COVID-19-associated vasculitis is a term used to describe a genuine vasculitis associated with SARS- COV-2 infection when all other possible causes of vasculitis have been ruled-out. We report a case of a 66- year-old-male, reinfected by COVID-19 after 5 months, who presented with a 2-week history of multiple petechiae on bilateral anterior legs that gradually evolved into targetoid purpura with central blisters, spreading to the proximal medial thighs and the trunk, associated with pruritus and a warm sensation over the affected areas. The patient also presented with marked periorbital swelling, abdominal and joint pains, and decreased kidney function. Histopathology of the skin biopsy showed leukocytoclastic vasculitis while direct immunofluorescence study came out positive result for fibrinogen but negative for IgA, IgG, IgM and C3. Skin lesions resolved and kidney function improved prior to discharge after treatment with IV antibiotics (azithromycin 500 mg and ceftazidime 1 g) and IV steroids (hydrocortisone 50 mg). Recurrence of the vasculitic skin lesions occurred 2 weeks after being tagged as COVID-recovered but improved after 14 days of treatment with oral prednisone. We highlight the importance of recognizing cutaneous vasculitis as a possible marker of a severe COVID-19 disease which could be in the form of single-organ damage particularly acute kidney injury.
case report

Acute ; Syndrome ; Case Report

Large ; Cysts ; Case Report

Obesity is an epidemic and a major public health concern, with 800 million obese people worldwide and 27 million in the Philippines. Several guidelines have recommended that all adults be screened for obesity and that obese patients be offered intensive, multi-component behavioral interventions. Barriers to addressing obesity include insufficient time during visits, a lack of available referral services, the perception that patients will not be willing or able to make lifestyle changes, poor reimbursement for nutrition and weight-management counseling, a reluctance to discuss weight among physicians, and uncertainty about whether interventions will have a positive impact. Lifestyle medicine interventions and smartphone diet-tracking apps may help individuals lose weight, manage chronic conditions, and understand dietary patterns. This is a case report of a 31-year-old obese Filipino male who sought consultation at the Health and Lifestyle Institute with a complaint of 11 kg of weight gain over the past 4 years. He had previously been diagnosed with Hodgkin’s lymphoma and had previously undergone chemotherapy and radiation therapy. He was currently working as a resident physician at a private institution. He considered himself physically active and was thus concerned with his gradual weight gain and the resultant decrease in body image, as well as his overall health. A detailed history and physical examination were done, as were the examinations of the six pillars of lifestyle medicine, namely, diet, exercise, sleep, stress, relationships, and substance use. The GAD 7 and PHQ 9 screening questionnaires were given. Lifestyle prescription and setting of goals were then done, and the patient was followed up at a 4-month interval. On all visits, body fat analysis using a Karada scan was done, and the results were discussed with the patient. On the second follow-up consult, the patient reported the usefulness of a diet-tracking application he found called Lifesum. The patient lost a total of 13 kg and improved his overall sense of well-being.
Obesity ; case report ; Asian ; male

Patency of ; seconds ; Fistula ; Case Report

seconds ; penis ; Fractures ; Case Report

Tension ; Pneumonia ; Infant ; Case Report

After values ; Syndrome ; Case Report

seconds ; Retropharyngeal Abscess ; Case Report

Pemphigus, Benign Familial ; Case Report