An instructive case of amlodipine-induced reversible granulomatous CD30+ T-cell pseudolymphoma.

We report an unusual case of drug-associated granulomatous CD30+ T-cell pseudolymphoma secondary to amlodipine. A 55-year-old Chinese man presented with a 6-month eruption of disseminated erythematous dermal papulonodules and annular infiltrated plaques over his neck and limbs symmetrically. Histopathology revealed a perivascular and interstitial infiltrate of histiocytes, eosinophils and morphologically normal lymphocytes associated with CD30 expression. The eruption improved rapidly after discontinuation of amlodipine and did not recur.

Idiopathic Generalized Exfoliative Dermatitis and Association with Antihypertensive Drugs and Statins: A Retrospective Case-Control Study.

BACKGROUND/AIMS: We aim to examine the hypothesis that antihypertensive drugs and statins may be responsible for the development of idiopathic generalized exfoliative dermatitis (GED) with a case-control study. METHODS: All inpatients who were hospitalized under the dermatology service at the Tan Tock Seng Hospital, Singapore, between 1 May 2013 and 31 May 2015, were analysed. Idiopathic GED cases had consistent clinical and histological features but no apparent cause despite comprehensive evaluation. Controls were randomly selected from inpatients with other dermatological conditions in a 1: 1 ratio during the same period. Their relationship was analysed using univariate (χ2 or Fisher exact tests) and multivariate logistic regression analysis. RESULTS: There were 78 cases and 83 controls. Of the 78 cases, 42 patients had a history of treatment with antihypertensive drugs or statins. Cases were not found to be more likely on angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, ß-blockers, calcium channel blockers, thiazides or statins compared to controls (OR: 0.81; 95% CI: 0.43-1.51; p = 0.507). CONCLUSIONS: There was insufficient evidence to suggest a significant relationship between the chronic use of antihypertensive drugs or statins and idiopathic GED in this study, despite previous evidence reporting this might be so. Further case-control studies with larger sample sizes are needed to evaluate this association.

Sun Exposure and Sun Safety Habits Among Adults in Singapore: A Cross-Sectional Study.

INTRODUCTION: Sun exposure increases skin cancer risk. Studies have shown that demographic factors influence sun safety behaviour but there is a paucity of such data in Singapore. We aimed to identify sociodemographic predictors of sun safety habits in Singapore. MATERIALS AND METHODS: A total of 2328 adults participated in a cross-sectional survey on time spent under the sun and sun safety habits (using protective headgear, body attire, umbrellas and sunscreens). A composite Sun Protection Score (higher scores represented better habits [range, 0-15]) and the average daily hours (ADH) of sun exposure were derived from the data. The relationship between the Sun Protection Score and ADH of sun exposure with sociodemographic factors was analysed using univariate (Mann-Whitney U or Kruskal-Wallis tests), multiple linear and logistic regression analyses. RESULTS: The following statistically significant variables predicted a lower Sun Protection Score: men (ß = -1.48, P <0.001), Indians (ß = -1.04, P <0.001), history of diabetes (ß = -0.60, P = 0.007) and people who do not consume alcohol (ß = 0.31, P = 0.03). Younger adults (ß = -0.2, P <0.001), men (ß = 0.80, P <0.001), darker skin type (ß = 0.27, P <0.001) and lower education level (ß = -0.18, P <0.001) were statistically significant variables that predicted a longer ADH of sun exposure. CONCLUSION: The study has identified sociodemographic predictors of sun safety habits in Singapore.

Clinical characteristics and management of patients with rosacea in a tertiary dermatology center in Singapore from 2009 to 2013.

INTRODUCTION: Rosacea is a common chronic facial skin disease. A multiethnic society such as Singapore provides an opportunity to evaluate the demographic characteristics and their impact on clinical outcome in rosacea. AIMS: The aim of this study was to evaluate characteristics and outcome of rosacea in a multiracial population in Singapore. METHODS: Records of all rosacea patients between January 2009 and December 2013 were retrospectively retrieved from the electronic medical records (EMR). Descriptive analysis was performed to understand the characteristics of patients with rosacea. Multivariate logistic regression was used to evaluate the associations between the various variables and types of rosacea as well as the clinical outcome. RESULTS: A total of 1340 patients were identified. The mean age at presentation was 42.8 years with a female predominance (65%). Most of the patients had erythematotelangiectatic rosacea (ETR) (56.3%) followed by papulopustular rosacea (PPR) (37%). With multinomial logistic regression, controlling for age, gender, and known triggers, Indians and Caucasians were more likely to have PPR compared to ETR (OR: 3.4, P = 0.01 and OR: 2.1, P = 0.01 respectively). Patients who had phymatous rosacea are also more likely to be older males (OR: 3.82 95% CI 1.64-8.92, P = 0.002). CONCLUSION: The epidemiology and outcome of rosacea among local patients were studied. Rosacea is more common among certain racial groups such as Chinese, Caucasian, and other races. The clinical subtypes also seem to be related to races of certain skin colors and might be related to varied natural intrinsic responses to the sun among different racial groups.