Bullous pemphigoid (BP) is an acquired sub-epidermal immune-mediated blistering disease associated with a humoral and cellular response directed against self-antigens. Childhood BP is uncommon with only <80 reported cases in literature.Often,  lesions of childhood BP are localized rather than widespread; and, acral distribution is more common among infants. Clinically, it is often confused with chronic bullous disease of childhood (CBDC). BP can be differentiated from CBDC by the presence of immunoglobulin (Ig) G antibodies, rather than IgA at the basement membrane zone on direct immunofluorescence (DIF). We present a case of childhood BP in a one-year-old baby girl who presented with CBDC-like lesions. DIF showed IgG and C3 at the basement membrane zone. Treatment given included topical and oral sterioids due to the extent of lesions as well as antihistamine to reduce pruritus. Most of the lesions improved after two weeks and 80% resolved after two month of treatment with no note of scarring. However, continuous monitoring of the patient is advised due to the need for long-term treatment of these patients.

Human ; Female ; Infant ; Autoantigens ; Basement Membrane ; Blister ; Cicatrix ; Histamine H1 Antagonists ; Immunoglobulin A ; Immunoglobulin G ; Linear Iga Bullous Dermatosis ; Pemphigoid, Bullous ; Pruritus

BACKGROUND: Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF) are now considered as major health problems in the Philippines. N,N,-dietyl-3-toluamide (DEET) is recognized as the most effective against Aedes aegypti. However, the concern about its use have underscored the need to find a safer alternative repellent.
OBJECTIVES: This study aims to determine and compare the repellent activity of tea tree (Melaleuca alternifolia) oil against Aedes aegypti with 7% DEET using a double-blind controlled experimental trial
METHODOLOGY: Twenty healthy subjects were allocated systematically by alternate assignment into three treatment groups (Control vs. Tea Tree oil, control vs. 7 percent DEET, Tea Tree oil vs DEET). All subjects were exposed to Aedes aegypti for 5 minutes every hour for 8 hours and the number of mosquitoes biting/landing were recorded and compared for each treatment group
RESULTS: Fifty percent tea tree oil has a repellent activity against Aedes aegypti and its efficacy is comparable to 7% DEET. Both treatments were equally effective in repelling mosquitoes for 7 hours. No cutaneous reactions to both repellents were noted
CONCLUSION: The efficacy of tea tree oil is comparable to 7% DEET and is recommended as an alternative natural mosquito repellent.

Human ; Aedes ; Deet ; Dengue ; Healthy Volunteers ; Insect Repellents ; Melaleuca ; Severe Dengue ; Tea ; Tea Tree Oil ; Trees

BACKGROUND: Mosquito bite is a common dermatological complaint with various treatments but with no gold standard treatment regimen. OBJECTIVE: To compare the safety and efficacy of 0.025% capsaicin cream against 1% hydrocortisone cream and placebo as anti-inflammatory and anti-pruritic preparation for mosquito bites. METHODS: Seventy-five volunteers were enrolled in the placebo-controlled trial and randomized into three treatment groups. They were exposed to laboratory-reared mosquitoes to incur bites and to apply the designated cream. Anti-inflammatory and anti-pruritic effects were determined by mean lesion size, physician's global assessment, pruritus intensity score and 100mm visual analog scale. RESULTS: The mean lesion size and physician's global assessment, pruritus intensity score and visual analog scale showed no significant difference between 0.025% capsaicin and 1% hydrocortisone and they were both found to be superior to placebo (p-value< 0.001 using repeated measures of ANOVA; Kruskal-Wallis test). CONCLUSION: 0.025% capsaicin is comparable to 1% hydrocortisone as an anti-inflammatory and anti-pruritic preparation for mosquito bites.

Human ; Animal ; Male ; Female ; Analysis Of Variance ; Capsaicin ; Cortisone ; Culicidae ; Hydrocortisone ; Insect Bites And Stings ; Pruritus ; Visual Analog Scale ; Volunteers

Introduction: There are very few reported incidences of juvenile dermatomyositis in the Philippine setting. Case Summary: This is a case of a 9-year-old female from Batangas City, who came in with a 3-year history of multiple non- tender, non-pruritic erythematous papules which started on the dorsal aspect of the metacarpophalangeal (MCP) and interphalangeal joints of the hands, with some progressing into plaques on the face and extremities. No other associated symptoms such as fever, cough, colds or weakness were noted. Three months prior to consult, there was persistence of the above-mentioned lesions with body weakness described as difficulty getting out of bed and climbing stairs. Consult with a dermatologist and rheumatologist was done. A skin punch biopsy showed hyperkeratosis of the stratum corneum. There was focal vacuolar alteration of the basal cell layer with thickening of the basement membrane zone. The papillary dermis showed pigment-laden macrophages, a calcified nodule, fibrosis, and a sparse perivascular inflammatory infiltrate of lymphocytes. There was also thickening of the basement membrane zone on Periodic acid-Schiff stain. Both clinical and histopathological findings point to Juvenile Dermatomyositis. Conclusion Juvenile Dermatomyositis requires prompt diagnosis for proper treatment and prognostication. This entails extensive diagnostic procedures such as skin punch biopsy, muscle enzymes such as CK-MB and CK- MM, and blood tests. Co-management with a pediatric rheumatologist is highly advised for initiation and regulation of oral corticosteroids as well as vitamin supplementation.
Dermatomyositis ; Connective Tissue ; Rheumatology

Background: Superficial pyoderma is an infection most commonly caused by Staphyloccoccus aureus. The drug of choice is 2% mupirocin cream. However, high cost and emerging drug resistance affect compliance and overall cure. Tinospora rumphii has demonstrated antibacterial activity in vivo rendering it a potential cost-effective alternative treatment. Objectives: To determine the safety and efficacy of 25% T. rumphii cream versus 2% mupirocin cream in the treatment of superficial pyodermas caused by S. aureus. Methods: A randomized, double-blind, controlled study of 60 patients with superficial pyodermas caused by S aureus, aged 18-60, were given either 25% T. rumphii or 2% mupirocin cream for two weeks. Bactericidal activity, erythema, edema, induration and size of lesion were evaluated at baseline, days 3, 7, and 14. Participants Global Assessment (PGA) score and adverse events were noted. Statistical analysis was done using Mann-Whitney U and Pearson Chi square test. RESULTS: Fifty-one subjects (85%) completed the trial. There were no statistically significant differences between the two treatment groups for bactericial activity against Staphylococcus aureus (p=0.687) at day 14, for erythema (p=0.923, 0.5335, 0.3726, 0.6949), edema (p=0.0972, 0.5967, 0.2052, 0.2783), induration (p=0.0855, 0.3113, 0.281, 0.3161), and size of lesions (p=0.7262, 0.169, 0.15, 0.3988) at baseline, days 3, 7 and 14. There was no significant difference in PGA score (p=0.3086, 0.3483, 0.2234) at Days 3, 7 and 14 in both groups. No adverse events were noted. Conclusion Twenty five percent T. rumphii cream is equally safe and effective as 2% mupirocin cream for treatment of superficial pyodermas caused by S. aureus.
Mupirocin ; Staphylococcus aureus

Background: Virgin coconut oil (VCO) has been reported to have anti-inflammatory and anti-pruritic properties and can be used as an alternative to corticosteroids for mosquito bites. No studies on VCO for mosquito bites have been published. Objective: To compare the safety and efficacy of VCO against 1% Hydrocortisone as an anti-inflammatory and anti- pruritic preparation for mosquito bites. Method: This is a randomized, double-blind study comparing the anti-inflammatory and anti-pruritic effect of VCO versus 1% Hydrocortisone on Aedes aegypti bites, by measuring the mean lesion size, subjective assessment of the effects on bites, pruritus intensity through the visual analog, and verbal rating scale in 91 subjects at baseline, 1 hour, days 1, 3, and 7. Results: During the first hour and throughout the seven-day period, there was a decrease in the mean lesion size, visual, and verbal scale score for both VCO and Hydrocortisone groups. The mean lesion size for both groups were not statistically significant on the 1st and 24th hour. On day 3, the mean lesion size for the VCO group was 0.02 and 0.71 for the Hydrocortisone group which was statistically significant in favor of VCO. The mean visual and verbal scale scores for pruritus for both treatment groups were not statistically significant. As early as the 1st hour, the proportion of patients who reported total clearance of lesions in the VCO group was 34.09% compared to 6.38% in the Hydrocortisone group. On day 7, both treatment groups had resolution of lesions. No adverse reactions were noted. Conclusion Virgin coconut oil is safe, cost-effective, and comparable to 1% Hydrocortisone as an anti- inflammatory and anti-pruritic agent.
Coconut Oil ; Hydrocortisone ; Anti-Inflammatory Agents

Background: Ophthalmologic evaluation is often neglected in routine screening of Hansen’s disease patients. In line with the global aim of reducing grade 2 disability, eye examination should be an essential part of routine examination of Hansen’s disease patients. Objective: To describe the ophthalmologic profile of patients with Hansen’s disease seen in a tertiary hospital. Methods: A point-prevalence survey was conducted. Sixty-six Hansen’s disease patients, aged 18 and above, underwent complete ophthalmologic examination including visual acuity, refraction, external eye examination, intraocular pressure determination, dilated pupil examination, palpebral aperture measurement, corneal sensation testing, and tear breakup time determination. Statistical analysis was done. Results: All patients had ocular findings with lepromatous leprosy (62%) being the highest. Fifty-three percent had Type 2 lepra reaction. Most were males, disease duration in majority was < 5 years and bacillary morphologic index was 4.0 – 4.99. Patients with Grade 1 and Grade 2 disability of the eyes were 62% and 17% respectively. The most common ocular complications were: abnormal tear breakup time (79%), cataracts (53%),blepharitis (47%), madarosis (39%) and corneal opacities (24%). Conclusion There is a significant number of ocular findings among leprosy patients in this study. The highest number of ocular complications is among patients in the lepromatous pole. There is a preference of M. leprae for cooler areas; hence, the anterior chamber was greatly affected.
Leprosy