Authors: Marlon R. Aljam, Benedicto dL. Carpio, Eileen Regalado-Morales, Armelia Lapitan-Torres
Introduction: Scleroderma is an autoimmune disease usually affecting women from 30s to 50s due to inflammation, changes in vasculature, and connective tissue-producing cells. Environment and chemical factors could be triggers, however, fetal microchimerism can also initiate scleroderma.
Case Summary: A patient in early twenties had three attempts before giving birth last July 2012. She noted facial and nape hyperpigmentation during her last pregnancy which did not resolve post-partum. On 2013, patient started to notice tightening of skin on both
arms. She was initially diagnosed with scleroderma and was managed with appropriate medications but she was non-compliant. Skin hyperpigmentation continued to spread in a centripetal manner, while skin hardening spread in the opposite direction. The past 2 years saw acceleration of disease process, and Raynaud’s phenomenon, sclerodactyly, weight loss, microstomia, dysphagia, dyspnea, abdominal pain and insomnia became evident. Diagnostics elicited SCL70 antibody at >200 (normal=<15). ESR (109 mm/hr, normal=42 mm/hr), CK-MM (151.22, normal=<115), CK-MB (183.82, normal=30-135) and CK Total (32.60, normal=0-16) were also elevated. These collectively suggest diffuse systemic sclerosis. Currently, her management includes vitamin D3 twice weekly and
beraprost 20 mg/tablet 1 tablet 2 times a day.
Conclusion: The timing of the presentation of initial signs of diffuse systemic sclerosis after childbirth highly suggests fetal microchimerism as a critical factor that may trigger
an autoimmune cascade leading to a full blown development of a rare disease like scleroderma.
Diffuse systemic sclerosis, scleroderma, diffuse scleroderma, primipara,
pregnancy, child-bearing years, young
Authors: Katrina Carmela M. Belen, MD, DPDS, Jasmin J.Jamora, MD, FPDS , Ma. Cecilia P. Ingente MD, DPDSAbstractBackground: Dermoscopy, a non-invasive diagnostic tool, has been proven to improve the diagnostic accuracy of vascular tumors since it can aid in...
A randomized, double-blind, comparative study on the safety and efficacy of virgin coconut (Cocos nucifera l.) oil against 1% hydrocortisone lotion as an anti-inflammatory and antipruritic preparation for mosquito reactions
Authors: Uy, Veronica S, MD; Gracia B. Teodosio, MD, FPDS; Ma. Teresita G. Gabriel, MD, FPDS; Mary Catherine T. Galang, MD; Mohammad Yoga A. Waskito, MD; Johannes F. Dayrit, MD, FPDS Abstract Background: Virgin coconut oil (VCO) has been reported...
Primary Cutaneous Anaplastic Large Cell Lymphoma (PC-ALCL) is a rare Non-Hodgkin lymphoma (NHL) representing approximately 9% of all cutaneous lymphomas.3 It usually manifests as a slow-growing, solitary tumor which has a tendency to regress spontaneously. However, metastasis is reported in 5-10% of cases.