Year 2013 in Review

Clinical A/Prof Tan Suat Hoon, Director

The resounding success of the Joint-Commission International
Re-accreditation of NSC ended the year 2013 on a high note.
It was a testimony of the hard work of our staff and the
unrelenting emphasis we place on providing quality care to
our patients. NSCs Patient Health Portal service was given
recognition as NSC was awarded the Best Practice Award for
Stakeholder Engagement in the Excellence in Public Service
Awards 2013. Our Research Department was also in the
limelight as we sealed the partnership with A*STAR and
Nanyang Technological University (NTU) to launch the Skin
Research Institute of Singapore (SRIS) on 26 September
2013. It was a well-matched partnership designed to translate
inter-disciplinary skin research into improved health
outcomes and quality of life.
Other highlights of the year included the NSC Updates in
Dermatology and Venereology on 27 and 28 September 2013
at the Max Atria, Singapore Expo. Over 360 delegates from
Singapore and the Asia-Pacific region attended. We had the
honour of having world-renowned Prof Jean Bolognia,
Professor of Dermatology, Yale University School of
Medicine, USA, as a Visiting Expert to give a lecture on New
Therapies for Melanoma at the Update. Another Visiting
Expert, Prof Frank Nestle, who holds the Mary Dunhill Chair
of Cutaneous Medicine and Immunotherapy at St Johns
Institute of Dermatology and an Honorary Consultant
Dermatologist at Guys and St. Thomas Hospital, gave five
lectures focusing on Immunology, Immunotherapy,
Melanoma and Psoriasis during his visit in May 2013. Both
Visiting Experts shared valuable experience and insights in
the field of dermatology.
NSC staff were also recognised individually for their excellence
in their work and contributions. Dr Colin Theng, Senior
Consultant was awarded the Healthcare Humanity Award.
Senior Staff Nurse Esther Tang was awarded the Nurses
Merit Award. Prof Roy Chan, Senior Consultant was awarded
the National Day Public Administration Medal (Silver) with Ms
Elizabeth Tian, Pharmacy Manager, and Ms Khatija
Mohamed, Senior Medical Technologist, receiving the
National Day Efficiency Medals. Dr Ng See Ket, Senior
Consultant was presented the Yong Loo Lin - NUS Deans
Award while Dr Mark Tang, Senior Consultant was awarded
the NHG Education Leaders Award. Both Dr Eugene Tan,
Associate Consultant and Sister Tan Kim Yoke, Nurse
Clinician received the NHG Teaching Award for Junior
Clinicians and Non-Physicians, respectively. Dr Chan Keen
Loong, Visiting Consultant, was also given recognition as he
won the NHG Outstanding Education Partners Award. Our
long time Visiting Consultant, Dr Rosalind Khoo, was
presented with the NSC Distinguished Friend Award at our
Annual Dinner & Dance 2013 at the Amara Sanctuary Resort,
Sentosa.
It was indeed a compact year of activities and recognition.
NSC is brought to greater heights year on year. Needless to
say, all staff has a hand in NSCs growth and I would like to
express my appreciation for their determination and
dedication to NSC.

Newly Appointed Director

Clinical A/Prof Tan Suat Hoon is our newly appointed Director with effect from 1 April 2014. She joined NSC in 1991
and became the Head of the Research Division in 1998 to 2007. She is an inspiration to many of our doctors and
was awarded the National Skin Centre Best Clinical Teacher Award twice in 2005 and 2007. She was also
presented with the prestigious NHG Outstanding Citizenship Award in 2012.

Presented with boundless opportunities during her employment in NSC, she feels that the time has come for me
to give back to NSC in a servant leadership role. In my opinion, NSC has firmly established its position as the
national skin centre of choice for patient care, training and education, locally and in the region that we are all
extremely proud to be working in. We can look forward to embarking in the next phase of research development in
our journey towards building a world class dermatology centre, and that we will truly be a great institution when we
move in to the new NSC slated to be ready in 2019. I look forward to working with all of you, the managers, doctors
and all colleagues towards achieving this shared vision .

Congratulations to Clinical A/Prof Tan on her new appointment!

Skin Facts

Male & Female Pattern Hair Loss

What is it?
It is the most common form of hair loss affecting men and
women. In male pattern hair loss, or androgenetic alopecia,
there is gradual recession of the frontal hairline with thinning of
hair over the crown. In female pattern hair loss there is more
diffuse thinning over the crown and unlike male pattern hair
loss, the hairline is usually preserved. Miniaturization of hair is
characteristic of pattern hair loss. Permanent loss of these
miniaturized hairs occurs when the condition is left untreated.
What is the cause?
Genetic factors, male hormones and increasing age may be
important contributing factors in the development of male and
female pattern hair loss. In men, testosterone is converted to
dihydrotestosterone via the enzyme 5-reductase.
Dihydrotestosterone acts on the hair follicle causing
miniaturization of the hair. In a small number of men and
women, the hair loss may be a reflection of increased male
hormone production from a range of medical and endocrine
conditions.

How will it affect me?

Pattern hair loss can affect a persons self esteem and confidence. This can result in significant psychological stress.

How is the diagnosis made?

Your doctor will make an assessment based on history and clinical examination. In some patients, tests may be required to exclude
other causes of hair loss.

What are the treatment options for male pattern hair loss?
Topical minoxidil and oral finasteride have been proven to be effective in the treatment of male pattern hair loss. They control
the progression of hair loss and stimulate hair regrowth.

What are the treatment options for female pattern hair loss?
Topical minoxidil has also been proven to be effective in the treatment of female pattern hair loss. Where indicated, an oral
medication such as spironolactone may be used. However, this medication may not be suitable for all individuals. Frequent
blood monitoring is required for someone on spironolactone. Women with androgen excess may benefit from hormonal therapy.
Finasteride is not usually used in FPHL.

How does minoxidil work, and what are its side effects?
Topical minoxidil is applied twice a day to the affected areas of the scalp. Minoxidil prolongs the growing phase of the hair cycle
and thickens the hair. Side effects include scalp irritation and dandruff. Infrequently, hair loss may be paradoxically increased
in the first few months of use. However, this increased hair loss is usually transient and self-limiting.

How does finasteride work and what are its side effects?
Oral finasteride is a 5-reductase inhibitor that decreases the dihydrotestosterone level. This also results in prolongation of the
growing phase and thickening of the hair. Sexual dysfunction may occur in a small percentage of men. This side effect is temporary
and reversal occurs following cessation of the drug. Finasteride can be safely taken with most other medications. Patients with
a history of prostate cancer should inform their doctors if they are on finasteride.

When can I see results?
Hair loss usually stabilizes after three
to six months of therapy. Hair growth
may be appreciated in some patients
six months to two years later.
How long is treatment
necessary?
Treatment for male and female
pattern hair loss is life-long. If
treatment is stopped, hair loss recurs
three to six months later. Hair that
was previously gained may also be
lost.
Can treatment reverse
complete balding?
Current medical therapy does not
reverse complete balding. Therefore,
early therapy before permanent hair
loss occurs is advised.
Education / Training

Pharmacy-Led Sun Protection Counseling Services in Dermatology:

Improving Patient Awareness and Adherence to Sun Protection
Lauw Xiu Ting, Senior Pharmacist

NSC sees many patients with skin conditions that are aggravated by sun exposure, such as skin cancer, immunodermatoses (e.g.
DLE, dermatomyositis), photodermatoses (e.g. chronic actinic dermatoses, solar urticaria, PMLE) and hyperpigmentation (e.g. solar
lentigines, melasma). As these can be better managed with appropriate sun protection habits, we saw the need to set up a sun
protection counseling service in collaboration with our doctors who can refer their patients to our pharmacists for extended counseling
advice. Walk-in customers are also entertained.

Our Sun Protection counseling service was first initiated in January 2013,
and is possibly the first such pharmacy initiative in Singapore. From
January 2013 to October 2013, at least 73 patients have been referred for
this service.
The main objective of sun protection counseling is to advocate for primary
prevention of skin conditions caused or aggravated by ultraviolet (UV)
radiation through adoption of effective sun protection habits. Patients are
also educated to adhere to correct use of sunscreens in order to improve
the outcome of existing skin conditions.

To complement this sun protection counseling service, NSC Pharmacy

stocks a wide range of broad spectrum sunscreens of different formulations,
and various sun protection apparel such as hats and sun sleeves with Our team of Pharmacist Sun Protections Counselors.
UPF 50+ to suit patients based on their needs and activities.

We hope to be able to sustain our initiative and encourage a continued take up of this service for a holistic approach to sun protection.

Invited Speaker for Nurses CNEP Talk

Wong Bee Yin, Senior Nurse Educator

Dr Lina Ma, Deputy Executive Director for the Lions Home for the Elders was invited
to speak at the Continuing Nursing Education (CNE) programme on 9 January 2014.
Dr Ma gave an overview of services provided by the Home and shared about the evolving
roles of nurses in long-term care and the challenges involved. In her candid presentation,
she highlighted some healthcare issues that the young nurses who would be over 60
years old in 2050, would be facing in Singapore then. The Home has leveraged on IT,
multidisciplinary training and the practice of evidence-based research to improve care
for their residents. Our nurses learnt about the many levels of care required at the
nursing homes to cater for different elderly patients needs such as dementia.

Our Nursing staff with Dr Lina Ma SSN Priscilla Tan shared, I was impressed with the advancement of care in the Voluntary
(in purple dress). Welfare Organisations nursing homes. The session has given us a better understanding of
how elderly care is run in the nursing homes.

Staff News

Quality Improvement Lunch

Audrey Wong, Corporate Communications Executive

The first Quality Lunch of 2014 was held on 14 March. The winner of the WeExcel award for
the last quarter of 2013 was presented to Procedure Suites and Mandalay Clinic. The lunch
event was also an opportunity for staff to showcase and share how their 6S projects helped
to improve their working environment. The three projects presented were Improving Workflow for
Medisave Payment Request at Private Clinic by Sister Tan Kim Lian, Nurse Clinician,
On-call Bag Checklist at Clinic A/B by Ms Bethia Chua, Clinic Executive and Creating A
System for Bin Card Location and Identification by Mr Chang Jun Hua, Support Services
Executive. It was an enjoyable lunch event to keep staff updated of the ongoing improvement
initiatives implemented in individual departments.
Staff Nurse Elaine Goh, receiving the
WeExcel award from A/Prof Tan Suat
Hoon on behalf of Procedure Suites and
Mandalay Clinic.
Staff News

Prof Roy Chan Steps Down as Director on 31 March 2014

Prof Roy Chan helmed the top leadership posts at National Skin Centre as Director and Chairman of the Medical Staff
Committee, for the past 10 years from 2004 to 2014. Under his leadership, NSCs services and facilities went through
continuous improvement and upgrading to ensure quality care is given to our patients. In that decade, Mandalay
Clinic Laser Suites, Subspecialty Clinics such as Skin Cancer, Acne, Itch as well as cellular grafting service, to name
a few, were made available for patients. The rigorous improvements led to NSC becoming the first healthcare facility
in South-East Asia to be JCI accredited in ambulatory care. He also saw through the launch of the Patient Health
Portal service, a first in South East Asia, and enhanced our research capabilities by forging partnerships with
A*STAR and Nanyang Technological University (NTU) to establish the Skin Research Institute of Singapore.

The recent Public Administration Medal (Silver) that he received at the 48th National Day Awards in 2013 for outstanding efficiency,
competence and leadership is a well deserved recognition of his leadership and valuable contributions in shaping NSC to be the centre
of choice for dermatology and venereology conditions.

Prof Chan will dedicate his time in NSC as a Senior Consultant and Medical Advisor after stepping down.

NSC Management and Staff would like to thank Prof Chan for his dedication, contributions and guidance during his office
as Director of NSC.

Newly Appointed Deputy Director

A/Prof Chua Sze Hon, Senior Consultant, is appointed as the new Deputy Director of NSC with effect from 1 April
2014. A/Prof Chua joined NSC in 1994. He became Head for the Medical Education Division in 2003 and is currently
the Program Director for the Dermatology Senior Residency Programme. He has been Chief of the Dermatology and
Laser Surgery Unit since 2005 and is the newly appointed Head of Clinical Services Division. On top of his clinical and
medical education appointments, he also champions various improvement initiatives to raise the service standards
in NSC, including enhancements to clinic layout, design and aesthetics. Congratulations to A/Prof Chua on his
appointment!

The Artwork Power to Fight Psoriasis Getting Fit With Zumba

on Show at Phototherapy Clinic Audrey Wong, Corporate Communications Executive
Tan Yoke Choo, Nurse Clinician
The Healthy Lifestyle Committee
introduced Zumba fitness
An expressive artwork titled Power
classes for staff at NSC every
to Fight Psoriasis was jointly
Tuesdays since 3 December
produced by Psoriasis patients,
2013. Zumba is a form of aerobic
family members and friends at the
dance fitness class, inspired by
2013 World Psoriasis Family Day,
Latin dance. The response for the class was overwhelming
held on 26 October. The artwork was
and another session on Wednesdays was added since 8
an expression of their strong desire to take control of their psoriasis
January 2014. Staff always look forward to the class as it helps
conditions through painting. The final product is a beautiful
to relieve stress, get fit and provides an opportunity for them to
150-tiles piece put together by students of the Art Collage. This
interact with fellow colleagues outside of the work environment.
artwork is currently displayed at the Phototherapy Clinic.

CME Calendar
Date Title Seminar for Fees
17 May, Sat Certificate of Competence: Derma Fillers GPs $450*/ $500
28 Jun, Sat Pharmacists Seminar: Psoriasis Pharmacists $8
16 Aug, Sat Certificate of Competence: Chemical Peels GPs $450*/ $500
*Early bird rate of $450 applies to registration made at least one month before the workshop.

For enquiries on our seminars and public forums, please call the Training Department at Tel: 63508476 or Fax: 62533255.
You may also register online at www.nsc.com.sg

National Skin Centre 1 Mandalay Road Singapore 308205 Website: www.nsc.com.sg

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APPOINTMENT Tel: 6350 6666 Fax: 6258 2475 RECORDED GENERAL INFORMATION Tel: 6350 6680
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Editorial: Ms Audrey Wong Advisors: Clinical A/Prof Tan Suat Hoon, Mrs Tang Lee Foon
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