The utilization of phototherapy in the department of dermatology, Hospital Kuala Lumpur: A 5-year audit.

INTRODUCTION: Ultraviolet phototherapies are important treatment modalities for a wide range of dermatological conditions. We aim to describe the utilization of phototherapy in the Department of Dermatology Hospital Kuala Lumpur. METHODS: This is a 5-year retrospective audit on patients who underwent phototherapy between 2011 and 2015. RESULTS: There were 892 patients, M:F=1.08:1, aged from 4- 88 years, with a median age of 38.8 years who underwent phototherapy. Majority (58.9%) had skin phototype IV, followed by type III (37.7%) and type II (0.7%). There were 697(78.1%) who underwent NBUVB, 136 (15.2%) had topical PUVA, 22(2.5%) had oral PUVA, 12(1.4%) had UVA1 and 23(2.6%) had NBUVB with topical or oral PUVA/UVA1 at different time periods. The indications were psoriasis (46.6%), vitiligo (26.7%), atopic eczema (9.8%), pityriasis lichenoides chronica (5.3%), mycosis fungoides (3.9%), lichen planus (2.5%), nodular prurigo (2.2%), scleroderma (1.2%), alopecia areata (0.7%) and others. The median number of session received were 27 (range 1-252) for NBUVB, 30 (range 1-330) for topical PUVA, 30 (range 3-190) for oral PUVA and 24.5 (range 2-161) for UVA1. The acute adverse effects experienced by patients were erythema (18%), pruritus (16.3%), warmth (3.3%), blister formation (3.1%), cutaneous pain (2.4%), and xerosis (0.8%), skin swelling (0.7%) and phototoxicity (0.2%). CONCLUSION: Narrow-band UVB was the most frequently prescribed phototherapy modality in our center. The most common indication for phototherapy in our setting was psoriasis. Acute adverse events occurred in a third of patients, although these side effects were mild.

Epidemiology And Clinical Features Of Paediatric Patients With Psoriasis In Malaysia: Evidence From The Malaysian Psoriasis Registry (2007-2012)

Background: Psoriasis is a common dermatological condition affecting both adults and children. It causes significant physical and psychological burden on patients and adversely affect their quality of life. Aim: To evaluate the clinical characteristics of paediatric patients with psoriasis in Malaysia. Materials & Methods: Data were obtained from the Malaysian Psoriasis Registry (MPR). All paediatric patients aged <18 years notified to the registry from July 2007 to December 2012 were included in this study. Results: A total of 677 patients were notified from 18 participating centres. There was a slight female preponderance (ratio 1.3:1). Malay accounted for 70.6%, followed by Chinese (8.9%), Indian (12.3%) and others (8.1%). Mean age of onset was 9.8 ± 4.4 years. Positive family history was noted in 19.1%. Plaque psoriasis was the commonest type of psoriasis (79.6%), followed by guttate psoriasis (7.4%), pustular psoriasis (1.6%), erythrodermic (1.2%) and flexural psoriasis (1.2%). Psoriatic arthropathy was reported in only 2.2% of patients. Nail involvement is common, affecting 38.1%. Pitting was the commonest (89.9%). Topical treatment remains the most popular choice of treatment and was given in 95.1% of our patients. Topical steroid was the commonest prescribed (81.4%), followed by tar preparations (78.7%) and emollients (51.6%). Only 1.2% of our patients received phototherapy. Of the patients who had phototherapy, narrowband UVB (NBUVB) was the commonest used (87.5%). Systemic therapy was given in 5.3% of paediatric patients. The most frequently used systemic therapy was methotrexate (50%) and acitretin (27.8%). The mean CDLQI score for paediatric patients with psoriasis was 7.7 ± 5.5. Conclusion: Data from the Malaysian Psoriasis Registry highlights the clinical features of paediatric patients with psoriasis in Malaysia. We hope to get more participation from other centres in the future, especially from private sectors, so that our results can represent the Malaysian data more accurately.