Hailey-Hailey Disease (HHD) is a rare, chronic skin condition characterized by relapsing episodes and spontaneous remissions, significantly affecting patients’ quality of life, especially in severe cases. Due to its rarity, there are no established evidence-based treatment guidelines or extensive clinical trials. This case report highlights the rapid improvement of HHD in a 55-year-old Filipino woman treated with a combination of 5-fluorouracil and excimer phototherapy, suggesting that this treatment approach may be an effective alternative for managing the disease.

Dystrophic epidermolysis bullosa (DEB) is characterized by blisters that heal with scarring and milia formation, including nail dystrophy, with an incidence of 2.1 per million live births. DEB is derived from defects of the anchoring fibril which results in sublamina densa separation.

We report a one-month old female who presented with vesicles and erosions on bilateral feet at birth. New vesicles and bullae were noted on other areas of the body such as the scalp, ears, anterior trunk, gluteal area, and extremities which spontaneously ruptured leading to erosions and crusts. Nails were thick and yellowish black. Consult was done at a clinic and was given unrecalled antibiotic, antihistamine, and cream for one week. There was no noted improvement hence she was brought to another clinic, diagnosed as staphylococcal scalded skin syndrome, advised admission and subsequently referred to dermatology service. After clinical assessment, findings of cell poor subepidermal blister on histology, linear C3 on DIF, and positive collagen 7 on ELISA, patient was managed as a case of dystrophic epidermolysis bullosa.

Epidermolysis bullosa is an inherited genetic disease with mutation in COL7A1 gene manifesting as vesicles and bullae on trauma prone areas. The diagnosis is based on clinical, histopathology, immunofluorescence, antigen studies, and electron microscopy. Uniquely, immunofluorescence revealed strong linear deposition of C3 at the basement membrane zone which is more suggestive of bullous pemphigoid than epidermolysis bullosa. This case highlights the importance of early diagnosis and proper management of the disease to limit unnecessary intervention.

Lupus vulgaris is a form of cutaneous tuberculosis (CTB) caused by Mycobacterium tuberculosis (MTB). It is characterized by a usually solitary, long-lasting skin lesion that most commonly develops on the head or neck, especially the nose, cheek, earlobe, or scalp.

A 69-year-old elderly, Filipino female presented with a 20-year history of progressively growing erythematous ulcerative plaques on the right arm and ear, with associated mild pruritus and pain. She appeared to be immunocompetent and had no clinically apparent underlying focus of TB infection. Tuberculin skin test (TST) showed a positive reaction and histopathologic examination revealed a chronic granulomatous dermatitis that is focally positive for acid-fast bacilli (AFB). She was given anti-koch’s therapy with subsequent resolution of the lesions.

The case report presents a rare instance of lupus vulgaris (LV) in a Filipino woman, characterized by large, ulcerative plaques on her body with no apparent infection source, emphasizing the need for early detection and Quantiferon-TB Gold (QFT-G) testing for diagnosis.

Vascular malformations are aberrant proliferations of blood vessels that may present at birth or develop subsequently. Capillary malformations (CMs) represent the most common category of vascular malformations. They generally present as localized discoloration, including port-wine stains (PWSs) and telangiectasia. Certain PWSs, especially those affecting the V2 dermatome, may give rise to pyogenic granulomas or other epithelial or mesenchymal hamartomas.

We present a case of a 46-year-old male with a 5-year history of a solitary, progressively enlarging firm papule on an erythematous patch or “birthmark” on his left cheek. Despite infrequent manipulation, there were no reports of bleeding or any associated symptoms, including pain, pruritus, and thrills. The patient sought consultation for cosmetic reasons and wanted to have the lesion removed. Hence, an excision biopsy revealed a well-defined proliferation of mature thick and thin-walled vessels, lined by a single layer of endothelial cells, surrounded by dysmorphic and irregularly arranged vessels consistent with arteriovenous malformation with capillary malformation.

Capillary malformation (CM) is the most common form of vascular malformation. Fifty percent of port-wine stains (PWSs), which is the most common (CM) in children, are in the face area innervated by the second branch of the trigeminal nerve. Arteriovenous malformations manifest in the advanced stages of PWSs and, alongside pyogenic granuloma, represent underreported histological changes inside mature PWSs, especially in the face area innervated by the second branch of the trigeminal nerve (V2).

Background: Turmeric demonstrated anti-inflammatory properties in laboratory and clinical studies that suggest its usefulness in psoriasis. This is the first randomized controlled trial comparing the efficacy and safety of turmeric 1% cream to clobetasol propionate 0.05% cream in the treatment of plaque-type psoriasis. Objectives: To determine the efficacy and safety of turmeric 1% cream versus that of clobetasol propionate 0.05% cream in the treatment of plaque-type psoriasis. Methods: This was a randomized, double-blind clinical trial to determine the proportion of patients with clinical remission. Secondary outcomes namely mean PASI and pruritus scores per visit, time to remission and incidence of adverse effects were also determined. Results: Fifty-nine patients were randomized into two groups: a turmeric (n=30) and a clobetasol (n=29) group. After four weeks of treatment, there was no significant difference (p=0.36) in the proportions of patients with clinical remission in the turmeric group (5/20, 25%) and the clobetasol group (8/23, 35%) (RR 1.15, 95% CI 0.78-1.70). The average time to achieve clinical remission was 4 weeks in the turmeric group and 3.38 ± 1.06 weeks in the clobetasol group (p=0.07). There was no significant difference in post-treatment mean PASI scores in turmeric (8.77 ± 5.71) and clobetasol (7.26 ± 6.04) groups (p=0.40). Post-treatment mean pruritus scores in turmeric (6.9 ± 2.83) and clobetasol (5.83 ± 3.87) groups (p=0.30) were also statistically comparable. Two patients in the clobetasol group developed folliculitis. Conclusion Turmeric 1% cream demonstrated comparable efficacy and safety with clobetasol 0.05% cream in the treatment of mild to moderate plaque-type psoriasis.
Curcuma ; Clinical Trial

Introduction: Cushing syndrome caused by application of topical corticosteroids is rarely reported. Systemic side effects like suppression of hypothalamic-pituitary-adrenal axis, growth retardation in children and iatrogenic Cushing syndrome can occur even in small doses of potent topical steroids.1 Case Summary: This is a case of a 3-month old female who was referred to our department due to generalized erythema with desquamation. History revealed that the patient had recurrent eczema and the mother applied an over-the-counter medication containing Ketoconazole+Clobetasol 10mg/500mcg per 7-gram cream thrice daily for ten weeks. The estimated topical steroid applied weekly was around 8.5 grams and at time of admission, the patient had been exposed to approximately 50 grams of a potent topical corticosteroid. The patient presented with fever, irritability, and had positive Nikolsky sign thus managed as a case of staphylococcal scalded skin syndrome associated with topical steroid – induced iatrogenic Cushing syndrome. Unfortunately, patient’s condition worsened and with progressive pneumonia, she expired on the 23rd hospital day. The fatal outcome was due to SSSS which was complicated by progressive pneumonia and topical steroid – induced iatrogenic Cushing syndrome. The complex interplay of these features eventually led to sepsis and death. Conclusion This case highlights the risks related to abuse of potent steroid-containing preparations and the importance of education to prevent severe and catastrophic outcomes of injudicious steroid use.
Staphylococcal Scalded Skin Syndrome