Microcystic lymphatic malformation (lymphangioma circumscriptum) is the most common cutaneous lymphatic malformation, consisting of abnormal, dilated, and tortuous lymphatic vessels in the dermis and subcutaneous tissue. It is due to irregular vessel contraction with subsequent dilatation and fluid build-up that manifests clinically as multiple, grouped, small macroscopic superficial vesicles filled with clear or serosanguineous fluid. The lesions are frequently located over proximal limbs, axillae and chest but may occur on any part of the body. We report a case of lymphangioma circumscriptumin a four-year-old child, partially treated with fractional carbon dioxide laser ablation under local anesthesia. Most of the lesions resolved but the treated areas healed with hypertrophic scarring after one month, which was cosmetically acceptable. Compared to surgical excision, carbon dioxide laser ablation may provide less chances of contractures especially in areas overlying a joint and may be considered as an alternative to more invasive procedures.

Human ; Female ; Child Preschool ; Anesthesia, Local ; Axilla ; Cicatrix ; Contracture ; Dermis ; Dilatation ; Lasers, Gas ; Lymphangioma ; Lymphatic Abnormalities ; Lymphatic Vessels ; Subcutaneous Tissue

Introduction: Primary cutaneous anaplastic large cell lymphoma (PCALCL) is an uncommonly encountered subtype of cutaneous lymphoma under the classification of CD30-positive lymphoproliferative disorders which presents histologically as large atypical lymphocytes with pleomorphic and anaplastic cytology that localizes to the dermis. Although recurrent, PCALCL usually carries a good prognosis, with 5-year survival rates ranging from 85% to 95%. Case Summary: We report a 73-year-old elderly male who consulted at our out-patient department with a 3-year and 6-month history of multifocal, gradually enlarging, erythematous nodules with dry, necrotic areas on the scalp, right auricular area, left axillary area, right forearm, and right thigh, accompanied by loss of appetite and nontender cervical, left axillary, and right inguinal lymphadenopathy. Previous skin punch biopsy and immunohistochemical stain done by the patient’s preceding dermatologist was signed out as “suggestive” of pseudolymphoma. However, management with intralesional corticosteroid injections provided no improvement. Skin punch biopsy done at our institution revealed ALK negative (-) anaplastic large cell lymphoma. Patient was then referred to an oncologist, however, the patient was lost to follow-up and succumbed to community acquired pneumonia. Conclusion This case highlights the importance of a thorough diagnostic assessment as recent studies indicate a poorer prognosis of ALK (-) cases, with overall 5-year survival rates consistently below 50%.
Lymphoma ; Lymphoma, Large-Cell, Anaplastic

We report a case of eumycetoma in a Filipino patient who presented with a solitary reddish brown, moist, multinodular tumor on the dorsum of the left foot of 2 years duration. Biopsy with Periodic acid Schiff (PAS) & Gomori methenamine silver (GMS) staining, fungal culture, ultrasound and X-ray of the foot were done in our institution which confirmed the diagnosis of eumycetoma. The patient was successfully treated with itraconazole 400/day for 3 months, followed by 200mg/day for the succeeding 9 months, leading to complete resolution of the lesion leaving an atrophic hypopigmented scar. A high index of suspicion supported by diagnostic tests aided in the early detection of the disease which also resulted to complete resolution of the disease.
Mycetoma ; Mycoses ; Itraconazole

Background: Human Immunodeficiency Virus (HIV) infection/Acquired Immunodeficiency Syndrome (AIDS) remains a major challenge worldwide. Physicians have a crucial role in the struggle against HIV/AIDS and must be equipped with proper knowledge, attitude and practices (KAP). No study has been done to assess the KAP of dermatologists related to HIV-AIDS. Objective: The study’s objective was to determine the KAP of Philippine Dermatological Society (PDS) members related to HIV/AIDS. Methods: A cross-sectional study was done among PDS members from February to November 2017 utilizing a questionnaire consisting of socio-demographic questions and KAP questions related to HIV. Results: Out of 210 participants, 71.43% show good working knowledge, 60.95% show negative attitudes, 55.71% show bad practices related to HIV/AIDS. Members aged 29 to 37 years old, having worked as dermatologists for 1 to 8 years, and having worked in the health care sector for 1 to 8 years have better working knowledge on HIV/AIDS. Although with lesser duration of work as dermatologist, these members have more positive attitudes towards HIV/AIDS. These findings may be attributed to greater exposure to HIV cases and better ability to access information by internet among younger dermatologists. Gender is not significantly associated with KAP related to HIV/AIDS. Practice related to HIV/AIDS is not significantly associated with any demographic variables. Bad working knowledge related to HIV/AIDS is associated with negative attitude and bad practices. This can be attributed to insufficient training in the field of HIV/AIDS. Conclusion Majority of PDS members show negative attitudes, bad practices, but good working knowledge related to HIV/AIDS.
HIV ; Acquired Immunodeficiency Syndrome ; Knowledge ; Attitude ; Dermatologists