Official Publication of the Philippine Dermatological Society
At the 12th International Congress of Dermatology in Buenos Aires, Dr. Stephen Katz, in his keynote lecture “Molecular Dermatology: Progress and promise”, shared the leading advancements in dermatology. He revealed prospects for gene, protein and stem cell therapy for Recessive Epidermolysis Bullosa, the discovery of BRAF inhibitors that prolong the life of patients with melanoma, and new findings in autoinflammatory diseases and Pharmacogenomics. Ten to fifteen years ago, these major breakthroughs in genetics, molecular biology and targeted therapies would be unimaginable. Their discovery has since significantly impacted the scientific community.
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Most clinical trials are designed to show that an experimental intervention, such as a drug or procedure, is superior to an existing intervention (or to no intervention, if none is currently available). These designs are called superiority trials. However, sometimes an experimental intervention is not expected to be clinically superior to an existing product, but has other advantages, such as being cheaper, easier to administer, or has a better safety profile. This latter concept is important in dermatology because some drugs that are considered the standard of care may cause unwanted side effects (e.g. steroids), or are perhaps too expensive or are non-sustainable for some our patients.
Psoriasis is a common and chronic papulosquamous skin disease leading to dissatisfaction and non-adherence to treatment
among patients. Dermatologists should identify preferences of patients in choosing treatment options in order to optimize treatment
satisfaction, adherence and outcome.
Factors related to treatment-seeking behavior among acne patients seen in a tertiary hospital in the Philippines: A cross-sectional study
Acne is a common disorder, which mostly affects adolescents. There is still little knowledge on the factors that affect patients’
decision to seek dermatologic consult.
Systematic Review and Meta-analysis
Combination therapy for moderate to severe chronic plaque psoriasis may be indicated for patients resistant to monotherapy
with first line agents such as topical therapy.
A novel mutation in the EDA gene in a Filipino family with X-linked hypohidrotic ectodermal dysplasia
X-linked hypohidrotic ectodermal dysplasia (XLHED) is a rare genetic disorder that affects the development and function of several structures of ectodermal origin, such as hair, teeth and sweat glands. It is associated to ectodysplasin-A (EDA) gene mutation, necessary for ectodermal development.
Allergic contact dermatitis (ACD) is a common dermatologic condition. ACD may present with a typical clinical presentations, requiring patch testing for diagnosis. A 77-year-old Filipino female presented with a 6 month-history of bilateral symmetrical pruritic scaly plaques on both feet diagnosed and treated as a case tinea pedis unresponsive to topical antifungal treatment. Patch test result was positive for Propolis
Arsenic is categorized as a class I human carcinogen by the International Agency for Research on Cancer and chronic exposure to its inorganic form have been associated with a variety of diseases.
Bubbly lupus: A case of a Filipino woman with bullous systemic lupus erythematosus successfully treated with prednisone and hydroxychloroquine
Bullous systemic lupus erythematosus (BSLE) is an autoimmune-mediated, chronic, widespread, non-scarring, sub-epidermal blistering skin disease. It is typically caused by autoantibodies against type VII collagen. BSLE is an uncommon manifestation of SLE and is found in less than 5% of SLE cases.
Pyoderma gangrenosum (PG) is a rare, inflammatory, ulcerative skin condition characterized by an ulcer with advancing violaceous border, negative cultures, unresponsiveness to antibiotics, the phenomenon of pathergy and histopathology showing neutrophilic infiltration.
Pachydermoperiostosis is a rare genetic disorder. The pathophysiology remains incompletely understood, and various patterns of inheritance have been proposed: autosomal dominant, autosomal recessive and x-linked. Variable penetrance has also been observed.
Juvenile hyaline fibromatosis and infantile systemic hyalinosis: The first two reported cases in the Philippines
Hyaline Fibromatosis Syndrome (HFS) is a rare, autosomal recessive condition characterized by abnormal deposition of amorphous hyaline material in the skin, joints and visceral organs. It represents a disease spectrum with infantile systemic hyalinosis (ISH) being the severe form with deaths in the first 2 years of life and juvenile hyaline fibromatosis (JHF) being the mild form with survival to adulthood. In both disorders, mental development is normal.
The first case is a 1-year-old male with a coarse facial appearance and gingival hypertrophy, multiple painful joint contractures, frog leg deformity, and characteristic cutaneous findings of multiple erythematous plaques with cobblestone appearance on the neck, back, perianal area and hyperpigmented patches overlying malleoli and metacarpophalangeal joints. He also had recurrent upper respiratory tract infections and intractable diarrhea. The second case is a 4-year-old girl who had a coarse facial appearance, wide-based gait and multiple joint contractures. She had multiple papules and plaques on the head and neck, multiple hard masses of the scalp and digits, gingival hyperplasia and sessile perianal masses. Diagnosis of ISH and JHF, respectively were confirmed by histopathology and skeletal survey.
HFS is a rare genetic disorder and only a few are reported in literature. Our paper highlights the importance of early recognition by presenting the characteristic clinical manifestations and diagnostic work-ups; genetic counselling of both the patients and their families; and the long-term, multidisciplinary approach in the management of such conditions. To the best of our knowledge, these are the first reported cases in the Philippines.
Multiple familial trichoepitheliomas: A disfiguring malady successfully treated with carbon dioxide laser
Trichoepithelioma is a rare benign skin lesion that originates from hair follicles usually located on the face but can also be present on the scalp, neck, trunk, and arms. It usually presents with multiple, skin-colored asymptomatic papules with a predilection on the upper lip, nasolabial folds, and eyelids. It is cosmetically disfiguring, usually affecting females during childhood or adolescent.
Disseminated superficial porokeratosis (DSP) is a rare variant of porokeratosis a heterogenous group of
disorders characterized by abnormal keratinization of the epidermis. There are no published worldwide incidence or prevalence rates of DSP but according to the Philippine Dermatological Society Health Information System data, there were only twelve cases of DSP, mostly females (92%), from 2011 to 2016
A case report on Chironex sp (box jellyfish) envenomation and literature review on the appropriate management
A jellyfish is a marine animal with a round body and tentacles which belong to the phylum Cnidaria. It is equipped with a nematocyst, a harpoon-like structure which functions to sting its prey. The nematocyst injects a complex mixture of toxins, which are associated with neurologic, cardiac and cutaneous repercussions.
What Lies Beneath
Telangiectasia Macularis Eruptiva Perstans in an Indian man: Correlation between clinical, dermoscopic, histopathological, and immunohistochemical findings
Cutaneous mastocytosis (CM) is characterized by accumulation of mast cells confined to the skin. Telangiectatic macularis eruptiva perstans (TMEP) is the rarest type of CM, seen in <1% of mastocytosis patients, presenting as telangiectatic patches on the trunk and upper limbs. Although mostly confined to the skin, TMEP may involve the bone marrow, lymph nodes, liver, spleen and gastrointestinal tract. Diagnosis is confirmed histopathologically by increased mast cells, dilated capillaries and venules of the dermal superficial plexus. When the number of mast cells are within normal range, special stains are utilized to highlight these cells, including Giemsa, and immunohistochemical staining for c-kit (CD117), which is involved in the pathogenesis of mastocytosis
Keratoacanthoma centrifugum marginatum (KCM) is an extremely rare variant of keratoacanthoma (KA) that is characterized by rapidly growing tumor with progressive peripheral expansion and central clearin. It predominantly affects white-skinned races, and affects areas with extensive exposure to UVB. We present a case of a Filipino farmer who presented with a verrucous lesion on the knee, which was eventually diagnosed histopathologically as KCM.