A 33-year-old male had a 22-year history of generalized xanthogranulomas but had a normal lipid profile. He also developed ulcerating plaques on his arm and back that were consistent with cutaneous tuberculosis on histopathologic and polymerase chain reaction PCR studies. In a normolipemic patient with generalized xanthogranulomas, a reactive granulomatous response of histiocytes to infection is explored since these share a common CD 14+ precursor with the macrophages that are vital in tuberculosis.

Human ; Tuberculosis ; Histiocytes ; Tuberculosis, Cutaneous ; Xanthomatosis

OBJECTIVES: The study aimed to confirm the association between androgenetic alopecia (AGA) and Metabolic Syndrome (MetS). It also aimed to determine if early-onset AGA among males and AGA among females increases the risk of developing MetS, and if severity of AGA increases the odds of developing MetS.

METHODS: Observational studies from electronic databases were selected by the consensus of three independent review authors. The Newcastle-Ottawa Scale for assessing the quality of non-randomized studies in meta-analysis was used. Statistical analyses were accomplished using Review Manager software.

RESULTS: A total of 11 case-control studies, one prospective cohort study, and five cross-sectional studies were selected. In the meta-analysis of ten case-control studies and three cross-sectional studies (3840 participants), AGA was significantly correlated with MetS (OR 2.59, 95% CI 1.51 to 4.44; p<0.0005). Early-onset AGA among males (

CONCLUSION: Although the pathophysiology still remains under investigation, the present study points to an association between AGA and MetS. It can be used as a marker to identify patients who should be screened for MetS and managed accordingly.

Alopecia ; Metabolic Syndrome

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

Human ; Neurofibromatosis 1 ; Hypertrichosis ; Neurofibroma

OBJECTIVES: To assess the efficacy and safety of excimer laser in combination with topical standard therapies for treatment of plaque-type psoriasis in comparison to excimer laser alone, standard topical treatment alone, or placebo.

METHODS: A literature search using Medline, Cochrane and HERDIN was conducted. Data were analyzed using mean difference at 95% confidence interval, with heterogeneity determined by I2 test.

RESULTS: Three articles with total of 130 patients fulfilled the inclusion criteria. Topical treatments studied were vitamin analog (calcipotriol), anthralin (dithranol), and steroid (flumethasone pivalate). A subgroup analysis comparing combination therapy and excimer laser alone showed a greater reduction in pooled PASI score reduction (-2.52; 95% CI: -4.28, -0.77) in the combination group after five to six weeks. There was also a significantly greater reduction in cumulative UVB dose (-3.29; 95% CI: -4.29, -2.30) needed for clearing in the combination group. Pigmentation was the commonly observed adverse event in both groups.

CONCLUSIONS: Excimer laser, in combination with topical treatment, is more effective than excimer laser alone, with significantly lower cumulative UVB dose, but the quality of current evidence is low. Long-term controlled trials are warranted to increase our confidence in the estimates of these outcomes.

Lasers, Excimer ; Psoriasis ; Calcipotriene ; Anthralin ; Flumethasone ; Meta-analysis ; Systematic Review

Background: Pruritus can impair quality of life in patients with atopic dermatitis. There is evidence that acupuncture reduces pruritus and disease severity, and improves quality of life. Objectives: This study aimed to determine the efficacy of acupuncture in reducing pruritus intensity, disease severity, and medication use, and improving quality of life. Methods: This was a patient- and assessor-blinded, randomized, placebo-controlled trial. Patients diagnosed with atopic dermatitis underwent twice-weekly acupuncture for 12 weeks, with an 8-week follow-up period. Baseline and weekly assessment were done using standard data collection forms and validated assessment tools. Results: Thirty patients were randomized and 28 patients were eligible for the efficacy analysis. There were no significant differences in the baseline demographic and clinical characteristics between the True Acupuncture group (TA) (n=16) and Sham Acupuncture group (SA) (n=12). Both groups showed reduction in mean itch intensity (visual analogue scale, VAS) (p=0.024) but TA showed greater reduction (p=0.009) that was sustained after end of treatment. There was also a reduction in medication use in both groups. The comparable efficacy of SA to TA is attributed to similar peripheral receptive fields and stimulation of cutaneous C-fibers which depletes the neurotransmitters mediating pruritus and results in tachyphylaxis. Mild adverse events, such as petechiae and erythema, were noted in both groups and resolved spontaneously. Conclusion: Acupuncture is a promising adjunct treatment in atopic dermatitis with significant reduction in pruritus, disease severity and medication use and a trend towards improved quality of life. Studies with larger sample size and comparison to acupuncture points farther from the true acupuncture points are recommended. Trial Registration Food and Drug Administration Philippine Health Research Registry ID PHRR171012-001696
Acupuncture ; Pruritus ; Dermatitis, Atopic