Sujith Kumarasinghe - Academia.edu (original) (raw)

Papers by Sujith Kumarasinghe

Australasian Journal of Dermatology, Sep 27, 2017

Toxic shock syndrome: A dermatological emergency Staphylococcus aureus is a Gram-positive bacteri... more Toxic shock syndrome: A dermatological emergency Staphylococcus aureus is a Gram-positive bacterium that can cause a wide range of infections, often with skin involvement. Some strains produce potent exotoxins leading to distinct clinical syndromes. We present a case of toxic shock syndrome (TSS) caused by Toxic Shock Syndrome Toxin-1 (TSST-1) strain of S. aureus as an example of how critical the history and examination can be, in making this potentially life-saving diagnosis. A 29-year-old woman presented with fever and an erythematous skin eruption. Her general practitioner had queried a drug eruption. On examination she was febrile (38.4°C), and had a wide spread toxic erythema-like blanching erythema (Figs 1 and 2). She appeared unwell, with a blood pressure was 110/60 mmHg. She

Ceylon Medical Journal, Aug 15, 2011

Archives of Pathology & Laboratory Medicine, Nov 1, 2004

Pigment international, 2019

4 ABSTRACT Lichen planus pigmentosus, erythema dyschromicum perstans and idiopathic eruptive macu... more 4 ABSTRACT Lichen planus pigmentosus, erythema dyschromicum perstans and idiopathic eruptive macular pigmentation are the three most commonly accepted subtypes of acquired dermal hyperpigmentary disorders. While some patients fit easily into one of these subtypes, others do not. Overlapping features of several subtypes may also be seen in the one patient. This paper covers these three entities in detail and highlights the diagnostic and classification challenges.

Pigment Cell Research, Oct 1, 2006

Asia is the home for billions of people with pigmented skin among whom millions have at least som... more Asia is the home for billions of people with pigmented skin among whom millions have at least some pigmentary problems. The need to have an organized forum to discuss pigmentary problems of the Asian population and to promote pigment cell research was a long felt need. Founding of the Asian Society for Pigment Cell Research (ASPCR) An historic meeting, held in Beijing, China on 21 May 2004 during the International Congress of Dermatology, was organized by a group of like-minded Asian dermatologists and researchers to establish the Asian Society for Pigment Cell Research (ASP-CR). Many members representing several countries,

Jurnal Ilmu Ternak dan Veteriner, 2010

Treatment of myiasis caused by the larvae of Chrysomya bezziana resulted in various results. The ... more Treatment of myiasis caused by the larvae of Chrysomya bezziana resulted in various results. The aim of the experiment was to compare larvacidal effect of atsiri oil of Piper betle leaf originated from Sri Lanka and Bogor agains Chrysomya bezziana larvae and to identify atsiri oil using Thin Layer Chromatography (TLC). Silica gel plate GF254 with toluena and ethyl ecetate as diluents was used in TLC. L1 and L2 of Chrysomya bezziana larvae were used for in vitro assay using agar plate contained atsiri oil of three concentrations ie. 2, 3 and 4%. Asuntol 1% and aquadest sterile were used as positive and negative control, respectively. Ten larvae were used in five replications. The larvae were observed every 30 minutes for four hours. Larval mortality were counted and probit analysed using POLO-PC software, therefore the lethal concentration (LC 50 and LC 95) and lethal time (LT 50 and LT 95) were defined. Result showed that there was a difference on migration distance between atsiri oil from Sri Lanka and Bogor on nRf 79-88 analysed using TLC. In vitro assay showed that both lethal concentration and lethal time of atsiri oil from Sri Lanka was higher than that of atsiri oil from Bogor. This results indicated that larvacidal effect of atsiri oil from Bogor was stronger than atsiri oil from Sri Lanka in in vitro both on L1 and L2.

Indian Journal of Dermatology, Venereology and Leprology, Mar 1, 1996

Chronic folliculitis (CF) is a chronic infection of hair follicles leading to atrophy and loss of... more Chronic folliculitis (CF) is a chronic infection of hair follicles leading to atrophy and loss of the affected hairs. This study was done on 51 patients with CF presenting at the Dermatology Clinic at General Hospital Matara, Sri Lanka, to identify specific clinical features and aetiological factors, and to study histopathology. Pus cultures were done on 25 cases. Biopsies were done on 6 patients. CF was commoner in males (59%); 76% were under 34 years, and 39% had occupational exposure to possible irritants. Thirty five precent admitted of scrubbing legs with rough objects. Ichthyosis vulgaris was evident in 47%. All pus cultures revealed Staphylococcus aureus. Clinical features and histopathological features were similar to those described by Harman (1968). Rough scrubbing, ichthyosis and occupational exposure to irritants may be aetiologically relevant.

PubMed, 2007

Cutaneous injuries by marine animals have a myriad of clinical presentations. Most require only s... more Cutaneous injuries by marine animals have a myriad of clinical presentations. Most require only symptomatic treatment, but some may be limb-threatening or even fatal. This is a report of three cases of marine animal injuries by a stingray, a sea anemone and a jellyfish, respectively, illustrating the potential severity of such injuries. The importance of early diagnosis is emphasised, with a discussion on the management of injuries from these three types of marine animals.

PubMed, Mar 22, 2000

Although daily itraconazole has been used effectively in chromoblastomycosis, there is no record ... more Although daily itraconazole has been used effectively in chromoblastomycosis, there is no record of pulse therapy for chromoblastomycosis. A 68-year-old woman with a history of slowly enlarging scaly plaque involving the left shoulder and lateral chest, presented to the dermatology clinic at General Hospital, Kalutara, Sri Lanka. Clinically chromoblastomycosis was suspected. Direct KOH smears showed sclerotic bodies and histology showed granulomata with characteristic brown spores. Itraconazole (Sporanox) 200 mg. b.i.d. orally was given for a week followed by 3 drug free weeks. This cycle was repeated for 6 months (i.e. 7 pulses). Clinical improvement was visible by 2 months. Scrapings and biopsy repeated 5 months after the commencement of treatment were negative for chromoblastomycosis. The lesion had clinically healed by 5 months. Examination 8 months after cessation of treatment did not show any recurrence. Itraconazole pulse therapy is cheaper than daily treatment but effective in chromoblastomycosis. The optimal dosage and end point of treatment need to be ascertained after a larger study.

Australasian Journal of Dermatology, Oct 18, 2017

PubMed, Mar 1, 2008

Subungual squamous cell carcinoma is a rare condition. Diagnosis is often delayed because it pres... more Subungual squamous cell carcinoma is a rare condition. Diagnosis is often delayed because it presents with minimal nail changes and mimics a number of benign nail conditions. We report a 43-year-old Chinese man who presented with a three-year history of an indolent melanotic macule of the fingernail. Histology from a punch biopsy revealed a well-differentiated squamous cell carcinoma. Wide local excision with full thickness skin grafting was performed. Physicians should have a high index of clinical suspicion as early nail biopsy and prompt tumour clearance can preserve joint function.

Pediatric Dermatology, May 1, 2005

Australasian Journal of Dermatology, Oct 12, 2017

Australasian Journal of Dermatology, Sep 29, 2017

Brimonidine for treatment of telangiectasia of dermatomyositis Cutaneous manifestations of dermat... more Brimonidine for treatment of telangiectasia of dermatomyositis Cutaneous manifestations of dermatomyositis significantly impacts quality of life in patients. 1 There are limited treatment options for widespread telangiectasia of DM. We present a case describing the use of brimonidine for the treatment of telangiectasia of dermatomyositis. A 32-year-old Caucasian woman was referred for management of cutaneous manifestation of biopsy proven dermatomyositis. Initially diagnosed a year earlier after developing a rash, severe lethargy and proximal myopathy, her myositis was refractory to high dose steroids and required rituximab. Her main concern at presentation to Figure 1 Top: Diffuse, non-scarring alopecia with significant hair thinning. Erythematous, poikilodermatous eruption over face. Bottom: Significant reduction in facial erythema after 3 months.

Australasian Journal of Dermatology, Feb 1, 2015

Despite the advances in diagnostic tools available in dermatology, a thorough history and examina... more Despite the advances in diagnostic tools available in dermatology, a thorough history and examination remain the basis of diagnosis. Sensory examinations, including a pinprick and a light touch, may form a crucial part of the examination such as in leprosy, where there is sensory loss on hypopigmented macules. 1,2 Although uncommon in Australia, the transmission of Mycobacterium leprae continues to occur, especially among the Indigenous and migrant population. 3 However, a sensory examination is not routinely performed and instruments such as standardized Semmes-Weinstein nylon monofilaments (NMF) or Neuropen (Owen Mumford, Oxford, UK) may not be readily available in wards or clinics. This leads to clinicians skipping this important part of examination or using an alternative instrument. 4 If an instrument such as a pen is used repeatedly, it can be a vector for disease transmission, particular in skin breaches. 4 A validated, user-friendly, cost-effective and practical method with no risk of disease transmission would be beneficial for sensory testing where standard instruments are not available. The use of the sharp point of a folded piece of paper for sensory testing has been previously validated in healthy volunteers and in patients with tuberculoid and borderline tuberculoid leprosy. 1 Among the full spectrum of leprosy, these two types depend most heavily on sensorium loss for accurate diagnosis. The piece of paper is folded twice to obtain a firm crease and to give a sufficiently sharp point. The folded paper is held perpendicular to the surface of the skin and a pinprick-like sensation is tested while pushing the paper into the skin, taking care not to bend the sharp point. 1 Twice-folded 45 gsm (g/m 2) and 80 gsm paper, the density of typical office paper, were found to be suitable alternatives to NMF, and 99.3 and 96.4% of participants reported that there was little or no difference between the paper and the NMF, respectively. 1 The sharp point can be gently pressed and dragged along the skin for a quick assessment of boundaries of sensory loss. 1 A light touch can also be tested for with a corner of a single layer of the same paper. 1 Furthermore, there is no risk of injury to patients and it is suitable for use in a paediatric setting where children may be afraid of pins. 1,2 Sensory testing with a sharp point of a folded piece of paper is convenient and simple; no special training is required. 1,2 After use, the paper is easily disposed of, unlike pins, which have to be disposed in a sharps container. Although it was originally developed for use in resource-poor countries, the method is also applicable to and easily accepted by the Australian population in our experience. The use of folded paper for sensory testing is advocated not only in the setting of leprosy but is likely to be equally useful in other forms of neuropathies such as diabetic peripheral neuropathy.

Australasian Journal of Dermatology, Feb 26, 2014

Mycosis fungoides is the most common subtype of primary cutaneous lymphoma and has several clinic... more Mycosis fungoides is the most common subtype of primary cutaneous lymphoma and has several clinical variants. We report a 74‐year‐old man presenting with an acquired palmoplantar keratoderma initially diagnosed and treated as psoriasis with suboptimal improvement. Several months later the patient developed patches and plaques that were histologically consistent with mycosis fungoides. These lesions were ameliorated with the treatment of the underlying mycosis fungoides and the palmoplantar keratoderma resolved promptly with radiotherapy. This case highlights the importance of considering mycosis fungoides as an infrequent but serious cause of acquired palmoplantar keratoderma.

International Journal of Dermatology, Jul 1, 2000

Dermatology clinic attendance at a major hospital depends on many factors. We planned to determin... more Dermatology clinic attendance at a major hospital depends on many factors. We planned to determine the monthly variations of skin disease presentation and whether there was a correlation between the clinic attendance pattern of skin diseases and meteorological parameters. The dermatology clinic attendance pattern was studied prospectively throughout a calendar year on a monthly basis at the dermatology clinic of the General Hospital, Matara, Sri Lanka. One thousand and twenty-three consecutive dermatology consultations in the private sector were also analyzed for comparison. Meteorological data were obtained from the Government Department of Meteorology. A total of 7419 first visit patients were seen at the general hospital. July and September recorded the highest number (718 each) and April recorded the lowest (426). The lowest relative humidity was in March (75%) and the highest in October (87%). The average maximum temperature ranged from 31.2 degrees C (April) to 29.1 degrees C (August, September). Average rainfall was between 622 mm (October) and 59 mm (June). Of the diseases considered to have a relationship to meteorological parameters, miliaria showed the biggest fluctuation (27 in May to zero in August). Photodermatitis was highest in August. The variation in asteatotic dermatitis patients was minimal. Dermatitis and fungal diseases comprised over 50% of clinic attendance throughout the year in both the state and private sectors. Although there were significant fluctuations in several disease categories in different months, a clear linear correlation between meteorological parameters and the disease presentation pattern could not be established. This could be due to the narrow range of variation in the meteorological parameters in the geographic area and the multiple variables involved in persons presenting to the dermatology clinic.

British journal of hospital medicine, Sep 2, 2015