BACKGROUND: Extramammary Paget's disease (EMPD) is a rare intraepidermal adenocarcinoma seen in areas with high density of apocrine glands such as the vulva, perianal area, scrotal and penile regions. Clinically the lesions appear to be well-defined erythematous or white plaques accompanied by pruritus; often misdiagnosed as inflammatory or infectious conditions i.e. psoriasis, candidiasis or dermatitis. At present, there is no retrospective study on the prevalence of EMPD in the Philippines.
OBJECTIVE: This study aimed to conduct a ten-year retrospective review of histologically diagnosed extramammary Paget's disease in the Philippine General Hospital from 1997 to 2006, and confirm the diagnoses by carcinoembryonic antigen immunostain (CEA).
METHODS: Histopathology logbooks and organ files of the PGH Section of Dermatology and PGH Department of Pathology from January 1997 to December 2006 were searched. Records and specimen paraffin blocks of EMPD patients were retrieved for review and CEA immunostain, respectively.
RESULTS: Nine EMPD patients were seen in a ten-year period, eight were positive for CEA, and one had no paraffin block available for review. The vulva was the most common site (89 percent) followed by the perianal area (11 percent), and all patients were females, aged 47 to 86 years old. The most common complaint was pruritus, often misdiagnosed as fungal infection, contact dermatitis, vulvar carcinoma or malignant melanoma; with one week to seven years before a final diagnosis of EMPD was made. Lesions were mostly erythematous, indurated plaques ranging from 0.48 cm to 299 cm with a mean of 120.67 cm . Malignancy was noted in one patient who had breast cancer prior to appearance of vulvar lesions. Surgical removal of the lesion was the main mode of-treatment. Vulvectomy, wide excision or local excision has been done with surgical flaps or grafts depending on the size of the lesion.
CONCLUSION: From 1997 to 2006 the Philippine General Hospital had nine histopathologically diagnosed EMPD, eight of which in the vulvar area and eight had CEA positive staining. Recurrence of lesions and appearance of concomitant malignancy could not be assessed due to the poor follow up of patients and incomplete records.

Human ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Candidiasis ; Carcinoembryonic Antigen ; Dermatitis, Contact ; Melanoma ; Mycoses ; Neoplasm Recurrence, Local ; Paget Disease, Extramammary ; Psoriasis ; Surgical Flaps

BACKGROUND: Extramammary Paget's disease (EMPD) is a rare intraepidermal adenocarcinoma seen in areas with high density of apocrine glands such as the vulva, perianal area, scrotal and penile regions. Clinically the lesions appear to be well-defined erythematous or white plaques accompanied by pruritus; often misdiagnosed as inflammatory or infectious conditions i.e. psoriasis, candidiasis or dermatitis. At present, there is no retrospective study on the prevalence of EMPD in the Philippines.
OBJECTIVE: This study aimed to conduct a ten-year retrospective review of histologically diagnosed extramammary Paget's disease in the Philippine General Hospital from 1997 to 2006, and confirm the diagnoses by carcinoembryonic antigen immunostain (CEA).
METHODS: Histopathology logbooks and organ files of the PGH Section of Dermatology and PGH Department of Pathology from January 1997 to December 2006 were searched. Records and specimen paraffin blocks of EMPD patients were retrieved for review and CEA immunostain, respectively.
RESULTS: Nine EMPD patients were seen in a ten-year period, eight were positive for CEA, and one had no paraffin block available for review. The vulva was the most common site (89 percent) followed by the perianal area (11 percent), and all patients were females, aged 47 to 86 years old. The most common complaint was pruritus, often misdiagnosed as fungal infection, contact dermatitis, vulvar carcinoma or malignant melanoma; with one week to seven years before a final diagnosis of EMPD was made. Lesions were mostly erythematous, indurated plaques ranging from 0.48 cm to 299 cm with a mean of 120.67 cm . Malignancy was noted in one patient who had breast cancer prior to appearance of vulvar lesions. Surgical removal of the lesion was the main mode of-treatment. Vulvectomy, wide excision or local excision has been done with surgical flaps or grafts depending on the size of the lesion.
CONCLUSION: From 1997 to 2006 the Philippine General Hospital had nine histopathologically diagnosed EMPD, eight of which in the vulvar area and eight had CEA positive staining. Recurrence of lesions and appearance of concomitant malignancy could not be assessed due to the poor follow up of patients and incomplete records.

Human ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Candidiasis ; Carcinoembryonic Antigen ; Dermatitis, Contact ; Melanoma ; Mycoses ; Neoplasm Recurrence, Local ; Paget Disease, Extramammary ; Psoriasis ; Surgical Flaps

BACKGROUND: The high rates of infestation, treatment failures and treatment costs have created the search for new therapies againts head lice.

OBJECTIVE: We compared the efficacy and safety of scalp occlusion with petroleum jelly (PJ) versus permethrin 1% shampoo against Pediculus humanus capitis among school-aged children

METHOD: Seventy-seven children were diagnosed with Pediculosis capitis. Thirty-eight subjects did eight-hour scalp occlusion with PJ, and 39 used permethrin shampoo, both followed by nit combing. Treatments were applied once weekly for three consecutive weeks. Patients were assessed at weeks 1,2,3 and 11. The primary outcome was the proportion of cured subjects and change in quality of life (QOL) scores om week 3 of follow-up. Cure was defined as the absence of variable lice on the hair/scalp or nits on the hair shaft attached within one centimeter from the scalp on visual examination.Secondary outcomes were relapse rate at week 11 ,cosmetic acceptability and adverse events. Effects on QOL were measured using the Dermatology Life Quality Index at baseline and at the end of the third week of treatment.

RESULTS: At Week 3, cure achieved in 47% (18/38) in PJ group 52% (17/33) in permethrin group (RRR 6.7%, 95% Cl: -40.4% to 38%). Relapse rate in the 12th week were 44% (8/18) and 58% (10/17), respectively (p=0.486, Fisher's test ). The differences in treatment effects were not statistically significant.

CONCLUSION: Petroleum jelly scalp occlusion was comparable in cure rates to permethrin. PJ can be a safe, affordable alternative to permethrin as a pediculicide.

Human ; Petrolatum