Atopic dermatitis (AD) is a relatively common disease in patients in the Asia-Pacific region. It presents a particular clinical challenge and requires careful clinical management. The chronic nature of AD characterized by flares, exacerbations and periods of quiescence requires a multipronged approach aimed at reducing itch, inflammation and the appearance of secondary lesions. In addition, varying levels of maintenance therapy may be required to avoid exacerbations. Survey data from the region indicate that there is significant variation across the Asia-Pacific with regard to current treatment practices. The management of AD may also be influenced by differing health-care systems, variable climate, access to medical care and cultural diversity. The current consensus guidelines have been developed to provide up-to-date and concise evidence-and experience-based recommendations directed towards general practitioners and general dermatologists in the Asia-Pacific region on the management of pediatric and adult AD.
We document the prevalence and the pattern of dermatologic diseases among primary and secondary school students visiting a Student Health Service Center in Hong Kong. In this study, the differences in prevalence of skin diseases between these two groups are pointed out. A total of 1006 students from both primary (n = 559) and secondary schools (n = 447) were seen in a regional, population-based screening center during the period from October 1996 to September 1997. Each student was asked to answer a simple questionnaire to identify any skin problems and to explore health-seeking behavior. Students were then examined for evidence of skin disease. A total of 314 students (31.3%) had one or more skin disorders, the most common of which were acne vulgaris (9.9%), eczema (6.8%), café au lait spots (4.4%), congenital melanocytic nevus (3.6%), superficial fungal infections (2.2%), keratosis pilaris (1.3%), and pityriasis alba (1.0%), which represented 93% of the skin disorders encountered. Acne vulgaris and tinea cruris were distinctly more common in secondary school students, while atopic eczema and congenital melanocytic nevi were more commonly found in primary school students. Among the 314 students with skin disease, 129 (41%) had symptoms while 185 (59%) did not. Ninety of the 129 students (70%) with symptomatic skin problems did not seek medical attention. The two predominant skin diseases, acne vulgaris and endogenous eczema, both chronic skin problems, incur not only morbidity in affected individuals and families, but also use considerable resources in the community. The lack of medical intervention reported by symptomatic students in this study was unexpectedly high. Therefore it is useful to monitor the epidemiology of skin problems in children so that relevant skin health education programs and preventive measures can be planned and implemented effectively.
Cutaneous tuberculosis is now uncommon in Hong Kong. Tuberculosis verrucosa cutis is no longer the commonest type in Hong Kong as described in some textbooks. Erythema induratum is now the most common among the total cases and lupus vulgaris is the most common among the true cutaneous forms of tuberculosis.
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