Sexually transmitted infections (STIs) remain a public health problem worldwide, with more than 1 million people acquiring an STI every day. In the Philippines, the total number of people with STIs other than human immunodeficiency virus (HIV) infection is not known. Hence, the Philippine Dermatological Society (PDS) has taken the initiative to document STI cases in its institutions since 2011. Syphilis, human papillomavirus (HPV), herpes simplex virus (HSV) and HIV infections are some of the common STIs in our country. A total of 665 syphilis patients, 2,053 HPV-infected patients and 977 patients with herpes have been seen and treated in PDS institutions throughout the country from 2011 to 2018. The number of HIV cases on the other hand, have already reached 58,181 from January 1984 to August 2018. In August 2018 alone, 1,047 new cases of HIV have been reported to the HIV/AIDS & ART Registry of the Philip- pines (HARP). The rates of STI infections like HIV, syphilis, HPV and herpes may be on the rise but clinicians can have a significant impact on this trend. With effective counselling, early and accurate detection, diagnosis and treatment, the threat and burden of STIs can be greatly reduced.
Sexually Transmitted Diseases ; Syphilis ; Human Papillomavirus Viruses ; Simplexvirus ; HIV

Objective To investigate the inhibitory effects of high mobility group chromosomal protein N2 (HMGN2)on growth of human bladder cancer T24 cells and ectopic tumor growth of nude mice. Methods MTT and flow cytometry assay were conducted to detect cell growth of bladder epithelial cells(T24)cells in vitro. The transplantation tumor models in nude mice were constructed by injecting T24 cells in vivo. The para-tumorswere injected with PBS,HMGN2 protein and cisdichlorodiamineplatinum(DDP),respectively. Tumor volume and weight were calculated. The expression of cell proliferation-related proteins was detected by Western blot assay. Results MTT assay proved that HMGN2 could significantly inhibit the growth of T24 cells. Flow cytometry assay verified that HMGN2 could block T24 cells in S stage of the cell cycle. The average tumor volume and weight in the HMGN2 group and DDP positive control group were smaller than those in the PBS group(P<0.05,respectively), with the tumor inhibitory rate of 25% and 23%,respectively. The results of Westernblot showed that HMGN2 could decrease Bcl-2 expression and increase Bax expression in tumor. Conclusion HMGN2 has a significant antitumor effect on T24 cells and bladder carcinoma in nude mice,which may be associated with the induction of the apoptosis of carcinoma cells and the regulation of the cell cycle.

BACKGROUND: Atopic dermatitis is a chronic, relapsing inflammatory condition of the skin that is commonly diagnosed among infants and children. Although it is known that AD can affect the quality of life of children, there is ambiguous information about the relationship of disease severity and quality of life in children with AD. To the best of our knowledge, such correlation study has not yet been conducted within the Philippine population.
OBJECTIVE: To determine if disease severity using Scoring Atopic Dermatitis (SCORAD) index and quality of life using the Filipino translation of the Children's Dermatology Life Quality Index (CDLQI)-cartoon version is correlated in Filipino children with AD
METHOD: Children aged 4-12 years diagnosed with atopic dermatitis at the outpatient dermatology clinic of a tertiary government hospital were recruited in the study. The severity of their disease was assessed by the investigator using the SCORAD index. Quality of life was evaluated using the Filipino translation of the CDLQI-cartoon version. Both were measured at initial consultation and at the follow-up visit one month after. The relationship between these parameters was statistically analyzed using Spearman's correlation.
RESULTS: Forty children were included in the analysis. The mean SCORAD index was 41.08 (SD= +16.54) at baseline and 14.3 (SD = +8.52) on follow-up, while the mean CDLQI score was 12.92 (SD = +5.64) at baseline and 3.35 (SD = +1.98) on follow-up. Majority of the participants had moderate negative effect on QOL at baseline and only a small negative effect on follow-up. Spearman's correlation showed a high positive correlation between the SCORAD index and CDLQI both at initial consultation (Spearman's p= 0.8647) and follow-up visit (Spearman's p= 0.8058). Majority of the children were affected by symptoms of pruritus and sleep disturbance.
CONCLUSIONS: Disease severity (using SCORAD index) and quality of life (using the Filipino translation of the CDLQI-cartoon version) were positively correlated among Filipino children with AD. The Filipino translation of the CDLQI-cartoon version is a valid tool which may be used as an additional subjective measure to the clinical objective scoring tools used in the assessment of AD in the Philippines.

Human ; Male ; Female ; Child ; Child Preschool ; Dermatitis, Atopic ; Dermatology ; Eczema ; Government ; Outpatients ; Pruritus ; Quality Of Life ; Research Personnel ; Skin

Cardiac Surgical Procedures - standards ; Heart Diseases - diagnosis

INTRODUCTION: Cutaneous involvement is relatively uncommon representing a small fraction (1-2%) of the localizations of extrapulmonary tuberculosis. Cutaneous TB presents with several clinical forms, wherein one of the most common is scrofuloderma resulting from the direct extension of a tuberculous focus from a deeper structure such as the lymph node into the overlying skin. Tuberculous gumma is a rare form which occurs due to hematogenous spread of the TB bacilli. Although presenting with a wide clinical spectrum, it is believed that the association of different morphologies as well as numerous lesions and sites of cutaneous TB in a same patient is very rare.

CASE REPORT: This is a case of a 20-year-old Filipino male presented with a fi ve-month history of several progressive cutaneous lesions initially presenting as subcutaneous nodules evolving into well-demarcated suppurative painless ulcers which were unresponsive to topical antibiotic. Skin punch biopsy from the medial malleolar area of the right foot revealed dilated blood vessels with a diffuse inflammatory infiltrate of lymphocytes, histiocytes, and few multinucleated giant cells. Clinical and laboratory findings were consistent with cutaneous tuberculosis. Patient was started on anti-Koch's treatment regimen and presented an excellent response to treatment showing resolution of the skin lesions on the neck and forearms and notable regression of the lesions on the right foot within four (4) months.

CONCLUSION: This case serves as a reminder that cutaneous tuberculosis can manifest with a wide spectrum of clinical presentation which can mimic diverse dermatological conditions and may present with high rates of negative or equivocal diagnostic testing results. This report highlights the importance of a high index of suspicion in the timely diagnosis and management of tuberculosis in countries wherein tuberculosis remains a significant health burden such as the Philippines.

KEYWORDS: Cutaneous tuberculosis, Scrofuloderma, Tuberculous gumma, Metastatic tuberculous abscess

Tuberculosis, Cutaneous

INTRODUCTIONThe ideal burn dressing for children should aim to alleviate pain, decrease length of hospital stay and minimise complications such as conversion and infection. The current literature is still inconclusive with regard to the gold standard burn dressing for the paediatric population.

METHODSWe retrospectively reviewed children with superficial partial thickness burns admitted to our paediatric burns unit from January 2014 to April 2015. A total of 30 patients were included in our study, of whom 13 had Biobrane dressing. The remaining 17 patients were treated with conventional silver foam dressing (i.e. Biatain Ag) and served as matched controls. Long-term follow-up scar evaluation was carried out at an average interval of two years after injury.

RESULTSIn the Biobrane group, the length of hospital stay was significantly shorter (Biobrane vs. silver foam: 4.76 ± 2.64 days vs. 8.88 ± 5.09 days; p = 0.01) and the infection rate was significantly lower (Biobrane vs. silver foam: 0% vs. 35.3%; p = 0.02). The Biobrane group had no hypergranulation or wound infection and did not require skin grafting. Long-term follow-up scar evaluation did not reveal any statistical difference between the patient groups at the two-year interval.

CONCLUSIONPaediatric patients with partial thickness burns treated with Biobrane dressing had shorter hospital stay and lower incidence of infection compared to those treated with conventional silver foam dressing. Biobrane and silver foam dressings did not demonstrate any significant difference in terms of long-term scar outcomes over an average follow-up duration of two years.

BACKGROUND: Several trials on relapse rates on duration of multibacillary regimens have varying results. OBJECTIVE: To compare the relapse rate among smear-positive Leprosy patients receiving 12 blister packs of multibacillary drug therapy and 24 blister packs of multibacillary drug therapy. METHOD: A review of records of smear positive Leprosy patients seen from 2002 to 2006 was done. Demographic, clinical and therapeutic data were collected. Bacteriologic index was determined from Leprosy Laboratory records. RESULT: A total of 391 patients were found to have complete records for review and analysis. Relapse rate was 11.9%(28) for patients who received 12 blister packs and 1.91%(3) for patients who received 24 blister packs and the difference was found to be statistically significant (p<0.01). Distribution of relapse was statistically significant according to age (p<0.01), bacteriologic index (p<0.01) and clinical spectrum (p<0.01). CONCLUSION: Relapse rates shown among smear positive leprosy patients receiving 12 blister packs vs. those receiving 24 blister packs was statistically higher which differs from previously published studies. Significant predictors were clinical spectrum, bacteriologic index of >3.5, and >4 and number of blister packs.
Leprostatic Agents ; Drug Therapy, Combination ; Leprosy ; Recurrence ; Chronic Disease

INTRODUCTION: Excessive screen time has been found to be detrimental to a child’s development. Despite its prevalence, there is a dearth of studies relating family dynamics and screen time. This study aimed to determine the association between family dynamics and the length of screen time among preschool children. METHODS: Participants were selected through convenience sampling and interviewed using the Family APGAR questionnaire. Families were classified as functional or dysfunctional. The adult respondents estimated the total screen time and this was classified as low-level or excessive. The association between screen time and APGAR classification was determined using prevalence rate ratio. RESULTS: Majority of 115 families had an APGAR classification of highly functional, with the children having an average screen time of five hours. Children from dysfunctional families were 1.23 times more likely to have an excessive amount of screen time than those with highly functional families and the difference was significant (p = 0.041). CONCLUSION Majority of the families in this study were highly functional and the average screen time of the children included in the study was five hours. Children from dysfunctional families were 1.23 times more likely to have an excessive amount of screen time than those with highly functional families.
child, preschool ; child ; Child development ; screen time ; family relations ;

Introduction: Lipoid proteinosis is a rare autosomal recessive genodermatosis with only approximately 300 cases reported worldwide. This condition is due to the loss of function mutation of the ECM1 gene which encodes for extracellular matrix protein 1 (ECM1), a secretory protein that promotes angiogenesis and is a negative regulator of endochondral bone formation. Case summary: We report a case of a 23-year-old male who presented with chronic recurrent verrucous and waxy lesions on the face and body, diffuse alopecia of the scalp, and hoarseness of voice. Lesions heal leaving scars. Dermoscopy of the eyelid margins show white to yellowish clods with accentuated brownish halo. Lesions on the nape show multiple follicular symmetric whitish-yellow clods with brownish halo and well-defined borders. Lesions on the elbows show a reticular pattern with white clods and diffusely distributed brown dots. Histopathology shows basket-woven stratum corneum, spongiosis of the epidermis with vacuolar alteration, and formation of clefts in the basal cell layer. The papillary dermis shows hyaline material which also surrounds the blood vessel and the adnexal structures. There is mild superficial and mid dermal perivascular inflammatory infiltrate of lymphocytes. PAS highlights eosinophilic material in the papillary dermis which also surrounds the blood vessels and the adnexal structures. Alcian blue staining reveals positive staining for hyaline deposits. Conclusion This report highlights the importance to recognize the clinical, dermoscopic and histopathological findings of lipoid proteinosis.
Lipoid Proteinosis of Urbach and Wiethe ; Dermoscopy

Netherton syndrome (NS) is an autosomal recessive genodermatosis characterized by cutaneous and systemic complications (recurrent infections, dehydration, and sepsis). This highlights the urgency of making an accurate diagnosis, especially in infants and children. However, it is important to note that the recognition of NS is usually delayed due to its rarity and similarity to cutaneous disorders with atopiform, erythrodermic, and ichthyosiform presentations. We report a case of a 1-year-old female who was previously diagnosed with a case of infantile psoriasis and was subsequently treated with topical emollients. However, after months of surveillance, the patient developed feeding problems, failure to thrive, recurrent diarrhea, upper respiratory tract, and gastrointestinal infection, leading to repeated hospitalizations. The patient then underwent further clinical examinations and laboratory analysis, which revealed abnormal hair shaft findings, elevated immunoglobulin (Ig) E levels, and normal chromosomal analysis. Multispecialty referrals with other services were done to address the current problems and ensure holistic care for the patient. On her last admission, the patient was given three doses of intravenous Ig therapy with noted improvement in lesion presentation without any systemic symptoms.
Netherton Syndrome