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  • 1
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    Online Resource
    The Efficacy of a Two-Fold Increase of H1-Antihistamine in the Treatment of Chronic Urticaria - the Vietnamese Experience
    Scientific Foundation SPIROSKI ; 2019
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 7, No. 2 ( 2019-01-28), p. 259-263
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 7, No. 2 ( 2019-01-28), p. 259-263
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2019.069
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2019
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  • 2
    Online Resource
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    Successful Treatment of Facial Atrophic Acne Scars by Fractional Radiofrequency Microneedle in Vietnamese Patients
    Scientific Foundation SPIROSKI ; 2019
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 7, No. 2 ( 2019-01-17), p. 192-194
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 7, No. 2 ( 2019-01-17), p. 192-194
    Abstract: AIM: The aim of this study was 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 at 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 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 down-time.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2019.002
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2019
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  • 3
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    Online Resource
    The Link between HLA-B Alleles and Causative Drugs in Vietnamese Patients with Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis
    Scientific Foundation SPIROSKI ; 2020
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 8, No. B ( 2020-06-10), p. 395-400
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 8, No. B ( 2020-06-10), p. 395-400
    Abstract: BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions. Human leukocyte antigens (HLA) may play an important role in the pathogenesis of SJS/TEN. AIMS: This study aims to identify HLA-B alleles in Vietnamese patients with SJS/TEN and to investigate the possible link between HLA-B alleles and causative drugs. MATERIALS AND METHODS: Sixty patients including SJS (30 patients) and TEN (30 patients) were enrolled in a cross-sectional descriptive study at two hospitals in Hanoi, Vietnam, from July 2018 to July 2019. Clinical features and laboratory findings were noted, HLA-B alleles were analyzed by the polymerase chain reaction (PCR)-sequence-specific oligonucleotide assay and LuminexTM Multiplex Technology. RESULTS: The most common HLA-B allele was HLA-B*15:02 (41.7%) followed by HLA-B*58:01 (25%) and HLA-B*46:01 (15%). Of the 25 patients possessing HLA-B*15:02 allele, culprit medicines were carbamazepine (13 patients; 52%), traditional medicine (two patients; 8%), and unknown drugs (seven patients; 28%). Of the 15 patients carrying HLA-B*58:01 allele, there were 13 patients whose offending medicine was allopurinol. Of the eight patients whose culprit drug was traditional medicine, there were 6 patients (75%) carrying HLA-B*51:02. Patients who carry HLA-B*15:02 were found to have 4 times higher risk of developing carbamazepine-induced SJS/TEN as compared with the tolerant control group (OR=4.17; 95% CI=2.07–8.37; p 〈 0.001). CONCLUSION: HLA-B*15:02 was the most common HLA-B allele in Vietnamese patients with SJS/TEN. In traditional medicine-induced SJS/TEN patients, HLA-B*51:02 allele might play an important role. The link between the HLA-B genotypes and causative drugs may suggest physicians to avoid risk medications for certain patients.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2020.4906
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2020
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  • 4
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    The effectiveness of local surgical technique in treatment of axillary bromhidrosis
    Scientific Foundation SPIROSKI ; 2019
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 7, No. 2 ( 2019-01-29), p. 187-191
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 7, No. 2 ( 2019-01-29), p. 187-191
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2019.133
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2019
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  • 5
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    Online Resource
    Improving Treatment Outcome of Pemphigus Vulgaris on Vietnamese Patients by Using Desmoglein Elisa Test
    Scientific Foundation SPIROSKI ; 2019
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 7, No. 2 ( 2019-01-22), p. 195-197
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 7, No. 2 ( 2019-01-22), p. 195-197
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2019.003
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2019
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  • 6
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    Online Resource
    The Effectiveness of Narrow Band Uvb (Nb-Uvb) In the Treatment of Pityriasis Lichenoides Chronica (PLC) In Vietnam
    Scientific Foundation SPIROSKI ; 2019
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 7, No. 2 ( 2019-01-25), p. 221-223
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 7, No. 2 ( 2019-01-25), p. 221-223
    Abstract: 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/cm2 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.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2019.055
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2019
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  • 7
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    Efficacy and Safety of Methotrexate in Combination with Mini Pulse Doses of Methylprednisolone in Severe Alopecia Areata. The Vietnamese Experience
    Scientific Foundation SPIROSKI ; 2019
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 7, No. 2 ( 2019-01-23), p. 200-203
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 7, No. 2 ( 2019-01-23), p. 200-203
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2019.004
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2019
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  • 8
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    Efficacy of Oral Isotretinoin in Combination with Desloratadine in the Treatment of Common Vulgaris Acne in Vietnamese Patients
    Scientific Foundation SPIROSKI ; 2019
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 7, No. 2 ( 2019-01-25), p. 217-220
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 7, No. 2 ( 2019-01-25), p. 217-220
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2019.054
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2019
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  • 9
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    Online Resource
    Using Patch Testing to Improve Therapeutic Outcome in the Treatment of Hand Eczema in Vietnamese Patients
    Scientific Foundation SPIROSKI ; 2019
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 7, No. 2 ( 2019-01-23), p. 204-207
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 7, No. 2 ( 2019-01-23), p. 204-207
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2019.051
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2019
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  • 10
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    Online Resource
    Successful Treatment of Intralesional Bleomycin in Keloids of Vietnamese Population
    Scientific Foundation SPIROSKI ; 2019
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 7, No. 2 ( 2019-01-29), p. 298-299
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 7, No. 2 ( 2019-01-29), p. 298-299
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2019.099
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2019
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