November 2018 Supplemental Issue

Residents’ Research Forum

Official Publication of the Philippine Dermatological Society

Research Forum Experimental Category

Research Forum Non-Experimental Category

Validation study of a psoriasis registry questionnaire

Psoriasis affects 0.1-3% of the world’s population. It is a chronic multifactorial disease with a genetic basis and various triggering factors. In the Philippines, extrapolated data from 2004 reveals a 2% prevalence.

PDS Poster Contest

Merkell Cell Carcinoma in a Filipino Male: a Case Report

Merkel cell carcinoma (MCC) is an aggressive dermal tumor of neuroendocrine origin. It is a rare, highly malignant primary skin tumor, with approximately 2,000 cases reported. This malignancy poses a challenge to clinicians due to its rarity and poor prognosis.

Behcet’s Disease in a 46 year old Filipino female

Behcet’s disease has been described to be both an autoimmune and an autoinflammarotory disorder. Recurrent oral aphthous ulcers characterize this disease, usually with the involvement of other organ systems including dermatologic manifestations. Due to its ability to involve blood vessels, vasculitis is the usual finding.

Tale of the Red Skin: Sezary Syndrome

Sezary syndrome is an extremely rare leukemic cutaneous T cell lymphoma, with annual incidence of 0.3 to 1 per 100,000, characterized by triad of erythroderma, lymphadenopathy, and circulating Sézary cells in the peripheral blood.

Steel magnolias: Erythema induratum in a mother and child

Erythema induratum of Bazin (EI) is a chronic recurrent panniculitis with vasculitis typically manifesting as erythematous, tender, nodules with occasional ulceration and scarring on the posterior calves as a hypersensitivity reaction to Mycobacterium tuberculosis (MTB). EI represents 35.8% of all cutaneous MTB infections in a recent retrospective study. Familial, non-MTB related cases of EI have been infrequently reported.

Diffuse systemic sclerosis on a young primipara patient

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.

A case of mucocutaneous colloid milium in an adult Filipino female with chronic kidney disease

Colloid milium is a rare disorder characterized by appearance of skin-colored to yellow papules mostly in sun-exposed skin. The exact pathogenesis of this disease is not yet known but ultraviolet exposure has been implicated. There have been reports of concurrence with beta thalassemia, vitamin C deficiency and trichinosis however no disease association has been definitely established.

Adverse Drug Reactions

Dapsone Hypersensitivity Syndrome

Dapsone hypersensitivity syndrome (DHS) is an allergic reaction caused by dapsone, one of the components in the WHO leprosy multidrug therapy (MDT), which usually occurs in the fourth-eighth week of the treatment.

Bullous Diseases

Pemphigus Vulgaris in a 23-year-old Filipino Male

Pemphigus vulgaris (PV) is a chronic, autoimmune bullous disease with a potentially fatal outcome. It typically presents with flaccid blisters and erosions on both the skin and mucous membranes due to loss of coherence among keratinocytes. It is an uncommon disease with an incidence rate estimated at 0.5 to 3.2 per 100,000 per year.

A Case of a 39-year-old Male with Pemphigus Foliaceus

Pemphigus foliaceus is an autoimmune blistering disease of the skin which causes a characteristic inflammatory attack at the subcorneal layer of epidermis, which results in skin lesions that are scaly or crusted erosions with an erythematous base distributed along the seborrheic areas of the body.

A case of a 15-year old male with Linear IgA Dermatosis

Linear IgA dermatosis is an autoimmune subepidermal blistering disease presented as tense bullae with a string-of-pearls appearance located most commonly in the trunk. It occurs bimodally with a slight predominance of females. This disease is caused by an antibody deposition leading to complement activation and neutrophil chemotaxis which eventuates in loss of adhesion at the dermo-epidermal junction and formation of a blister.

A rare case of Dermatitis Herpetiformis in a 37-year-old Filipino female

Dermatitis Herpetiformis is a subepidermal blistering disease that can be confirmed by histologic, immunologic, and gastrointestinal criteria. It occurs most commonly in individuals of Northern European descent and is in uncommon in Asians. Incidence rates are between 0.4 to 3.5 per 100,000 people per year worldwide and is associated with the HLA DQ2 and HLA DQ8 haploptype.

A case report on pemphigus vulgaris in a 14-year-old female

Pemphigus vulgaris is an autoimmune blistering disease predominantly seen in patients between 40-60 years with an incidence between 0.076 and 1.6 per 100,000-person years. Most cases of pemphigus vulgaris are seen in adults but also occur in adolescents in 1.4-3.7% of cases. The majority of pemphigus of childhood onset is of vulgaris type with onset at 12 years with no gender predilection and called juvenile pemphigus vulgaris. We present a 14-year-old female who presented with mucocutaneous lesions of pemphigus vulgaris with modest improvement on oral corticosteroids.

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Dermatologic Surgery

Closure of Post-Excision Defect of Basal Cell Carcinoma With Full Thickness Skin Graft Method: 3 Case Reports

Basal cell carcinoma (BCC) is the most common skin cancer which is derived from unkeratinized cells in the basal epidermal layer. BCC occurring on the head and neck accounts for 80% of all cases while 30% occurs on the nose. The lesion grows slowly is locally invasive and destructive. The combination of operative therapy and histologic confirmation is the standard approach in the management of BCC. In addition, aesthetic aspect has to be taken account.

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Genodermatoses

Incontinentia pigmenti: a case report

Incontinentia Pigmenti (Block-Sulzberger Syndrome) is a multi-system disorder whose name refers to the histopathologic finding of dermal melanophages in the third stage. An incidence of 0.6- 0.7/1,000,000 live births have been established with only 42 cumulative cases reported in the PDSHIS from 2011 to 2018.

Age in a furrow: a case of a 27-year old male with pachydermoperiostosis

Pachydermoperiostosis or primary hypertrophic osteoarthropathy is a rare, genetic syndrome with familial and idiopathic forms characterized by progressive joint effusion associated with pachydermia, periostosal proliferation of the long bones, and finger clubbing. This condition presents with distinctive thickening and furrowing of the skin of the scalp, forehead and cheeks, enlargement of the distal parts of the extremities, excessive sweating, and severe seborrhea of the scalp and face.

A Case of Darier’s Disease in a 32-year-old Filipino Female

Darier’s Disease is a rare autosomal dominant genetic disorder characterized by predominantly scaly or keratotic papules distributed on the seborrheic areas of the body, with nail splitting, palmar pits and a malodorous scent. It is a chronic disease with a prevalence of 1-4 out of 100,000 people. Abnormality in the gene ATP2A2 that codes for the Sarcoendoplasmic Reticulum Calcium ATP-ase pump is implicated in the disease.

A case of a 16-year old male with Tuberous Sclerosis Complex

Tuberous sclerosis complex is a rare, multi-system genetic disease that causes benign tumors to grow in the brain and on other vital organs such as the kidneys, heart, eyes, lungs, and skin. In familial cases, TSC is autosomal dominant. However, most cases actually occur as sporadic cases due to new, mutations in a tumor suppressor gene, either TSC1 or TSC2. Characteristic skin lesions include angiofibroma, facial fibrous plaques, shagreen patch, hypomelanotic macules and ungal fibromas. Many TSC patients show evidence of the disorder in the first year of life. However, clinical features can be subtle initially, and many signs and symptoms take years to develop.

A Case of Multiple Neurofibromas with Hypertrichosis in a Patient with Neurofibromatosis I

We report a case of multiple neurofibromas with hypertrichosis in an 11-year-old male. Classic cutaneous neurofibromas, café-au-lait macules, axillary freckling, Lisch nodules and scoliosis were also present fulfilling a diagnosis of Neurofibromatosis type 1. Hypertrichosis overlying a neurofibroma is rarely reported and the mechanism remains to be elucidated.

A Case of Bilateral Segmental Neurofibromatosis

We report a case of bilateral segmental neurofibromatosis in a 47-year old female with classic cutaneous neurofibromas and café-au-lait macules. There were no ophthalmologic, neurologic or skeletal abnormalities.

Hair/Scalp Disorders

Acne Keloidalis Nuchae with Tufted Hair Folliculitis in a 42-year-old Male: A Case Report

Acne Keloidalis Nuchae (AKN) is a chronic disorder involving inflammation and
scarring of hair follicles with subsequent development of keloid-like papules and plaques
commonly affecting the occipital scalp. Tufted Hair Folliculitis (THF) is a rare and progressive
inflammatory condition of the scalp characterized by peculiar tufting of hair. Several authors
suggest THF is a secondary phenomenon occurring in inflammatory scalp disorders, including
Dissecting Cellulitis, Acne Keloidalis Nuchae, and Folliculitis Decalvans.

Efficacy of azathioprine for alopecia areata: a systematic review of observational and interventional studies

Alopecia areata is postulated to be an autoimmune hair disorder characterized by patches of hair loss. Corticosteroids have been utilized to treat the said disorder, but efficacy has proven to be subpar when applied to severe and extensive variants such as alopecia areata totalis, alopecia areata universalis, and ophiasis. Prolonged steroid therapy leads to side effects such as skin atrophy, weight gain, Cushing syndrome, immunosuppression, and hypothalamic-pituitary-adrenal axis suppression, while discontinuation of the treatment leads to high relapse rate. There is a need for alternative treatment modalities with better safety profile and sustained treatment response to address this dilemma.

Ichthyoses

Epidermolytic Hyperkeratosis with Significant Improvement in Quality of Life after Treatment with Acitretin

Epidermolytic hyperkeratosis (EH) is a rare and severe form of ichthyosis with occurrence in 1 of 300,000 persons. EH is an autosomal dominant condition caused by mutations in keratin 1 and keratin 10. Few published literature owing to the rarity of the condition has limited the treatment options for EH. Traditional management with emollients are unsatisfactory in relieving the concerns of the patients, including the odor attributed to bacterial colonization, skin thickness and hyperpigmentation. EH is a severely debilitating disorder impairing the personal, social and economic activities of patients affected, further adding to the cost of management.

A case report of Harlequin Ichthyosis

Harlequin Ichthyosis (HI) is a rare type of Autosomal Recessive Congenital Ichthyosis associated with poor survival. Clinically the diagnosis can be made for their distinct appearance characterized by diffuse epidermal hyperkeratinization and defective desquamation.

A rare case of Confluent and Reticulated Papillomatosis of Gougerot and Carteaud in a 23-year old male treated with Doxycycline

Confluent and Reticulated Papillomatosis is a rare disease seen in young adults characterized by persistent brown scaly papules that are confluent in the center and reticulated in the periphery distributed mainly on the neck, upper trunk and axillae. It is an acquired Ichthyosiform dermatosis. Misdiagnosis is frequent for it resembles lesions like that of Tinea Versicolor. Different treatment approaches have been use such as keratolytics and antibiotics. But Minocycline is still the first-line of treatment supporting that the condition is caused by an infection or inflammation.

Infections

Lepromatous leprosy in type 2 reaction in a primigravid, a case report

Leprosy is a chronic infectious disease caused by Mycobacterium leprae primarily affecting the skin, mucous membranes and peripheral nerves. Pregnancy causes a relative decrease in cellular immunity resulting in first appearance of the disease, reactivation, or relapse in treated patients. Alteration in cell mediated and humoral immunity may trigger leprosy reactions. We report a case of a primigravid in her second trimester of pregnancy diagnosed with lepromatous leprosy in type 2 reaction treated with multidrug regimen and prednisone.

Crusted Scabies: Presenting as Erythroderma in A Patient with Hepatitis B

Crusted scabies, also known as Norwegian scabies, is a rare and highly contagious clinical variant of scabies infection caused by ectoparasite Sarcoptes scabiei var. hominis. This form of scabies mostly occur in elderly patients with malnutrition, sensory neuropathy, mental retardation, and immunosuppression. In <0.5% of reported cases, crusted scabies may present as erythroderma with erythema and scales on more than 90% of the body surface.

ROM Therapy in Multibacillary Leprosy Patient: A Report of Three Cases

Leprosy is caused by Mycobacteriom leprae which attacks the peripheral nerves, the skin, the upper respiratory tract mucosa, the other organs except central nervous system. Multibacillary leprosy is characterized by the finding of acid-fast bacili on skin slit smear examination, thickening of more than one nerve, and the presence of more than five lesions. Treatment of leprosy with MDT-WHO decreases the incidence of leprosy. However, long treatment period, resistance, adverse events, and relapse events encouraged the discovery of new treatment regimens. One of the recommended therapeutic regimens of WHO is single-dose ROM (Rifampicin 600 mg, Ofloxacin 400 mg, Monocyclin 100mg) for single PB leprosy. However, some studies have shown the effectiveness of ROM in both PB leprosy and MB.

A Case of an 18-year-old Filipino Male with Tuberculosis Verrucosa Cutis

Tuberculosis verrucosa cutis is one variant of cutaneous tuberculosis caused by exogenous inoculation of M. tuberculosis at sites of minor wounds or trauma. Lesions usually occur at the upper and lower extremities and buttocks. They initially present as a solitary small asymptomatic papule which slowly expands peripherally leading to hyperkeratotic verrucous plaque with an irregular border. Regional lymph nodes are rarely affected. TVC also does not present with an “apple jelly appearance” on diascopy.

Lepromatous Leprosy: One Case Report

Leprosy is chronicle infectious disease on humans caused by Mycobacterium leprae that mainly attack the peripheral nerve vessels and skin. Leprosy with the highest frequency attacks people within the range of age 25-35 years old. There is no distinction susceptibility among male and female. Bacteria caused this leprosy, Mycobacterium leprae, is obligate aerob intracellular bacteria which cannot be bred in vitro, shaped in 3 – 8 μm x 0,5 μm positive-gram basil. It is acid and alcohol resistant.

Left Herpes Zoster Ophthalmicus on Elderly Patients

There are about 10%-25% of population with herpes zoster got infected by Herpes Zoster Ophthalmicus (HZO) and 50% of this case got infected on the eyes as well. The clinical manifestation such as erythema lesions, maculopapular, vesicles gregarious and distributed pain in the branch of trigeminus nerve area. A comprehensive treatment will be able to prevent complication and morbidity.

A Case of Histoid Leprosy in a 39-year-old Filipino Male

Histoid leprosy (HL) in a rare variant of lepromatous leprosy (LL) which has distinct clinical, immunological, and bacteriologic findings. It presents as subcutaneous domeshaped, smooth, shiny papules or nodules arising from apparently normal skin. It was initially described in patients who were inadequately treated with dapsone monotherapy. However, de novo cases have been occasionally found.

Candidiasis Cutis is caused by candida famata

Candidiasis is an infection caused by yeast of the genus Candida, which can attack the skin, mucous membranes, nails, gastrointestinal tract, even involving some parts of the body. The most common fungi found are C. albicans, but can also be caused by other species Candida, such as C. famata. Candidiasis Cutis is found most commonly in the intertriginous area and in immunocompromised patients such as Diabetes Mellitus.

A Case of Filariasis in a 68 year old Filipino Female

Filariasis is caused by nematodes (roundworms) that inhabit the lymphatics and subcutaneous tissues. Infections are transmitted by mosquito vectors and humans are definitive hosts. It can be asymptomatic or associated with acute and/or chronic clinical manifestations, including adenolymphangitis, filarial fevers, hydrocele, chronic lymphatic disease, and tropical pulmonary eosinophilia.

Relationship between interleukin-10 and monoctye count in multibacillary leprosy patients

Leprosy remains a public health problem in developing countries. However, the underlying immune mechanism is still poorly understood. In the early non-specific immune protective mechanism, monocyte acts as phagocytes and holds the most significant role. A recent study suggested that IL-10 on APC is might inhibit the expression of MHC-II and co-stimulatory molecules; hence reducing the production of T cells stimulator cytokines.

A Case of Erthyema Induratum in a 24-year-old immunocompetent female

Tuberculosis is major health problem in the Philippines with an incidence of 323 per 100,000. It is caused by Mycobacterium tuberculosis (MTB), which mostly affect the lungs. Cutaneous TB comprises only <2% of TB cases, with high incidence in developing countries. Erythema Induratum of Bazin (EIB) is a tuberculid presenting with inflammatory panniculitis on lower legs.

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Laser Treatment

A Case of Rhinophyma in a 57-year old Male

Rhinophyma is a slowly progressive enlargement of the nose with irregular thickening of the skin and nodular deformation. This reflects the hypertrophy of the sebaceous glands in nasal skin. It occurs almost exclusively in middle-aged to elderly Caucasian men with a male predominance of 5:1. Exact pathogenesis remains unknown.

Spearheading Available Treatment Options for a 17 Year Old Filipino Female with Lymphangioma

Lymphatic malformations (LMs) are due to hyperplasia of the lymphatics. Lesions appear just after birth and expand with the growth of the patient. Although many cases are asymptomatic, cosmetic concerns and complications such as fluid leakage and secondary infection causes patient discomfort and embarrassment. Surgical excision is often considered first-line treatment. But after destructive measures, lymphangioma has a tendency toward recurrence. Thus, more palliative treatment options have been tried.

Bowen Disease: A Case Report

Bowen’s disease (BD) is generally regarded as a premalignant dermatosis. If untreated, 3% to 5% of patients may develop invasive carcinoma, which is capable of metastasizing and may even cause death. Clinically, the lesions of BD present as a scaly, slightly elevated, erythematous plaque with surface fissures and foci of pigmentation.

Medical Dermatology

Penile calciphylaxis in an end-stage-renal disease patient under conservative management: a case report

Calcific uremic arteriolopathy commonly known as calciphylaxis is a rare, life-threatening, vasculopathy affecting approximately 4% of patients with end stage renal disease. Involvement of the penis is considered an unusual phenomenon indicating a higher rate mortality at 69% within 6 months. Management of the condition remains controversial. Here, we report a case of a 40-year-old male, diagnosed with end-stage renal disease since 2016, who presented with firm, necrotic, plaques on his glans penis.

Generalized Discoid Lupus in Systemic Lupus Erythematosus with myelopathy

The occurrence of generalized discoid lupus erythematosus (DLE) and myelopathy has not been reported to date. DLE in the context of systemic lupus erythematosus (SLE) is considered to have a more benign prognosis. Among the subsets of cutaneous lupus erythematosus (CLE), DLE is the least likely to progress to SLE. Less than 5% of DLE cases progress to SLE. We report a 19-year-old woman who presented with generalized DLE and myelopathy.

Novel Therapeutics

The value of dermoscopy in generalized granuloma annulare: from time of diagnosis to successful treatment with acitretin and narrowband UV-B phototherapy

Dermoscopy is traditionally used for diagnosis of cutaneous tumors and malignancies, but it has gained importance in the diagnosis of inflammatory skin diseases such as granuloma annulare (GA). Diagnosis and management of the disease is challenging due to its intractable and recurrent nature. There are few reports on the treatment of granuloma annulare with combination of acitretin and narrowband UV-B phototherapy.

Oral Aphthosis/Behcet's Disease

Behcet’s disease in 2 Filipinos: a case report

Behcet’s disease in 2 Filipinos: a case report

Behçet’s disease is a chronic multisystem disease that is characterized by vasculitis. Recurrent oral aphthous ulcers, genital ulcers, skin and ocular lesions, and arthritis are the most frequent clinical manifestations. Pathergy may or may not be present. Due to its distinct clinical presentation, knowledge and clinical expertise are needed in order to promptly establish the diagnosis and address the disease. We report two cases of Behcet’s Disease in 2 Filipinos on the basis of history, clinical presentation, and supported by skin punch biopsy findings.

Primary idiopathic complex aphthosis: diagnosis and successful treatment with colchicine and montelukast in a 44-year old Filipino female

Recurrent aphthous stomatitis (RAS) is a common oral ailment characterized by frequent attacks of painful oral ulcers that heal spontaneously. Severe form of RAS is known as complex aphthosis (CA) which is an unfamiliar term for many. Characterized by almost always constant presence of ≥3 painful aphthae alone, with or without genital aphthosis AND exclusion of Behcet disease (BD). CA may be a reactive condition; thus, diagnosis is based on exclusion.

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Papulosquamous Disorders

A case of adult Filipino male presenting with colocalized psoriasis and segmental vitiligo

Vitiligo and psoriasis are common dermatoses with autoimmune pathomechanisms. There are numerous case reports on the coexistence of these two conditions but only a few have reported the colocalization of lesions. Moreover, to our knowledge, only one case of concurrent segmental vitiligo and plaque type psoriasis has been documented. Several theories have been put forward however the exact pathogenesis of the association between these two remain unknown.

Koebner phenomenon in psoriasis vulgaris

Psoriasis vulgaris is a chronic autoimmune disease in the skin. It could be triggered by infection, trauma either in the wound (koebner phenomenon) or in the other areas, and drugs.

Inverse psoriasis in obese woman

Psoriasis is an inflammatory skin disease with complex etiology which is an interaction between genetic and environment factors.

Pediatric Dermatology

Psoriasis vulgaris in an obese boy

Psoriasis is an inflammatory skin disease with complex interplay between genetic and environment factors. Psoriasis in children is very rare, it needs more attention and good handling because it may affect the quality of life of children both physically and psychologically. Increasing epidemiological evidence suggests that patients with psoriasis may be more obese compared with the general population. The exact mechanism underlying the association between psoriasis and obesity is uncertain. However it was theorized that adipocyte elaboration of pro-inflammatory cytokines may exacerbate psoriasis.

Diffuse cutaneous bullous mastocytosis in a Filipino girl: a case report

Cutaneous Mastocytosis is characterized by a pathological increase and activation of mast cells in various tissues, particularly in the skin. It is the most common type of mastocytosis occurring in children. Bullous mastocytosis is a very rare variant with onset usually in the first year of life. It has a reserved prognosis with risk of systemic involvement, shock, and sudden death.

Cluster of Jewels Pattern in Filipino Child: A Case Report

Chronic bullous disease of childhood (CBDC) is a rare autoimmune blistering disease, non-hereditary, and is characterized by immunoglobulin A (IgA) deposits at the basement membrane zone. It has been considered the pediatric variant of adult linear IgA disease.

A warty plaque on the hand of a 13-year old male student

Tuberculosis Verrucosa Cutis (TVC) occurs in previously sensitized individuals due to exogenous reinfection with Mycobacterium tuberculosis or Mycobacterium bovis. The sites of predilection for TVC in children are the lower extremities.

Norwegian Scabies in a 2-month-old Filipino male infant: A Case Report

Norwegian or crusted scabies is a rare and highly contagious form of skin parasitosis caused by Sarcoptes scabiei var. hominis. Individuals mainly affected are considered to be immunocompromised such as those on prolonged glucocorticosteroid therapy, with AIDS or organ transplant patients.

Chronic Non-Healing Wounds in Children: What Lies Beneath? A Case of Pediatric Pyoderma Gangrenosum in a 14 year-old Male: A Diagnostic and Treatment Challenge

Pyoderma gangrenosum (PG) is a rare neutrophilic disease. Its etiology remains unknown. Incidence is estimated at 3-10 patients per million per year. It is rarely seen in the pediatric population. A painful rapidly enlarging ulcer with a violaceous, undermined, and well-defined border containing granulation tissue, blood and purulent exudate is the hallmark of classical or ulcerative PG. A delay or miss in diagnosis of PG is not uncommon especially for pediatric patients due to its rare occurrence.

Pregnancy Dermatoses

Darier’s Disease in Pregnancy

Darier’s disease is a rare autosomal dominant disease which can affect both sexes and all ethnic groups. Literature search has revealed limited reports of Darier’s disease among pregnant women.

Impetigo Herpetiformis in a 33-year-old Filipino Female: A case report

Impetigo herpetiformis is a rare pustular disorder that affects pregnant women. It is also otherwise termed as “pustular psoriasis of pregnancy”, owing to the fact that the pustules are sterile and are not associated with a viral etiology. The classic lesions are erythematous patches or plaques studded with subcorneal pustules spreading centrifugally. A cardinal feature of this disorder is the rapid resolution of lesions after delivery. The complications of this disease include placental insufficiency, stillbirth or neonatal death.

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T-Cell Lymphomas/Pseudolymphomas

A 17-year old Filipino successfully treated with narrowband UVB for lymphomatoid papulosis and limited cutaneous systemic sclerosis

Lymphomatoid papulosis (LyP) is a recurrent, self-healing papulonodular skin eruption, belonging to the group of cutaneous CD30+ lymphoproliferative disorders. It is rare worldwide and in the Philippines with only 11 cases recorded from 2011- 2018. Here we describe a case of LyP who was later diagnosed with limited cutaneous systemic sclerosis (lcSSc), an autoimmune inflammatory condition where the skin becomes hard and thickened and the internal organs develop fibrosis and vascular abnormalities. Only 10 cases of this have been recorded from 2011-2018 in the PDS His.

NB-UVB phototherapy for a 70-year-old Filipino male with concomitant nonsegmental vitiligo and mycosis fungoides in patch-plaque stage, a case report

Mycosis Fungoides is a peripheral T-cell lymphoma caused by skin-homing CD4+ T cells which may progress to involve the lymph nodes and viscera. It is uncommon among East Asians. Vitiligo is a chronic pigmentary disorder due to progressive autoimmune mediated melanocytic destruction. NB-UVB phototherapy is an effective treatment modality for both MF and vitiligo. However, the two conditions coexisting makes it complicated to determine effective dose of NB-UVB.

Tattoo-induced pseudolymphoma: a case report

Tattooing has been practiced through the centuries as a form of artistic expression and cosmetic application. Currently, the tattoo industry is one of the most rapidly growing industries. However, it remains unregulated hence, the incidence of tattoo reactions is likewise expected to continue to rise. Reactions can be attributed to untrained tattoo artists, contaminated inks, and unhygienic practices. Direct causal relationship is hard to prove as a multitude of factors are often present simultaneously. Infections have always been the primary concern of the public.

Primary Cutaneous Anaplastic Large Cell Lymphoma in a 73-year-old Filipino Male: A Diagnostic Conundrum

Primary Cutaneous Anaplastic Large Cell Lymphoma in a 73-year-old Filipino Male: A Diagnostic Conundrum

Primary cutaneous anaplastic large cell lymphoma (PLACL) is a rare form of cutaneous lymphoma under the classification of CD30 positive lymphoproliferative disorders which presents histologically as large atypical lymphocytes with pleomorphic and anaplastic cytology that localizes to the dermis. Although recurrent, PCALCL usually carries a good prognosis, with 5-year survival rates ranging from 85% to 95%.

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Benign Tumors

Lymphangioma circumscriptum: a case report

Lymphagioma circumscriptum (LC), also known as microcystic lymphatic malformation, is thought to arise from muscular lymphatic cisterns that failed to segment during embryonic development. Clinically, this pathology manifests as red, pink, or black scattered aggregates of small, thin-walled, translucent vesicles, giving it the classic appearance of “frog-spawn on the skin.” Some lesions exhibit overlying hyperkeratosis, resulting in a verrucous appearance. Histologic examination of superficial lesions reveals solitary or grouped cystically dilated lymph vessels located within the papillary dermis. Management remains a challenge while surgical excision is regarded as the most definitive treatment with lowest rates of recurrence, but has the highest risk of complications. Other treatments reported in literature include electrodessication, Laser, Imiquimod cream, percutaneous drainage, and sclerotherapy.

It comes in threes: A case of syringocystadenoma papilliferum associated with tubular apocrine adenoma and verruca in the axilla of a Filipino female

Syringocystoadenoma papilliferum (SCAP) is a benign adnexal tumor usually located in head and neck. The occurrence of SCAP in the axilla is uncommon. The occurrence of SCAP coexisting with two other histopathological types of tumors in one cutaneous lesion is unusual.  We presented the case of a syringocystoadema papilliferum associated with tubular apocrine adenoma (TAA) and verruca.

A case study of Clear Cell Acanthoma in a 69 year old Filipino female patient

Clear cell acanthoma is an uncommon benign epidermal tumor usually seen in the 60-80 year old age group and presenting in the lower legs. In the Philippines there has by far been one reported case of the disease (Philippine Dermatologic Society-Health Information System). We present a case of clear cell acanthoma in a Filipino female.

Topical treatments for seborrheic keratosis: a systematic review

Seborrheic keratosis is a benign epidermal tumor commonly seen in the sun-exposed skin of adults. Current treatment modalities are invasive, which include electrodessication, cryotherapy, or surgery. Alternative options such as topical therapy may be beneficial to patients who have contraindications to standard treatment, or to those who prefer a non-invasive approach. However, evidence supporting the use of topical agents is lacking.

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Malignant Tumors

Pigmented Nodular Basal Cell Carcinoma from a Congenital Melanocytic Nevus in a 68-year old female

Basal cell carcinoma (BCC) is the most common skin malignancy seen in sun-exposed areas. Pigmented nodular basal cell carcinoma (PBCC) is a clinical and histologic variant of BCC. Aside from displaying features seen in nodular BCC, it also contains increased brown or black pigment, the presence of which makes it necessary to rule out melanoma. Congenital melanocytic nevi (CMN), on the other hand, are common skin lesions that carry a risk of malignant transformation, especially melanoma.

A rose by any other name: squamous cell carcinoma of the vulva

Dermatoses affecting the genitals may be of infectious, inflammatory, or neoplastic cause, and can be simply confined to the genitalia or a manifestation of a more widespread condition. Patients with cutaneous diseases of the external genitalia often initially present to their primary care provider which may be a dermatologist.

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