vietnamese Patients.

Open Access Maced J Med Sci 2019 Jan 29;7(2):293-297. Epub 2019 Jan 29.

University of Rome G. Marconi, Rome, Italy.

Aim: To evaluate the effectiveness and safety of micro-needling therapy in atrophic acne scar treatment.

Method: A prospective, single centred study was implemented in a total of 31 patients suffering from atrophic acne scar grade 2 to 4 of Goodman and Baron scaring grading system was recruited. They were treated by microneedle derma roller every week in 3 months. The scars were evaluated by a magic system camera and by dermatologists clinically using Goodman and Baron scaring grading system, and Lipper and Perez score at baseline, at final treatment, 1 month and 2 months after the final treatment.

Results: The results showed improvement in all patients. The mean of Goodman and Barron's grade was decreased from 3.29 ± 0.59 at baseline, 2.23 ± 0.56 at final treatment, 1.93 ± 0.58 one month after the completion of therapy and to 1.77 ± 0.57 two months after the completion of therapy (with the p-value < 0.05). Similarly, Lipper and Perez score also dropped significantly from 36.48 ± 12.07 at baseline to 23.16 ± 15.01 at final treatment, to 17.83 ± 7.00 one month after the final treatment and to 16.37 ± 7.29 at two months after the final treatment (p-value < 0.05). Skin roughness and hyperpigmented spots got improved significantly. History of having nodular-cystic or vulgaris acne did not affect the effectiveness of the therapy. Side effects of the therapy were burning sensation, erythema but they were very mild and recovered in 1-2 days. No severe complication and post-inflammatory hyperpigmentation were noted. 83.3% of the patients satisfied after the completion of the therapy.

Conclusion: Skin needling is an effective and safe method for the treatment of atrophic acne scars.
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http://dx.doi.org/10.3889/oamjms.2019.098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364723PMC
January 2019

The Effectiveness of Oral Mini-Pulse Methylprednisolonein - the Treatment of Alopecia Areata in Vietnam.

Open Access Maced J Med Sci 2019 Jan 29;7(2):291-292. Epub 2019 Jan 29.

University of Rome G. Marconi, Rome, Italy.

Background: Systemic corticosteroid is used to treat alopecia areata, but it is associated with side effects. Mini-pulse therapy is thought to be effective but able to reduce side effects.

Aim: The study aimed to evaluate the effectiveness of oral mini-pulse methylprednisolone in the treatment of alopecia areata.

Methods: Patients received methylprednisolone 16 mg orally for 2 consecutive days every week.

Results: After 3 months, among patients, 40% recovered well, and 55.6% recovered fairly. After 6 months, 82.2% recovered well, 17.8% recovered fairly. No adverse events were detected, and the recurrence rate was low (2.2%).

Conclusion: Oral mini-pulse methylprednisolone therapy is an effective and safe therapeutic option for alopecia areata without side effects, and the time of the treatment is short.
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http://dx.doi.org/10.3889/oamjms.2019.097DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364712PMC
January 2019

Successful Treatment of Freckles by Alex Trivantage Laser Wavelight 755 nm in Vietnamese Patients.

Open Access Maced J Med Sci 2019 Jan 29;7(2):287-290. Epub 2019 Jan 29.

University of Rome G. Marconi, Rome, Italy.

Objectives: This study aims to evaluate the effectiveness of Alex Trivantage laser wavelength 755 nm (ATL) in the treatment of freckles at Hanoi Hospital of Dermatology and Venereology, Vietnam.

Patients And Methods: A group of 30 patients with freckles were treated by ATL (Alex Trivantage-Candela Co America) with spots size 3 mm, wavelength 755 mm, and energy 5-6 j/cm. All the patients were treated 2 times with 4-weeks interval. The results were evaluated at 4, 8, and 12 weeks after treatment. The colour of the lesions was evaluated by using Von-Luchan's chromatic scale and Visia® complex analysis system. Brown spot index (BSI) was calculated by the VISA complexion analysis system devices. The data was analysed by SPSS 16.0.

Results: After 2 times of treatment, the lesion colour of all of the patients had been improved. The good and very good levels of improvement were noted in 63.3% of patients; there was 26.7% of them had partial improvement. Brown spots index was significantly improved (39.13 ± 20.66 before and 54.23 ± 16.78 after treatment; p < 0.001). Hyperpigmentation was noted in 6.7% of patients.

Conclusion: freckles have been improved by treatment with Alex trivantage laser wavelength 755 nm with safety.
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http://dx.doi.org/10.3889/oamjms.2019.096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364722PMC
January 2019

Successful Treatment of Vitiligo Vietnamese Patients with Vitilinex® Herbal Bio-Actives in Combination with Phototherapy.

Open Access Maced J Med Sci 2019 Jan 29;7(2):283-286. Epub 2019 Jan 29.

University of Rome G. Marconi, Rome, Italy.

Background: Vitiligo is an acquired pigmentary disease, that causes progressive loss of melanocytes, resulting in hypopigmented skin patches. Current treatments aim at stopping the disease progression and achieving repigmentation of the amelanotic areas. Corticosteroids, surgery, topical immunomodulators, total depigmentation of normal pigmented skin and phototherapy are current treatment options for vitiligo although phototherapy remains the treatment of choice. There is no documented evidence that herbal bio-active products may also be effective treatment options for vitiligo.

Aim: This study aimed to investigate the efficacy and safety of Vitilinex® (herbal bio- actives) alone and in combination with UVB narrowband (311 nm) phototherapy, in the treatment of localised stable or active forms of vitiligo.

Material And Methods: Sixty two subjects with mean age 34.5 years (range: 18-58 years) with mild to moderate vitiligo, consisting of 36 females and 26 males were randomly divided into three treatment groups - Group A (13 females, 10 males) treated with Vitilinex® alone; Group B (12 females, 11 males) were treated with Vitilinex® in combination with narrowband UVB (311 nm) phototherapy for 15 seconds, using a handheld lamp and Group C (8 females, 8 males) were treated with nbUVB (311 nm) phototherapy alone, for 15 seconds over a 12-week period.

Results: In Group A, 9 patients (39%) achieved outstanding improvement with a re-pigmentation rate higher than 75%, with 2 patients experiencing total repigmentation. 6 patients (26%) had marked improvement with a repigmentation rate between 50-75% while 5 patients (22%) showed a moderate response between 25-50% re-pigmentation rate. 3 patients (13%) had minimal or no improvement. In Group B, 16 patients (69.5%) achieved outstanding improvement with a re-pigmentation rate higher than 75%, with 12 patients experiencing total re-pigmentation. 4 patients (17.5 %) achieved a marked improvement with a re-pigmentation rate between 50-75%; 2 patients (8.7%) showed a moderate response with a re-pigmentation rate between 25-50%. 1 (4.3%) patient had minimal or no improvement. In Group C, 6 patients (37.5%) achieved a re-pigmentation rate higher than 75%, with 2 patients experiencing total re-pigmentation. 4 patients (25%) achieved marked improvement with a re-pigmentation rate between 50-75% while 3 patients (18.75%) had a re-pigmentation rate between 25-50%. 3 patients (18.75%) had minimal or no improvement.

Conclusion: Vitilinex® herbal bio-actives in combination with nbUVB is a more effective treatment option for vitiligo with 87% of the patients achieving a re-pigmentation rate higher than 50%, compared to Vitilinex® alone (65%) or nbUVB alone (62.5%).
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http://dx.doi.org/10.3889/oamjms.2019.095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364738PMC
January 2019

Successful Treatment of Intralesional Triamcilonon Acetonide Injection in Keloid Patients.

Open Access Maced J Med Sci 2019 Jan 28;7(2):275-278. Epub 2019 Jan 28.

University of Rome G. Marconi, Rome, Italy.

Aim: Evaluation the effect of intralesional corticosteroid injection on keloid, at the National Hospital of Dermatology and Venereology from 1/2009 to 12/2009.

Methods: A group of 65 patients with keloid were randomly assigned into three groups. In the studied group, 33 patients were intralesionally injected 7.5 mg/1 cm of TCA. In the control group, TAC 32 patients were intralesionally injected 15 mg/1 cm of TCA. The result was evaluated basing on the criteria of Henderson (1998) and El-Tonsy (1996).

Results: In comparison between 2 groups, good to excellent improvement in the studied group was statistically higher than the control group (90.7% versus 68.7%; p < 0.05). After each injection, the thickness of the scar was reduced 1.24 ± 0.53 mm in the studied group and 0.81 ± 0.39 mm in the control group. The disappearance of pain and itching after treatment were 86.6% and 95.5% in the studied group and 78.1% and 80% in the control group (p > 0.05). Ulceration, acne and troublesome with menstrual cycles were sometimes were noted more frequently in the control group than in the studied group.

Conclusion: Intralesional triamcinolone acetonide injection had a good result, and 7.5 mg/1 cm scar is the best dose for treatment of keloid.
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http://dx.doi.org/10.3889/oamjms.2019.093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364710PMC
January 2019

Efficacy of Azole Antifungal in Treatment of Pityriasis Versicolor.

Open Access Maced J Med Sci 2019 Jan 28;7(2):272-274. Epub 2019 Jan 28.

Psoriasis Eczema Clinic, Melbourne, Australia.

Aim: Compare itraconazole alone, fluconazole combined with ketoconazole and ketoconazole in the treatment of patients with pityriasis versicolor.

Material And Methods: A group of 240 pityriasis versicolor patients (confirmed with KOH and culture) were classified into 3 groups: Fluconazole 300 mg a week and 2% ketoconazole foam twice a week for 2 weeks (Category I), Itraconazole 200 mg daily for one week (category II); Ketoconazole 2% foam daily for 2 weeks (Category 3). Clinical (colour of macule, scale, pruritus) and mycological assessment were done after 4 weeks of therapy.

Results: After 4 weeks of treatment, clinical cure was observed in 62.4% (Category I), 36.3% (Category II) and 37.5% (Category III).

Conclusion: It was reported in our study that the most effective regimen for PV patients is fluconazole 300 mg per week combined with ketoconazole 2% twice a week for 2 weeks.
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http://dx.doi.org/10.3889/oamjms.2019.092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364740PMC
January 2019

Efficacy of 10% Potassium Hydroxide Solution Versus 10% Salicylic Acid Ointment in Treatment of Molluscum Contagiosum - the Low - Cost Dermatologic Therapy in Vietnam.

Open Access Maced J Med Sci 2019 Jan 28;7(2):269-271. Epub 2019 Jan 28.

University of Rome G. Marconi, Rome, Italy.

Background: Molluscum contagiosum is a common viral disease primarily affecting children.

Aim: The objective is to compare the efficacy of 10% potassium hydroxide (KOH) solution versus 10% salicylic pomade in the treatment of molluscum contagiosum.

Methods: Clinical trials on 70 patients were randomised into 2 groups: 39 patients treated with 10% KOH solution and 31 patients treated with 10% salicylic pomade. The evaluation was based on the complete clearance of lesions, side effects and complications of the drug.

Results: The clearance of all lesions after 2, 4, 6, 8 weeks of treatment in both groups were 7.7%; 23.1%; 53.8%; 79.5% and 0%; 3.2%, 9.7% 22.6%, respectively (p < 0.05). Side effects were seen in both groups include burning (76.9% versus 19.4%; p < 0.05); redness (59% versus 14%; p < 0.01); desquamation (12.8% versus 19.3%; p < 0.05).

Conclusion: The efficacy of KOH solution in the treatment of MC was better than that of salicylic pomade and both products are safe, effective, and easy to apply at home.
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http://dx.doi.org/10.3889/oamjms.2019.090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364743PMC
January 2019

Efficacy of BAFF in Monitoring Treatment Response in Early Vietnamese Systemic Sclerosis Patients.

Open Access Maced J Med Sci 2019 Jan 28;7(2):264-268. Epub 2019 Jan 28.

University of Rome G. Marconi, Rome, Italy.

Background: B-cell activating factor (BAFF) is considered to have a role in the pathogenesis of systemic sclerosis (SSc).

Aim: We conducted a longitudinal study on early SSc patients to determine the change in BAFF serum level after treatment and its association with organ involvements.

Methods: A total of 46 patients (32 diffuse, 14 limited) were recruited, among which 35 patients (24 diffuse, 11 limited) completed 12-month follow-up.

Results: Higher pretreatment BAFF levels were observed in patients with positive anti-topoisomerase antibody (ATA) (2252.1 ± 899.7 pg/ml versus 1475.5 ± 697.6 pg/ml in ATA-negative patients; p = 0.01) and muscular involvement (2741.9 ± 1039.9 pg/ml versus 1897.2 ± 762.9 pg/ml in patients without muscular involvement; p = 0.005). Lower levels were observed in patients with interstitial lung disease (ILD) (1926.7 ± 757.9 pg/ml versus 2721.6 ± 1131.4 pg/ml in non-ILD patients; p = 0.01). After treatment, BAFF level reduced significantly in diffuse SSc patients (1652.2 ± 892.7 pg/ml versus 2147.6 ± 945.5 pg/ml before treatment; p = 0.03).

Conclusion: Patients with worsening outcome had the highest pretreatment BAFF level and was associated with increased BAFF level after treatment. BAFF can be used to predict and monitor patients' response to therapy.
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http://dx.doi.org/10.3889/oamjms.2019.070DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364724PMC
January 2019

The Efficacy of a Two-Fold Increase of H1-Antihistamine in the Treatment of Chronic Urticaria - the Vietnamese Experience.

Open Access Maced J Med Sci 2019 Jan 28;7(2):259-263. Epub 2019 Jan 28.

University of Rome G. Marconi, Rome, Italy.

Background: Chronic urticaria, a mast cell-driven condition, is common, debilitating and hard to treat. H1-antihistamines are the first line treatment of chronic urticaria, but often patients do not get satisfactory relief with the recommended dose. European guidelines recommend increased antihistamine doses up to four-fold.

Aim: We conducted this study to evaluate the efficacy of increased H1-antihistamine doses up to two-fold in Vietnamese chronic urticaria patients.

Methods: One hundred and two patients with chronic urticaria were recruited for treatment with levocetirizine (n = 52) or fexofenadine (n = 50). Treatment started at the conventional daily dose of 5 mg levocetirizine or 180 mg fexofenadine for 2 weeks and then increased to 10 mg levocetirizine or 360 mg fexofenadine for 2 weeks if patients did not have an improvement in symptoms. At week 0, week 2 and week 4 wheal, pruritus, size of the wheal, total symptom scores, and associated side-effects were assessed.

Results: With the conventional dose, the total symptom scores after week 2 decreased significantly in both groups compared to baseline figures, i.e. 7.4 vs 2.3 for levocetirizine group and 8.0 vs 2.6 for fexofenadine group (p < 0.05). However, there were still 26 patients in each group who did not have improvements. Of these 26 patients, after having a two-fold increase of the conventional dose, 11.5% and 38.5% became symptom-free at week 4 in levocetirizine group and fexofenadine group, respectively. At week 4 in both groups, the total symptom scores had significantly decreased when compared with those at week 2 (2.8 ± 1.5 versus 4.7 ± 1.6 in levocetirizine group; 2.1 ± 1.9 versus 5.1 ± 1.4 in fexofenadine group). In both groups, there was no difference in the rate of negative side effects between the conventional dose and the double dose.

Conclusion: This study showed that increasing the dosages of levocetirizine and fexofenadine by two-fold improved chronic urticaria symptoms without increasing the rate of negative side effects.
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http://dx.doi.org/10.3889/oamjms.2019.069DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364734PMC
January 2019

The Decline of PUVA Therapy in Vietnam: Effective Treatment of Narrow Band UVB in Vietnamese Vitiligo Patients.

Open Access Maced J Med Sci 2019 Jan 28;7(2):256-258. Epub 2019 Jan 28.

University of Rome G. Marconi, Rome, Italy.

Aim: To examine the efficacy and safety of Narrowband ultraviolet B (NB-UVB) in Vietnamese vitiligo patients.

Methods: We recruited thirty-one patients (14 males, 17 females), aged from 7 to 67 years, with both segmental vitiligo (SV) and non-segmental vitiligo (NSV), treated three times weekly with NB-UVB. The starting dose for adults from 15 years old and children less than 15 years old was 200 mJ/cm and 150 mJ/cm, respectively, with 50 mJ/cm and 20 mJ/cm dose increments at each subsequent visit, respectively, until mild erythema lasting less than 24 hrs reported by patient, given for a period of 6 months. Response to therapy was assessed based on VASI score changes.

Results: Based upon our results, 38.7% (12/31) of patients achieved a very good response of more than 50% VASI changes, 41.9% (13/31) obtained a good response (VASI changed from 25 to 50%). Total good and very good response to therapy significantly increased with prolonged treatment, increasing from 19.4% to 64.5% and 80.6% after 2, 4 and 6 months, respectively. Localised NSV patients obtained good and very good response significantly more frequently than generalised NSV (55.6% versus 18.2%). Adverse effects were minimal, of which one case developed herpes simplex, and 4 cases reported mild photo burn reaction which completely disappeared after adjusting the dose.

Conclusion: NB-UVB therapy is an effective and safe tool in the management of Vietnamese vitiligo patients.
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http://dx.doi.org/10.3889/oamjms.2019.068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364711PMC
January 2019

Successful Psoriasis Treatment Using NB-UVB with Methotrexate: The Vietnamese Experience.

Open Access Maced J Med Sci 2019 Jan 27;7(2):253-255. Epub 2019 Jan 27.

University of Rome G. Marconi, Rome, Italy.

Aim: To compare the effectiveness of narrowband ultraviolet B (NBUVB) and oral methotrexate (MTX) to oral MTX alone in Vietnamese psoriasis patients, from May 2016 to May 2018.

Methods: We conducted a non-randomized trial on 70 patients with plaque-type psoriasis of moderate to severe. Thirty-five patients apply NBUVB once/day in 5 days/week for 4 weeks plus oral MTX 7.5 mg/week and 35 patients oral MTX 7.5 mg/week and both two groups treatment for 3 months. The extent of the lesion was assessed by the Psoriasis Area and Severity Index (PASI).

Results: The proportion of decreasing PASI was comparable (68.49% in NBUVB and MTX versus 57.62% in MTX alone); p < 0.05. Inside, good 28.58%, moderate 68.57% and poor 2.85% in NBUVB and MTX better than good 2.85%, moderate 71.4% and poor 25.72% in MTX alone; p < 0.05. The recurrence rate after 24 months of the NBUVB and MTX group (42.9%) was lower than the MTX alone group (71.4%); p < 0.05.

Conclusion: NBUVB and oral MTX have affected treatment with chronic plaque psoriasis better than oral MTX alone.
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http://dx.doi.org/10.3889/oamjms.2019.065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364742PMC
January 2019

Effectiveness, Safety and Tolerance of Methotrexate in Vietnamese Psoriatic Arthritis Patients.

Open Access Maced J Med Sci 2019 Jan 27;7(2):250-252. Epub 2019 Jan 27.

University of Rome G. Marconi, Rome, Italy.

Aim: To access the effectiveness, safety and tolerance of methotrexate (MTX) in psoriatic arthritis (PsA) treatment.

Methods: We recruit 37 patients, admitted at HCMC Hospital of Dermato-Venereology from 1/2016 to 3/2017, with MTX dosage ranging from 10 mg to 15 mg per week.

Results: Skin lesion response after 12 weeks improved PASI 50: 40.5%, PASI 75: 24.3%. Disease activity score decreased after 12 weeks with ∆DAS28 = -1.43 + 0.79, 37.8% PsA achieved complete remission. Nausea and vomiting were 8.1%. These symptoms were mild and transient. We did not stop MTX usage. The rate of elevating SGPT 2-3 times as much as the upper limit of the normal range was 2.7%.

Conclusion: We finally demonstrated that the rate of treatment response in Vietnam is the same as demonstrated by foreign authors in other countries.
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http://dx.doi.org/10.3889/oamjms.2019.063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364709PMC
January 2019

Antifungal Susceptibility of Dermatophytes Isolated From Cutaneous Fungal Infections: The Vietnamese Experience.

Open Access Maced J Med Sci 2019 Jan 27;7(2):247-249. Epub 2019 Jan 27.

University of Rome G. Marconi, Rome, Italy.

Aim: Evaluate the resistance of dermatophytes to systemic antifungal drugs in the Vietnamese population.

Methods: We enrolled 101 patients with cutaneous dermatophytosis at the Dermato-Venereology hospital in HCMC from August 2016 to March 2017. All the specimens were subjected to direct examination (10% KOH mount) and culture on Sabouraud dextrose agar. In vitro antifungal sensitivity testing was done on species isolated from a culture with broth microdilution method.

Results: Direct microscopy was positive for dermatophytes in all patients. However this pathogen was found in fungal cultures in only 61.38% of patients. The main causative agent isolated was . (90.3%), followed by . (8%) and . (1.7%). . Has shown resistance to fluconazole, griseofulvin, ketoconazole, and itraconazole in 92.9%, 46.4%, 5.4% and 1.8% of strains, respectively. All Microsporum spp. Strains were found resistant to fluconazole and griseofulvin while resistance to ketoconazole was demonstrated in only 20% of strains and none of them was resistant to itraconazole. strains were all resistant to fluconazole, griseofulvin, ketoconazole while none of them was resistant to itraconazole.

Conclusion: Based upon our results, Itraconazole shows the greatest probability of efficacy in the treatment of cutaneous dermatophytosis in Vietnamese patients.
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http://dx.doi.org/10.3889/oamjms.2019.062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364716PMC
January 2019

Efficacy of Adding Oral Simvastatin to Topical Therapy for Treatment of Psoriasis: The Vietnamese Experience.

Open Access Maced J Med Sci 2019 Jan 27;7(2):237-242. Epub 2019 Jan 27.

University of Rome G. Marconi, Rome, Italy.

Background: Psoriasis, the prevalence of which ranges from 2% to 3% of the general population, has been recently recognised as not only a chronic inflammatory skin disorder but also an immunometabolic systemic disease. Dyslipidemia is one of the most important comorbidities of psoriasis. Statins, frequently used as anti-hyperlipidemic agents, may be beneficial in the treatment of several autoimmune diseases, including psoriasis, due to their anti-inflammatory and immunomodulatory characteristics. Hence, we hypothesised that using this medication was not only beneficial for reducing hyperlipidemia but also improving psoriatic conditions.

Aim: We conducted a study to determine the prevalence of dyslipidemia in psoriatic patients as well as whether the addition of statins (simvastatin prescribed forms) to standard topical antipsoriatic treatment can improve skin lesions in psoriatic patients.

Methods: A group of 128 psoriatic patients and 128 healthy controls who were matched with the patients regarding ethnicity, age, and sex were enrolled, and their lipid concentrations were determined. Furthermore, sixty patients were randomly selected from the former group and divided into two treatment subgroups to evaluate the effect of statins on the severity of psoriasis using the PASI score.

Results: We found that the rate of dyslipidemia in the patient group was significantly higher than in the healthy group (53.9% versus 21.9%, p < 0.001), particularly the triglyceride concentration (1.86 ± 1.17 versus 1.43 ± 0.79 mg/dL, p < 0.001). Also, the PASI score reduction in the simvastatin-treated subgroup was significantly different from that in the placebo-treated one after eight weeks of therapy (8.63 ± 4.78 versus 5.34 ± 3.59, p < 0.01).

Conclusion: This study showed that simvastatin might play a role in controlling hyperlipidemia and in turn decrease the PASI score in psoriatic patients.
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http://dx.doi.org/10.3889/oamjms.2019.060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364708PMC
January 2019

The Efficacy and Safety of Hyaluronic Acid Microinjection for Skin Rejuvenation in Vietnam.

Open Access Maced J Med Sci 2019 Jan 26;7(2):234-236. Epub 2019 Jan 26.

University of Rome G. Marconi, Rome, Italy.

Background: Aging is an increasing concern of modern society, particularly facial ageing. In recent years, the microinjection technique has increasingly been emphasised as a skin rejuvenation strategy. Hyaluronic acid (HA) plays an important role in the hydration of the extracellular space and can thus improve skin hydration, firmness and viscoelastic properties.

Aim: To evaluate the efficacy and safety of HA microinjection in skin rejuvenation.

Methods: We enrolled thirty participants underwent three sessions of HA microinjection involving multiple injections in the face or back of the hands at 2-week intervals. The aesthetic outcomes were assessed at baseline and after 2, 4 and 8 weeks. Clinical evaluation was based on the Global Aesthetic Improvement Scale (GAIS) and the Wrinkle Severity Rating Scale (WSRS).

Results: Evaluation of photographs from 2, 4 and 8 weeks revealed significant clinical improvement in the brightness, texture and wrinkling of the skin. Analysis of the GAIS and WSRS scores revealed statistically significant results after 2 months.

Conclusion: Most of the participants felt satisfied with the treatment (93.3%).
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http://dx.doi.org/10.3889/oamjms.2019.059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364739PMC
January 2019

Efficacy of Narrow - Band UVB Phototherapy versus PUVA Chemophototherapy for Psoriasis in Vietnamese Patients.

Open Access Maced J Med Sci 2019 Jan 25;7(2):227-230. Epub 2019 Jan 25.

University of Rome G. Marconi, Rome, Italy.

Background: Psoralen UVA (PUVA) and narrow-band UVB (NBUVB) chemophototherapy are treatment options for psoriasis.

Aim: To compare the effectiveness of NBUVB with PUVA in Vietnamese psoriasis patients.

Methods: We conducted a non-randomized trial on 60 patients with plaque-type psoriasis (30 NBUVB, 30 PUVA). Both regimens were thrice-weekly. The extent of lesion was assessed by the Psoriasis Area Severity Index (PASI). Clearance was defined as a ≥ 75% reduction in a follow-up PASI score from baseline. Patients with clearance were followed-up until 6 months after stopping treatment. Relapse was defined as 50% or more of the original extent.

Results: The proportion of patients achieving PASI75 was comparable (76.7% in NBUVB versus 80% in PUVA; p > 0.05). Patients in both groups had a similar number of sessions to achieve clearance but patients in the PUVA group exposed to a significantly higher cumulative UV dose. After six months, the relapse rate was higher in the NBUVB group compared with in the PUVA group (p > 0.05).

Conclusion: Thrice weekly NBUVB is as effective as thrice weekly PUVA in treating psoriasis for Vietnamese patients.
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http://dx.doi.org/10.3889/oamjms.2019.057DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364720PMC
January 2019

Efficacy of Oral Itraconazole in the Treatment of Seborrheic Dermatitis in Vietnamese Adults Patients.

Open Access Maced J Med Sci 2019 Jan 20;7(2):224-226. Epub 2019 Jan 20.

University of Rome G. Marconi, Rome, Italy.

Aim: This longitudinal study aims to evaluate the efficacy of oral itraconazole in the treatment of seborrheic dermatitis in Vietnamese patients.

Methods: Thirty patients were enrolled at National Hospital of Dermatology and Venereology, Hanoi, Vietnam and were treated with oral itraconazole (200 mg daily in 14 days followed by 200 mg weekly in 4 weeks). The clinical severity was assessed by a four-parameter scoring system. All patients completed the six-week regimen with good adherence.

Results: At the week 2nd, 70% of the patients had moderate to severe diseases. At the week 6th, 63.4% of the patients achieve clearance of the lesions, and none had severe disease. No side effects were reported.

Conclusion: Oral itraconazole can be an option for seborrheic dermatitis because of good efficacy, safety profile and adherence.
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http://dx.doi.org/10.3889/oamjms.2019.056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364731PMC
January 2019

The Effectiveness of Narrow Band Uvb (Nb-Uvb) In the Treatment of Pityriasis Lichenoides Chronica (PLC) In Vietnam.

Open Access Maced J Med Sci 2019 Jan 25;7(2):221-223. Epub 2019 Jan 25.

University of Rome G. Marconi, Rome, Italy.

Aim: This prospective clinical study presents the experiences with NB-UVB monotherapy in the treatment of PLC on Vietnamese patients.

Methods: We enrolled at National Hospital of Dermatology and Venereology (NHDV), Vietnam, 29 PLC patients with generalised disease involving at least 60% of the total body surface (based on Nine's Rule) and/or failed to respond to other modalities of treatment. Patients were treated with NB-UVB followed the guideline of the psoriatic treatment of AAD-2010, three times weekly.

Results: A complete response (CR) was seen in 24 out of 29 PLC patients (82.8%) with a mean cumulative dose of 9760.5 mJ/cm after a mean treatment period of 4.6 weeks (13.8 ± 7.4 exposures). Mild side effects were observed: 69% erythema minimum, 55.2% irritation related to dry skin. No severe side effects were seen during the study. No relapses occurred in 24 CR patients within a mean period of 3 months after the last treatment.

Conclusion: NB-UVB therapy is an effective and safe option for the treatment and management of PLC.
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http://dx.doi.org/10.3889/oamjms.2019.055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364744PMC
January 2019

Efficacy of Oral Isotretinoin in Combination with Desloratadine in the Treatment of Common Vulgaris Acne in Vietnamese Patients.

Open Access Maced J Med Sci 2019 Jan 25;7(2):217-220. Epub 2019 Jan 25.

University of Rome G. Marconi, Rome, Italy.

Aim: To evaluate the efficacy of oral isotretinoin used alone and in combination with desloratadine in the treatment of moderate acne vulgaris.

Methods: A comparative clinical trial was undertaken to evaluate the efficacy of oral isotretinoin alone and in combination with desloratadine in the treatment of 62 moderate acne vulgaris patients. Patients were randomised into two groups with 31 patients in each group. Each studied group's patient took 20 mg isotretinoin and 5 mg desloratadine per day. In the control group, patients took only 20 mg isotretinoin per day. The treatment time was 16 weeks. The evaluation and follow-up were done at week 2, 4, 8, 12 and 16 of the treatment.

Results: The studied group had a better curative rate than the control group (45.2% versus 22.6%). The average number of inflammatory lesions in the studied group was significantly lower than the control group (0.19 versus 0.94). The mean GAGS score of the studied group was significantly lower than the control group (3.71 versus 6.52). Acne outbreaks rate of the studied group was lower than the control group (in week 2: 22.6% versus 45.2% and in week 4: 16.1% versus 38.7%, respectively). The rate of itchy was lower in the studied group.

Conclusion: In the treatment of moderate acne vulgaris, oral isotretinoin in combination with desloratadine is more effective and has fewer side effects than using isotretinoin alone.
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http://dx.doi.org/10.3889/oamjms.2019.054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364732PMC
January 2019

Efficacy of Surgical Excision for Nevus Sebaceous - Vietnamese Experience.

Open Access Maced J Med Sci 2019 Jan 24;7(2):211-213. Epub 2019 Jan 24.

University of Rome G. Marconi, Rome, Italy.

Background: Nevus Sebaceous (NS) is hamartoma predominantly composed of sebaceous glands and is classified as a type of epidermal nevus. In most case, clinical manifestation of NS is typical, so histopathology examination is important only in atypical lesions for its risk of malignancy. Clinical symptoms are plaques or papules (100%), appearing in the head area (100%) with smooth surface (65.8%), usually with hair loss (60.7%). The histopathology is mostly characterized by the image of sebaceous gland hyperplasia (100%), no hair follicles (60.7%) or immature follicles (14.3%).

Aim: The aim of our study is describing clinical and histopathological manifestation, make diagnosis and evaluate the best therapy.

Methods: Our study recruited 38 patients with NS, 3 patients (7.9%) with atypical aspects. All patients were treated by surgical excision.

Results: Complications as hair loss and infections were reported in 36.8% patients. No patients had recurrence after one year of treatment.

Conclusion: Based upon our experience, surgery is cheap, simple, associated with high aesthetics effectiveness and low recurrence rate, proposing as the first choice for treatment of NS.
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http://dx.doi.org/10.3889/oamjms.2019.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364719PMC
January 2019

Anatomical Evaluation for Successful Dye Laser Treatment of Port Wine Stain in Vietnamese Patients.

Open Access Maced J Med Sci 2019 Jan 23;7(2):208-210. Epub 2019 Jan 23.

University of Rome G. Marconi, Rome, Italy.

Aim: To assess the efficacy in the treatment of port wine stain in the head and neck by using (Vbeam perfecta®).

Methods: Forty-two port wine stain patients were recruited at the National Hospital of Dermatology and Venereology, Hanoi, Vietnam.

Results: We reported an excellent response (43.8%) (76%-100% lightening), a good response (18.8%) (51%-75% lightening), fair improvement (18.8%) (26%-50% lightening), and no response (18.8%) (0%-25% lightening).

Conclusion: In conclusion, pulsed dye laser is an excellent technique to remove port wine stains on the face and neck.
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http://dx.doi.org/10.3889/oamjms.2019.052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364725PMC
January 2019

Using Patch Testing to Improve Therapeutic Outcome in the Treatment of Hand Eczema in Vietnamese Patients.

Open Access Maced J Med Sci 2019 Jan 23;7(2):204-207. Epub 2019 Jan 23.

University of Rome G. Marconi, Rome, Italy.

Background: Hand eczema is a common chronic and relapsing skin disease with various clinical features. Hand eczema aetiology can be allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), atopic dermatitis (AD) and unknown or combination causes. If the causative agents are not detected treatment of hand eczema will be a failure. A patch test can be useful to detect causative agents in suspected allergic contact hand eczema. Then patients will avoid contacting them. This results in the improvement of hand eczema. In Vietnam, patch test has not been used before, so we conduct this study.

Aim: To identify causative allergens by using patch test with 28 standard allergens in consecutive patients.

Methods: A group of 300 HE patients from the National Hospital of Dermatology and Venereology (NHDV) in Vietnam were enrolled in this study. They were divided into 4 groups-ACD, ICD, AD and unknown aetiology. The patient was patch tested with 28 standard allergens to identify the causative agents.

Results: Among the 300 HE enrolled patients, ACD accounted for 72.7%, AD and ICD had the same rate of 12.7%. 39.3% of the patients had a positive patch test. Reaction to nickel sulfate was the most common (10.3%), followed by potassium dichromate (9.7%), cobalt (4%) and fragrance mix (3.1%). About one-third of the cases had relevant clinical reactions correlated with the contact agents and clinical history. Males reacted to cement, thiuram mix and formaldehyde more than females, while females reacted to a nickel more than males.

Conclusions: Hand eczema has variable clinical features and diverse aetiology. ACD is an important cause of hand eczema that can be managed with a patch test to detect causative allergens. Nearly 40% of HE cases had positive patch test. Relevant patch test reactions were seen in one-third of the patients. We propose using patch test detect causative agents in suspected allergic contact hand eczema. Then patients will avoid contacting them. This results in the improvement of hand eczema.
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http://dx.doi.org/10.3889/oamjms.2019.051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364736PMC
January 2019

Efficacy and Safety of Methotrexate in Combination with Mini Pulse Doses of Methylprednisolone in Severe Alopecia Areata. The Vietnamese Experience.

Open Access Maced J Med Sci 2019 Jan 23;7(2):200-203. Epub 2019 Jan 23.

University of Rome G. Marconi, Rome, Italy.

Background: Treatment of severe alopecia areata remains very difficult, especially in alopecia areata totalis and alopecia areata universalis. Methotrexate is known to be effective in the treatment of severe and chronic autoimmune disorders.

Objective: To assess the effectiveness and safety of MTX in combination with mini pulse dose of methylprednisolone in the treatment of severe alopecia areata.

Patients And Methods: The open, uncontrolled study compared pre-treatment and after-treatment. Thirty-eight patients (age 16-64) with severity AA (SALT score > 50 %) visiting National hospital of Dermatology and Venereology from April-2004 to September-2015 were enrolled. All patients received oral methylprednisolone 24mg/day for 3 consecutive days of a week in combination with oral MTX 7,5 mg weekly. This regimen is maintained up to 12 weeks and follow-up until to 6 months.

Results: After 6 months, 60.5% of patients show complete hair growth (good response) and 18.4% shows the medium response. There is a significant SALT score reduction: mean baseline SALT score 84.39 ± 17.03 compared to mean post-treatment SALT score 24.19 ± 29.42. Good clinical improvement noted in after 3 months. We do not observe any side- effects related to oral MTX and oral methylprednisolone, and no patients had to withdrawal treatment due to side- effects.

Conclusion: Combination Methotrexate and mini pulse dose of methylprednisolone are effective and safe in treatment severity alopecia areata.
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http://dx.doi.org/10.3889/oamjms.2019.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364718PMC
January 2019

Improving Treatment Outcome of Pemphigus Vulgaris on Vietnamese Patients by Using Desmoglein Elisa Test.

Open Access Maced J Med Sci 2019 Jan 22;7(2):195-197. Epub 2019 Jan 22.

Psoriasis Eczema Clinic, Melbourne, Australia.

Background: Pemphigus Vulgaris (PV) is a chronic disease, is characterized by the presence of flacid bullous in skin and mucosa. There are 2 main autoantibodies against desmoglein3 (Dsg3) and desmoglein1 (Dsg1).

Aim: The aims of this study were to evaluate the before and after treatment outcome with corticosteroid, using Desmoglein ELISA test.

Method: Forty patients with Pemphigus include 36 PV and 4 PF (28 women, 12 women) were enrolled. The titers of Dsg in pemphigus patients by using ELISA test were done before and 1-month treatment.

Results: Both anti-Dsg1 and anti-Dsg3 levels were significantly reduced after treatment (P < 0.05). The severity of skin lesions was correlated with anti-Dsg1 antibody level and the severity of oral lesions was significantly correlated with anti-Dsg 3 antibody levels (p < 0.05).

Conclusion: It is recommended that we can predict and improve the outcome of treatment by using Desmoglein ELISA test.
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http://dx.doi.org/10.3889/oamjms.2019.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364727PMC
January 2019

Successful Treatment of Facial Atrophic Acne Scars by Fractional Radiofrequency Microneedle in Vietnamese Patients.

Open Access Maced J Med Sci 2019 Jan 17;7(2):192-194. Epub 2019 Jan 17.

University of Rome G. Marconi, Rome, Italia.

Aim: This study aimed to evaluate the effect of the fractional Radiofrequency microneedle treatment for facial atrophic acne scars.

Methods: A group of 52 patients were recruited for the study. Goodman & Baron's acne scar grading system was used for assessment at their first visit and the end of 3 months after the last treatment session.

Results: The results displayed that 73.1% of patients have the improvement of the Goodman scar level after four times of treatment. The Goodman and Baron scar point mean was reduced from 16 ± 7.6 to 5.6 ± 5.0 (p < 0.01). Post-inflammatory hyperpigmentation was experienced in 5 patients (9.6%).

Conclusion: The microneedle fractional Radiofrequency is an effective treatment method of facial atrophic acne scars, with minor side effects and a short downtime.
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http://dx.doi.org/10.3889/oamjms.2019.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364741PMC
January 2019

The Effectiveness of Local Surgical Technique in Treatment of Axillary Bromhidrosis.

Open Access Maced J Med Sci 2019 Jan 29;7(2):187-191. Epub 2019 Jan 29.

University of Rome G. Marconi, Rome Italy.

Background: Up to now, surgical excision of apocrine glands still has been a method that yields high treatment results and low rate of odour recurrent for patients, but many people worry about some serious complications that have been observed postoperatively, such as hematoma and skin necrosis. These prolong wound healing, leading to unsightly scars in the axillary fossae.

Aim: We conducted this research to investigate the effects and complications of our surgical technique for axillary bromhidrosis.

Methods: Forty-three patients with axillary bromhidrosis were treated. An elliptical incision was made at a central portion of the area marked, with both tips of the ellipse along the axillary crease. The elliptical skin with the subcutaneous tissue was removed en lock. The adjacent skin was undermined to the periphery of the hair-bearing area with straight scissors. The undermined subcutaneous tissue was removed with curved scissors, and the skin was defatted to become a full-thickness skin flap. Any suspected hemorrhagic spots were immediately coagulated electrosurgically. Appropriate drains were placed, and the treated area was covered with thick gauze to each axilla. Arm movement was strictly controlled in the first 3 days post-operatively.

Results: Thirty-one patients have been followed up and evaluated for 6 months. 56 out of 62 axillae (90.3%) showed good to excellent results for malodor elimination. All patients reported a reduction in axillary sweating. There were two axillae of skin necrosis and three axillae of hematoma, with one patient receiving an anticoagulant from a cardiologist after the first day of surgery, to treat heart valve disease. The Dermatology Life Quality Index (DLQI) score decreased significantly, and the quality of life improved after the operation.

Conclusion: Our technique is a simple surgical procedure and easy to perform helping to achieve results for high malodor elimination, with almost no serious complications. Patient's life quality improved significantly after the operation.
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http://dx.doi.org/10.3889/oamjms.2019.133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364733PMC
January 2019

Distribution of Malassezia Species from Scales of Patient with Pityriasis Versicolor by Culture in Vietnam.

Open Access Maced J Med Sci 2019 Jan 28;7(2):184-186. Epub 2019 Jan 28.

Psoriasis Eczema Clinic, Melbourne, Australia.

Background: The detection of pathogenic fungus is an important step and key to assessing the sensitivity of the antifungal drugs, and therefore choosing an effective treatment method.

Aim: To identify Malassezia species from scales of a patient with pityriasis versicolor.

Methods: Three hundred patients with pityriasis versicolor who were positive with direct examination, were isolated by culture.

Results: Identification of Malassezia species by culture: the growth rate was 90.3%; the detection rate was 97.0%, including 11 species: (42.4%), (17.3%), (14.4%). was the most prevalent species in the 20-29 group 36.5%, in hyphae and yeast cells (42.2%).

Conclusion: is the main cause of pityriasis versicolor in Vietnam.
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http://dx.doi.org/10.3889/oamjms.2019.091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364713PMC
January 2019

Antibiotic Resistance in Bacterial Infected Eczema at Ho Chi Minh City Hospital of Dermatology.

Open Access Maced J Med Sci 2019 Jan 27;7(2):181-183. Epub 2019 Jan 27.

University of Rome G. Marconi, Rome, Italy.

Background: Infected eczema is one of the most common complications of eczema. The progression and treatment of infected eczema have become more complex and difficulty due to the antibiotic resistance of bacteria and the abuse of antibiotics in treatment.

Aim: Our research was conducted with the aim of investigating the severity of in vitro antibiotic resistance in patients with bacterially infected eczema at Ho Chi Minh City Hospital of Dermatology.

Methods: We studied 40 cases of patients, suffering from atopic dermatitis, contact dermatitis, vesicular palmoplantar eczema, with positive results of infected eczema.

Results: accounted for 82.5%, followed by (15%), (12.5%), (5%) accounted for a small percentage. (2.5%) and (2.5%) accounted for the lowest percentage. Both MSSA and MRSA were completely resistant to penicillin. MRSA is completely resistant to penicillin, erythromycin, and cefuroxime, highly resistant to clindamycin (82.35%). Our research showed that was not resistant to a variety of antibiotics. It was completely resistant to tetracycline, trimethoprim/sulfamethoxazole (100%). Most bacteria are highly sensitive to linezolid, vancomycin as other studies in the world shown. There are also rifampicins, pristinamycin. Hence, it`s prioritised to be used for only patients with eczema infected with multidrug-resistant bacteria.

Conclusion: Penicillin is not recommended for the treatment for infected eczema. Linezolid, vancomycin has a high sensitivity to bacteria including multidrug-resistant bacteria like MRSA.
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http://dx.doi.org/10.3889/oamjms.2019.067DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364728PMC
January 2019

A clinician's reference guide for the management of atopic dermatitis in Asians.

Asia Pac Allergy 2018 Oct 29;8(4):e41. Epub 2018 Oct 29.

Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Background: Atopic dermatitis (AD) is a common skin condition among Asians. Recent studies have shown that Asian AD has a unique clinical and immunologic phenotype compared with European/American AD.

Objective: The Asian Academy of Dermatology and Venereology Expert Panel on Atopic Dermatitis developed this reference guide to provide a holistic and evidence-based approach in managing AD among Asians.

Methods: Electronic searches were performed to retrieve relevant systematic reviews and guidelines on AD. Recommendations were appraised for level of evidence and strength of recommendation based on the U.K. National Institute for Health and Care Excellence and Scottish Intercollegiate Guidelines Network guidelines. These practice points were based on the consensus recommendations discussed during the Asia Pacific Meeting of Experts in Dermatology held in Bali, Indonesia in October 2016 and April 2017.

Results: The Expert Panel recommends an approach to treatment based on disease severity. The use of moisturizers is recommended across all levels of AD severity, while topical steroids are recommended only for flares not controlled by conventional skin care and moisturizers. Causes of waning efficacy must be explored before using topical corticosteroids of higher potency. Topical calcineurin inhibitors are recommended for patients who have become recalcitrant to steroid, in chronic uninterrupted use, and when there is steroid atrophy, or when there is a need to treat sensitive areas and pediatric patients. Systemic steroids have a limited role in AD treatment and should be avoided if possible. Educational programs that allow a patient-centered approach in AD management are recommended as an adjunct to conventional therapies. Recommendations on the use of phototherapy, systemic drugs, and emerging treatments are also included.

Conclusion: The management of AD among Asians requires a holistic approach, integrating evidence-based treatments while considering accessibility and cultural acceptability.
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http://dx.doi.org/10.5415/apallergy.2018.8.e41DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6209602PMC
October 2018