Human ; Female ; Adult ; Acne Vulgaris ; Dapsone ; Safety ; Treatment Outcome

Basal cell nevus syndrome (BCNS) is a rare autosomal dominant multisystem disorder due to a mutation in the PTCH1 gene. Dermatologic manifestations include basal cell carcinoma (BCC) and palmoplantar pits. This case of childhood-onset BCC arising in a child of Filipino descent with BCNS illustrates the importance of early detection and diagnosis, which will then facilitate early counseling and management of this lifelong condition. An 11-year-old Filipino-American girl presented with multiple variegated pearly papules on the face, clavicular area and upper back. She also had multiple palmoplantar pits. Shave biopsy of a papule showed BCC. Trans-abdominal ultrasound revealed bilateral ovarian calcifications. Jaw and chest radiography were unremarkable. Skin lesions were initially treated with ablative erbium:YAG laser and later recurred after 3 months. Imiquimod cream was then started which resulted in partial resolution of lesions after 12 weeks. The dermatologist's role in the diagnosis of BCNS is integral, especially in this case where the patient is a seemingly well child with predominantly dermatologic manifestations. Clinical findings of BCNS, including BCC, are recurrent. Lifetime monitoring, counseling and adequate patient education and appropriate treatment of lesions are central to the management of this condition.

Human ; Female ; Child ; Aminoquinolines ; Basal Cell Nevus Syndrome ; Biopsy ; Carcinoma, Basal Cell ; Dermatologists ; Erbium ; Lasers, Solid-state ; Mutation ; Neoplasm Recurrence, Local ; Skin ; Skin Neoplasms

BACKGROUND: Seborrheic dermatitis is a common chronic, relapsing inflammatory skin condition occurring most often on the face, scalp and chest.
OBJECTIVE: To compare the efficacy and safety of 10% guava extract shampoo versus 2% ketoconazole shampoo and clobetasol 0.05% shampoo in the treatment of scalp seborrheic dermatitis.
METHODS: Forty-five patients clinically diagnosed with scalp seborrheic dermatitis were randomized to one of the three treatment groups: 10% guava extract shampoo, 2 % ketoconazole shampoo and 0.05% clobetasol shampoo. Patients were followed-up weekly for two weeks to assess the Seborrheic Area Severity Index (SASI) scores, pruritus score, patient's global assessment of improvement and adverse events.
RESULTS: After two weeks of treatment, there was no significant difference in the three groups in terms of the mean change in SASI scores (p= 0.46, ANOVA), pruritus scores and in the patient's global assessment of improvement, and frequency of adverse events.
CONCLUSION: 10% guava extract shampoo is a safe and effective alternative treatment for scalp seborrheic dermatitis.

Human ; Male ; Aged ; Middle Aged ; Adult ; Clobetasol ; Dandruff ; Dermatitis, Seborrheic ; Ketoconazole ; Pruritus ; Psidium ; Scalp ; Skin ; Treatment Outcome

BACKGROUND: Common warts are among the top causes of dermatologic consultations. Apple cider vinegar is an old time home remedy for various ailments including common warts.
Objectives: To compare the safety and efficacy of apple cider vinegar with salicylic-lactic acid solution in the treatment of common warts.
METHODS: Twenty-seven patients clinically diagnosed with a total of 88 common warts were assigned randomly for topical application of either apple cider vinegar or salicylic-lactic acid solution which were applied and occluded for 3 consecutive days. Clinical evaluation and curettage were conducted on day 3 and every 3 days thereafter until complete resolution of the lesion for a maximum of 4 weeks. The primary outcome measured in this study was complete clinical cure of the treated wart. One week post-treatment evaluation assessment was also graded as clinical cure, clinical improvement, clinical failure and side effect failure. Adverse events were monitored.
RESULTS: In the ACV group, 33 out of 44 (75%) common warts were completely cleared while in the salicylic-lactic acid (SA/LA) group, 26 common warts were completely cleared (59%). There was no significant difference in the cure rates between the two groups (p=0.112, chi-square test). There was no significant difference in the mean time to cure between the two groups, 11 days and 12 days in the apple cider vinegar and salicylic-lactic acid groups, respectively (p=0.090; log rank test). There was no significant difference in the incidence of adverse reactions between the two groups (p=0.676; Fisher's exact test).
CONCLUSION: Apple cider vinegar is a safe and effective topical treatment that was comparable to salicylic-lactic acid solution in the treatment of common warts.

Human ; Male ; Female ; Acetic Acid ; Curettage ; Lactic Acid ; Malus ; Medicine, Traditional ; Pharmaceutical Solutions ; Receptor Activator Of Nuclear Factor-kappa B ; Salicylic Acid ; Warts

BACKGROUND: Stevens Johnson syndrome (SJS), Stevens Johnson Syndrome-Toxic Epidermal Necrolysis (SJS-TEN) and Toxic Epidermal Necrolysis (TEN) are dermatologic emergency that necessitate early recognition and management to prevent fatal outcome.
OBJECTIVES: To identify the demographic, etiologic and clinical features, management, outcomes and complications commonly seen in patients diagnosed with SJS-TEN and admitted at the Philippine General Hospital.
METHODS: Available records of all patients with the diagnosis of SJS, SJS-TEN and TEN admitted to the Philippine General Hospital from January 2004 to December 2010 were reviewed.
RESULTS: A total of 31 cases of SJS/TEN were seen. This accounted for 0.01% of the total admissions. Mean age was 45 years with 1: 1.07 female-to-male ratio. Etiologic drugs were mostly anticonvulsants (38.7%), allopurinol (19.4%) and antibiotics (16.20%). The mean time interval between drug intake and onset of symptoms was 15.36 days. Antibiotics had the shortest mean interval (7 days), while phenytoin had the longest (26.8 days). Systemic steroids were given as treatment intervention in majority of cases (98.9%). Average hospital stay was 10 days. Secondary infection was the most common complication seen (41.90%). Resolution was observed in 93.5% of the cases. High SCORTEN score (SCORTEN = 4) corresponded with increased mortality (6.45%).
CONCLUSION: SJS, SJS-TEN and TEN are rare and potentially fatal conditions commonly affecting the middle age group as seen in this study. Anticonvulsant was the most common group of drug implicated in our review. These findings were similar with studies done in other Asian countries. Systemic corticosteroid was the mainstay of treatment at our institution due to its low cost, availability and efficacy when given early on in the disease.

Human ; Male ; Female ; Adrenal Cortex Hormones ; Allopurinol ; Anti-bacterial Agents ; Anticonvulsants ; Coinfection ; Demography ; Fatal Outcome ; Hospitalization ; Hospitals, General

Human ; Male ; Female ; Dermoscopy ; Dermatology ; Melanoma

Human ; Male ; Female ; Patients ; Hair ; Cosmetics

Human ; Male ; Female ; Leprosy ; Mycobacterium Leprae

Buschke-Lowenstein tumor(BLT) is a rare sexually transmitted disease triggered by human papillomavirus type 6 or 11. It presents as an anogenital exophytic tumor characterized by its size, local infiltration, high recurrence rate and risk of malignant transformation to squamous cell carcinoma. A 45-year-old heterosexual male presented with a 22-year history of slow-growing, multiple, dark brown, verrucous, exophytic nodules and plaques over the trunk, extremities, inguinal and gluteal areas. Two years prior to consult, there was coalescence of lower abdominal plaques with rapid growth of a pinkish cauliflower-like tumor. Pelvic MRI showed that the tumor was limited to the skin. Biopsy of the lower abdominal mass was consistent with BLT and positive for HPV DNA. There was no internal organ involvement or metastasis. Pulsed dye and erbium:YAG lasers were done on the gluteal area test sites followed by wide excision and split-thickness skin graft of the lower abdominal and pubic area.

Human ; Male ; Middle Aged ; Biopsy ; Brassica ; Buschke-lowenstein Tumor ; Carcinoma, Squamous Cell ; Dna ; Erbium ; Heterosexuality ; Human Papillomavirus 6 ; Lasers, Solid-state ; Papillomavirus Infections ; Torso

Scleredema is an uncommon condition of unknown etiology that is characterized by dermal mucinosis and mild sclerosis. It is a symmetrical, diffuse, non-pitting induration of the skin commonly associated with an antecedent febrile illness, diabetes mellitus or paraproteinemia.This is the case of an obese, middle-aged adult female with type 2 diabetes mellitus on oral hypoglycemic medication, who presented with an ill-defined, diffuse erythema and non-pitting induration of the skin on the posterior neck and upper back. It has been estimated that as many as 2.5%-14% of diabetic patients have scleredema. This subset of patients may be under-reported as a consequence of subtle onset and under- recognition. Even lithe prognosis of scleredemadiabeticorum is usually benign, it is important that this condition is recognized since it may have systemic involvement that can lead to complications.

Human ; Female ; Middle Aged ; Diabetes Mellitus, Type 2 ; Erythema ; Hypoglycemic Agents ; Obesity ; Paraproteinemias ; Prognosis ; Scleredema Adultorum ; Sclerosis ; Skin ; Diabetes Mellitus ; Mucinoses