Measuring melasma patients' quality of life using willingness to pay and time trade-off methods in thai population

<p>Abstract</p> <p>Background</p> <p>Melasma is a common hyperpigmentation disorder that has a significant effect on an individual's quality of life. However, there is no preference-based measurement that reflects quality of life in patients with melasma. The objective of this study was to assess the impact of melasma on quality of life by using a health status measurement - the Dermatology Life Quality Index (DLQI) - and a preference-based measurement - Willingness to Pay (WTP) and Time Trade-Off (TTO).</p> <p>Methods</p> <p>A cross-sectional descriptive study was conducted. Seventy-eight patients with melasma who attended the melasma clinic at Siriraj Hospital from February to March 2009 were recruited in this study. The Thai version of the DLQI, questionnaires about WTP, standard TTO, and daily TTO were used to assess patients' quality of life.</p> <p>Results</p> <p>Seventy-seven (98.7%) patients were female with a mean age of 47.8 ± 7.9 years. The mean health utility based on standard TTO was 0.96. The utility obtained by the daily TTO method was 0.92 and was significantly correlated with an economically inactive occupation (p < 0.05). The mean monthly WTP for the most effective treatment was 1,157 baht (7.2% of monthly income), ranging from 100 to 5,000 baht (1 USD ~ 35.1 baht). The WTP was significantly correlated with monthly personal income and the total DLQI score.</p> <p>Conclusion</p> <p>The WTP method could be a useful tool with which to measure the quality of life of patients with melasma.</p

Clinical Application of Toothbrush Technique for Specimen Collection of Tinea Capitis

Objective: To demonstrate the efficacy of toothbrush culture test. Moreover, influential factors which affected the success of these methods were analyzed. Methods: To retrospectively analyze clinical presentation and investigation data of 59 Buddhist novices who diagnosed TC. The laboratory data of the toothbrush technique was reviewed and the efficacy of this technique was investigated. Results: The efficacy of toothbrush technique was demonstrated as 49.2% by comparing to the standard method. The analysis proved that more than 15% area TC involvement of scalp group achieved higher positive fungal culture outcome to be 65.5 % (p-value = 0.013). In the aspect of the clinical presentation, the effectiveness of the hairbrush technique significantly increased in the gray patch TC group (p-value 0.024). For the reason that the toothbrush technique demonstrated statistically higher efficacy in a group of patients with > 15 % gray patch area involvement (p-value = 0.007). Conclusion: The toothbrush technique was a good cooperation method that was recommended to apply in TC patients who presented as gray-patch type and more than 15% scalp area involvement

A Novel Technique of Aluminum Multiplier Slide Culture for Fungal Identification

Objective: Single slide culture technique (SSC) is the standard method of preparing fungal colonies for species identification. As contamination was frequently found, restarting the process wasted time and delayed diagnosis for patients. Aluminum slide culture (ASC) is the novel method, which aims to increase more fungal colonies in same time. Even through, some colonies showed contamination, there would be others left to use for identification. This study aimed to evaluate contaminate rate and time consumed in ASC technique to identify mold fungi compared to SSC. Methods: ASC and SSC were used to identify 50 fungal colonies comprising 3 species of dermatophytes including Trichophyton mentagrophytes, T. rubrum, Microsporum canis, and 2 species of non-dermatophytes including Neoscytalidium dimidiatum and Fusarium solani which are common causative molds for superficial fungal skin and nail infection. Fungal colonies were microscopically examined every 5 days. Time to species identification and contamination rate were recorded and analyzed. Results: This study demonstrated that ASC had equal efficacy in fungal identification with SSC. Median time from inoculation to fungal identification in ASC technique was 15 days which was significantly less than in SSC technique (18 days, p-value ≤ 0.05). At 15 days after inoculation, contamination rate revealed 2% in ASC whereas in SSC it was significantly higher at 16%. Conclusion: ASC technique is an effective alternative method to prepare fungal colonies for identification. This study demonstrated that ASC uses less time to identify mold fungi and revealed lower contamination rate than SSC technique

Clinical Application of Toothbrush Technique for Specimen Collection of Tinea Capitis

Objective: To demonstrate the efficacy of toothbrush culture test. Moreover, influential factors which affected the success of these methods were analyzed. Methods: To retrospectively analyze clinical presentation and investigation data of 59 Buddhist novices who diagnosed TC. The laboratory data of the toothbrush technique was reviewed and the efficacy of this technique was investigated. Results: The efficacy of toothbrush technique was demonstrated as 49.2% by comparing to the standard method. The analysis proved that more than 15% area TC involvement of scalp group achieved higher positive fungal culture outcome to be 65.5 % (p-value = 0.013). In the aspect of the clinical presentation, the effectiveness of the hairbrush technique significantly increased in the gray patch TC group (p-value 0.024). For the reason that the toothbrush technique demonstrated statistically higher efficacy in a group of patients with > 15 % gray patch area involvement (p-value = 0.007). Conclusion: The toothbrush technique was a good cooperation method that was recommended to apply in TC patients who presented as gray-patch type and more than 15% scalp area involvement

Supplementary figure 1

Supplementary figure 1. Terminology for morphological features: a. redness b. induration c. vesicle d. pustule e. a red-rubber-ring appearance f. active border g. scale h. excoriation i. post-inflammatory hyperpigmentation (PIH) j. a ring-within-a-ring appearanc

Supplemental figure 2 of the correlations between clinical features, dermoscopic and histopathological findings, and treatment outcomes of patients with pitted keratolysis

Supplemental figure 2 The histopathology demonstrated color alteration of the keratin with alternate light and dark columns (figure 2A and 2B). Alternate dark and light vertical bands with depressed area corresponding to the light columns (arrow) (Hematoxylin and Eosin x100 and x 200, respectively; figure 2C and 2D). Depressed area with empty space represented the pit with cluster of bacteria along the side and at the bottom of the pit (figure 2C, Hematoxylin and Eosin x 400 and figure 2D, Periodic-acid Schiff x 600

Supplemental figure 1 of the correlations between clinical features, dermoscopic and histopathological findings, and treatment outcomes of patients with pitted keratolysis

Supplemental figure 1 The characteristics of each dermoscopic findin

Posaconazole Induced Diffuse Lentigines: A Case Report

Objective: To report a case of posaconazole induced diffuse lentigines. Case presentation: A 57-year-old Thai male with acute promyelocytic leukemia who received chemotherapy and antifungal drug prophylaxis then appeared abruptly generalized multiple discrete well-defined brownish macules on face, lips, trunk, back, both arms, forearms, both thighs, legs, both palms and soles about eight days after received posaconazole. Conclusion: Multiple lentigines could be found in patients who received immunosuppression or immunomodulation, and antifungal drugs such as voriconazole

Cutaneous Manifestations and Associated Systemic Findings of Patients with Zika Infections

Objective: This retrospective study explored the clinical characteristics and laboratory results of ZIKV infections, and compared them with those of other viral exanthems. Methods: The medical records of patients presenting with maculopapular viral exanthems between January 2017 and December 2018 were reviewed. The patients were divided into 2 two groups: ZIKV infections (confirmed by urine RT-PCR testing for ZIKV), and other viral exanthems. The clinical characteristics and laboratory results of complete blood counts of the two groups were compared. Results: In all, 104 viral-exanthem patients were reviewed, with 35 patients diagnosed with a ZIKV infection (33.7%) and 69 with other viral exanthems (66.3%). The mean age of the ZIKV-infected patients was significantly higher than that of the other-viral-exanthem group (43.6 vs 36.2 years; p-value = 0.005). A multivariate analysis revealed that the incidences of a family/close contact cluster, conjunctivitis, and myalgia were significantly associated with ZIKV infections. However, there were no significant associations between the laboratory results of the ZIKV and other-viral-exanthem groups. Conclusion: The ZIKV infection exhibits a prominent pattern recognition, including a family/close contact cluster, conjunctivitis, and myalgia, that can be used to distinguish it from other exanthematous viral diseases

Supplementary figure 1

Supplementary figure 1. Terminology for morphological features: a. redness b. induration c. vesicle d. pustule e. a red-rubber-ring appearance f. active border g. scale h. excoriation i. post-inflammatory hyperpigmentation (PIH). a ring-within-a-ring appearanc