OBJECTIVE: To investigate the different treatment modalities employed for melasma by practicing dermatologists in the Philippines. BACKGROUND: Melasma is a prevalent skin condition among Filipinos due to our skin type and climate. To date, no local studies have been done investigating the different treatment regimens practiced/ employed by Filipino dermatologists in treating melasma. METHODS: This is a descriptive study investigating the different treatment strategies used by Filipino dermatologists using a questionnaire.The questionnaires were given to practicing Filipino dermatologists personally during conferences and conventions held in 2005 as well as to the different Philippine Dermatological Society accredited training institutions and private clinics of the doctors. The total sample size was 117. RESULTS: Melasma is frequently seen among Fitzpatrick skin type IV (50%),females, 41-50 year-old age group (50%) and commonly on the cheeks (98%). Grade 2 severity melasma was often seen by 75% of the respondents. The top 3 topical depigmenting agents of choice are tretinoin, hydroquinone and combination therapy. Microdermabrasion was preferred by 43.5% of the respondents over laser. Once combination treatment regimens fail, laser treatment more than doubled to 28.7%. Vitamin C (37.7%) and glutathione (31.6%) are the most common oral maintenance therapy given by the respondents. Half of all the respondents advise continuous maintenance therapy while a third of them advise maintenance for a year. The most common side effect of melasma treatment is erythema according to 51% of the respondents followed largely by hyperpigmentation (23%) and scaling (22%). More than half of the dermatologists surveyed stop the treatment regimen when side effects are observed. Almost all respondents advise patients to use sunblock daily and majority of respondents prescribe both UVB and UVA sunblocks.

Human ; Female ; Ascorbic Acid ; Cheek ; Dermatologists ; Erythema ; Glutathione ; Hydroquinones ; Hyperpigmentation ; Melanosis ; Philippines ; Skin Lightening Preparations ; Sunscreening Agents ; Surveys And Questionnaires ; Tretinoin

Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive dermal and subcutaneous mesenchymal neoplasm that often presents as a slow-growing lesion on the trunk, proximal extremities, head and neck. We report a rare case of DFSP arising on the dorsum of the left hand. A 35-year-old male, who presented with a solitary verrucous nodule on the dorsum of the left hand and had experienced two recurrences of the lesion following local excision and electrocautery. Histopathologic examination was consistent with DFSP. CD34 immu-nostain was positive. Wide surgical excision with a three centimeter margin and direct skin closure was done. Although metastasis is rare, DFSP is associated with marked tendency towards local recurrence after surgery hence patient is for follow-up every six to twelve months post operatively.
Dermatofibrosarcoma

Atrophoderma of Pasini and Pierini (APP) is an idiopathic disorder of dermal atrophy, presenting as round or oval depressed lesions most commonly observed on the trunk and extremities. Herein, we report the first case of APP initially appearing on the head. Histopathologic examination of lesional skin demonstrated a decrease in elastic fibers. Serologic tests for Borrelia and antinuclear antibody titers were negative. There was no noted improvement after 6 weeks tretament with Hydroxycholoroquine 200 mg/tab BID. Definitive disease etiology and treatment of APP remains to be elucidated.