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.

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.

AIM:Evaluation the effect of intralesional corticosteroid injection on keloid, at the National Hospital of Dermatology and Venereology from 1/2009 to 12/2009.METHODS:A group of 65 patients with keloid were randomly assigned into three groups. In the studied group, 33 patients were intralesionally injected 7.5 mg/1 cm2 of TCA. In the control group, TAC 32 patients were intralesionally injected 15 mg/1 cm2 of TCA. The result was evaluated basing on the criteria of Henderson (1998) and El-Tonsy (1996).RESULTS:In comparison between 2 groups, good to excellent improvement in the studied group was statistically higher than the control group (90.7% versus 68.7%; p < 0.05). After each injection, the thickness of the scar was reduced 1.24 ± 0.53 mm in the studied group and 0.81 ± 0.39 mm in the control group. The disappearance of pain and itching after treatment were 86.6% and 95.5% in the studied group and 78.1% and 80% in the control group (p > 0.05). Ulceration, acne and troublesome with menstrual cycles were sometimes were noted more frequently in the control group than in the studied group.CONCLUSION:Intralesional triamcinolone acetonide injection had a good result, and 7.5 mg/1 cm2 scar is the best dose for treatment of keloid.

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.

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.