May 2017

Volume 26, Number 1

Official Publication of the Philippine Dermatological Society
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Editorial

PUBLICATIONS IN DERMATOLOGY: TRENDS, CONTROVERSIES AND THE FUTURE OF THE JPDS

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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Let's Hear From a Colleague

Non-inferiority trials: Why, what and how?

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.

Observational Studies

Systematic Review and Meta-analysis

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Case Reports

Allergic contact dermatitis to propolis presenting as tinea pedis

Allergic contact dermatitis to propolis presenting as tinea pedis

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

Mutilating pyoderma gangrenosum in an infant: A case report

Mutilating pyoderma gangrenosum in an infant: A case report

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.

Juvenile hyaline fibromatosis and infantile systemic hyalinosis: The first two reported cases in the Philippines

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

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 in an adult Filipino female treated with oral isotretinoin

Disseminated superficial porokeratosis in an adult Filipino female treated with oral isotretinoin

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

Tropical Grove

What Lies Beneath

Telangiectasia Macularis Eruptiva Perstans in an Indian man: Correlation between clinical, dermoscopic, histopathological, and immunohistochemical findings

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 in brown skin:  A diagnostic conundrum

Keratoacanthoma centrifugum marginatum in brown skin: A diagnostic conundrum

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.

Frequently Asked Questions

Have any questions about how to use the JPDS?
Read about commonly asked questions and their answers.

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