A clinical appraisal of adult psoriasis patients in Serdang Hospital

Objectives To determine the socio-demographic profile, clinical characteristics and quality of life of adult psoriasis patients as well as the association between the first two variables with the latter. Methods A cross-sectional study of 30 adult psoriasis patients was conducted in the Dermatology Clinic, Serdang Hospital from 9th to 23rd May 2011. A questionnaire regarding clinical data containing multilingual Dermatology Life Quality Index (DLQI) was used in a face-to-face interview. Results Male-to-female ratio was 1:1.5. Psoriasis was more common in Malays (76.7%) compared to Chinese (10%) and Indians (10%), however this ethnic distribution was proportionate to that of the clinic attendance. The onset of psoriasis was during the second to third decade of life in most patients (53.3%) with a mean of 31 years (range 7 - 62). Nine (30%) patients had positive family history of psoriasis. The main aggravating factors were stress and sunlight. Hyperlipidemia was the commonest associated co-morbidity. Plaque psoriasis was the commonest clinical type (66.7%) and majority (66.7%) had <10% body surface area affected. Nail changes were present in 15 (50%) patients and psoriatic arthropathy occurred in 11 (36.7%), with mono/oligoarticular type being as common as symmetrical polyarthropathy. All patients were treated with topical therapy, six were on systemic medication and only one underwent phototherapy. The mean DLQI score was 10.77 ± 6.22. The duration of disease and the age group were negatively correlated with the DLQI scores (r= -0.45 and -0.42 respectively, p < 0.05). Conclusion The clinical findings are similar to previous local studies and are valuable to improve patient care.

Independent component analysis for assessing therapeutic response in vitiligo skin disorder.

This paper describes an image analysis technique that objectively measures skin repigmentation for the assessment of therapeutic response in vitiligo treatments. Skin pigment disorders due to the abnormality of melanin production, such as vitiligo, cause irregular pale patches of skin. The therapeutic response to treatment is repigmentation of the skin. However the repigmentation process is very slow and is only observable after a few months of treatment. Currently, there is no objective method to assess the therapeutic response of skin pigment disorder treatment, particularly for vitiligo treatment. In this work, we apply principal component analysis followed by independent component analysis to represent digital skin images in terms of melanin and haemoglobin composition respectively. Vitiligo skin areas are identified as skin areas that lack melanin (non-melanin areas). Results obtained using the technique have been verified by dermatologists. Based on 20 patients, the proposed technique effectively monitored the progression of repigmentation over a shorter time period of six weeks and can thus be used to evaluate treatment efficacy objectively and more effectively.

Determination of skin repigmentation progression.

In this paper, we describe an image processing scheme to analyze and determine areas of skin that have undergone repigmentation in particular, during the treatment of vitiligo. In vitiligo cases, areas of skin become pale or white due to the lack of skin pigment called melanin. Vitiligo treatment causes skin repigmentation resulting in a normal skin color. However, it is difficult to determine and quantify the amount of repigmentation visually during treatment because the repigmentation progress is slow and moreover changes in skin color can only be discerned over a longer time frame typically 6 months. Here, we develop a digital image analysis scheme that can identify and determine vitiligo skin areas and repigmentation progression on a shorter time period. The technique is based on principal component analysis and independent component analysis which converts the RGB skin image into a skin image that represent skin areas due to melanin and haemoglobin only, followed by segmentation process. Vitiligo skin lesions are identified as skin areas that lack melanin (non-melanin areas). In the initial studies of 4 patients, the method has been able to quantify repigmentation in vitiligo lesion. Hence it is now possible to determine repigmentation progression objectively and treatment efficacy on a shorter time cycle.