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

BACKGROUND: The ubiquity of complementary and alternative medicine (CAM) mirrors patient interest and use. Nonetheless, many physicians are still hesitant to recommend and use CAM.
Objective: To determine the knowledge, attitudes and practices of Philippine-based dermatologists regarding CAM.
METHODS: This was a cross-sectional survey using a self-administered questionnaire. An in-depth interview was conducted among selected respondents.
RESULTS: A total of 148 dermatologists responded. Most had adequate knowledge (58.78%) and a positive attitude about CAM (81.08%). Most respondents reported patient interest in CAM (70.95%) and recommended CAM (87.24%) for dermatologic conditions. Among respondents who recommended CAM, most recommended CAM as a complement to conventional treatment (73.76%) rather than as an alternative. Personal CAM use was reported by 30.41%. A positive attitude about CAM was directly related to increased likelihood of recommending CAM to patients (p=0.00) and to personal use of CAM (p=0.003).
CONCLUSIONS: Respondents generally had a positive attitude about CAM and were open to recommending CAM as a complement to conventional treatment for dermatologic conditions.

Human ; Male ; Attitude ; Complementary Therapies ; Dermatologists ; Knowledge ; Philippines ; Physicians ; Surveys And Questionnaires

Behcet Syndrome ; history ; Dermatologists ; Dermatology ; history ; France ; History, 20th Century ; Humans ; Philately ; Turkey

BACKGROUND: Quality systematic reviews (SRs) are essential in the practice of evidence-based dermatology. We assessed the methodologic quality of SRs in dermatology from the Philippines. METHODS: We searched databases (MEDLINE, CDSR, PROSPERO, HERDIN; from inception until June 30, 2019), and secondary sources. We included SRs, authored by Filipino primary authors, which included clinical trials on any intervention for the treatment or prevention of a dermatologic disease or for maintenance of healthy skin, hair or nails. Two reviewers independently extracted data and appraised the methodological quality of each included SR using the AMSTAR 2. The 16-item AMSTAR 2 has 7 critical items and 9 non-critical items. The number of critical items mainly determine the overall confidence in the results of the review. Descriptive analysis using means and standard deviation for continuous data, and frequency and percentage distribution for categorical data were employed. RESULTS: Twenty SRs were included in this review, and were mostly published in the 2010s. Majority of SRs had three authors, who belonged to a single institution, with at least one dermatologist. The most common topic was infections and both oral and topical interventions were used. Majority had 5 included studies in the SRs, with a median number of 425 participants. The median number of critical flaws in the included SRs was 4.5, and non-critical flaws, 5. Overall confidence was critically low in majority (19/20 ) of included reviews, with only one review rated as low. CONCLUSION: The methodologic quality of the dermatology SRs from the Philippines based on the AMSTAR 2 tool was poor with a rating of critically low in majority. There is a need to improve quality of conduct and reporting through dissemination of the reporting guidelines such as the PRISMA
Humans ; Nails ; Philippines ; Dermatologists ; Dermatology ; Data Management ; Data Collection ; Publications ; Maintenance ; Reference Standards

Glutathione (GSH) is a naturally produced tripeptide composed of glutamine,glycine,and cysteine. GSH has several important metabolic and regulatory functions in our body but it is most popular for its antioxidant role. Oxidative stress states such as chronic diseases or low protein levels can deplete intracellular glutathione. Glutathione levels may be increased by correcting any protein deficiency, administering glutathione supplements or other precursors, usually by oral or intravenous routes. Glutathione supplements are generally considered safe to administer either intravenously or orally. Dermatologists need basic knowledge about glutathione supplements need to be scientifically studied by dermatologists before these supplements become part of our therapeutic options.

Human ; Antioxidants ; Biological Products ; Chronic Disease ; Cysteine ; Dermatologists ; Dietary Supplements ; Glutamine ; Glutathione ; Glycine ; Oxidative Stress ; Protein Deficiency

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

Basal cell nevus syndrome (BCNS) is a rare autosomal dominant multisystem disorder due to a mutation in the PTCH1 gene. Dermatologic manifestations include basal cell carcinoma (BCC) and palmoplantar pits. This case of childhood-onset BCC arising in a child of Filipino descent with BCNS illustrates the importance of early detection and diagnosis, which will then facilitate early counseling and management of this lifelong condition. An 11-year-old Filipino-American girl presented with multiple variegated pearly papules on the face, clavicular area and upper back. She also had multiple palmoplantar pits. Shave biopsy of a papule showed BCC. Trans-abdominal ultrasound revealed bilateral ovarian calcifications. Jaw and chest radiography were unremarkable. Skin lesions were initially treated with ablative erbium:YAG laser and later recurred after 3 months. Imiquimod cream was then started which resulted in partial resolution of lesions after 12 weeks. The dermatologist's role in the diagnosis of BCNS is integral, especially in this case where the patient is a seemingly well child with predominantly dermatologic manifestations. Clinical findings of BCNS, including BCC, are recurrent. Lifetime monitoring, counseling and adequate patient education and appropriate treatment of lesions are central to the management of this condition.

Human ; Female ; Child ; Aminoquinolines ; Basal Cell Nevus Syndrome ; Biopsy ; Carcinoma, Basal Cell ; Dermatologists ; Erbium ; Lasers, Solid-state ; Mutation ; Neoplasm Recurrence, Local ; Skin ; Skin Neoplasms

Tuberous sclerosis complex (TSC) is an autosomal dominant condition where loss-of-function mutation in 2 tumor suppressor genes, hamartin and tuberin, result in hamartoma formation in multiple organs, notably the skin, brain, kidney, retina, lungs, and heart. Many of the diagnostic features for TSC involve the skin. Because TSC is relatively rare even among Filipinos, there is limited data on the use of any treatment modality which addresses the cutaneous aspects of this disease in this population. A 33-year-old Filipino male presented with multiple skin-colored to hyperpigmented papules and nodules on the centrofacial area, which gradually progressed in size and number since childhood. He had normal growth and development. Family medical history was significant for a brother with similar facial lesions who died of a brain tumor in childhood. Further physical examination revealed shagreen patches, ashleaf spots, confetti macules, periungual fibromas, gingival fibromas and dental pitting. Work-up revealed the presence of renal angiomyolipomas and retinal hamartomas. A diagnosis of TSC was made. Histopathology of a facial nodule was consistent with angiofibroma. Desiring cosmesis, the patient underwent 2 sessions of ablation of the facial angiofibromas using a carbon dioxide laser (ESC/Sharplan) at 1.0W 3mm spot size at continuous mode, spaced one month apart. Follow-up at one month and six months post-treatment showed satisfactory results described as flattening of lesions with no noted recurrence of lesions. The dermatologic manifestations of TSC comprise majority of the features needed for diagnosis, and may warrant treatment because of cosmetic disfigurement. The role of the dermatologist in the recognition, diagnosis and management of this condition is emphasized. This case of a Filipino patient with TSC demonstrates that carbon dioxide laser treatment is effective for the facial angiofibromas of TSC, although the risk for recurrence is high. Definitive treatment still entails addressing the underlying genetic defect.

Human ; Male ; Adult ; Angiofibroma ; Angiomyolipoma ; Brain ; Brain Neoplasms ; Dermatologists ; Fibroma ; Genes, Tumor Suppressor ; Hamartoma ; Mutation ; Neoplasm Recurrence, Local ; Retina ; Tuberous Sclerosis ; Tumor Suppressor Proteins

Basal cell nevus syndrome (BCNS) is a rare autosomal dominant multisystem disorder due to a mutation in the PTCH1 gene. Dermatologic manifestations include basal cell carcinoma (BCC) and palmoplantar pits. This case of childhood-onset BCC arising in a child of Filipino descent with BCNS illustrates the importance of early detection and diagnosis, which will then facilitate early counseling and management of this lifelong condition. An 11-year-old Filipino-American girl presented with multiple variegated pearly papules on the face, clavicular area and upper back. She also had multiple palmoplantar pits. Shave biopsy of a papule showed BCC. Trans-abdominal ultrasound revealed bilateral ovarian calcifications. Jaw and chest radiography were unremarkable. Skin lesions were initially treated with ablative erbium:YAG laser and later recurred after 3 months. Imiquimod cream was then started which resulted in partial resolution of lesions after 12 weeks. The dermatologist's role in the diagnosis of BCNS is integral, especially in this case where the patient is a seemingly well child with predominantly dermatologic manifestations. Clinical findings of BCNS, including BCC, are recurrent. Lifetime monitoring, counseling and adequate patient education and appropriate treatment of lesions are central to the management of this condition.

Human ; Female ; Child ; Aminoquinolines ; Basal Cell Nevus Syndrome ; Biopsy ; Carcinoma, Basal Cell ; Dermatologists ; Erbium ; Lasers, Solid-state ; Mutation ; Neoplasm Recurrence, Local ; Skin ; Skin Neoplasms

Neurocutaneous melanosis (NCM) is a rare congenital syndrome characterized by the development of congenital melanocytic nevi and benign or malignant melanocytic tumors of the central nervous system. Neurologic symptoms usually manifest during the first two years of life with a high mortality rate.
This is a case of a 3-year-old girl presenting with generalized large and multiple hyperpigmented macules and patches, some with hair, over the scalp, face, trunk, and extremities, present since birth. Histologic findings of a nodule within a nevus include nested melanocytes at the epidermis, cords and strands of melanocytes extending to the deep reticular dermis showing maturation with descent and lack of mitosis consistent with melanocytic nevi. The cranial magnetic resonance imaging contrast study revealed melanocytic deposits on the cerebellum and amygdala. She has regular follow-up with her dermatologist, pediatrician, and neurologist. The patient has remained asymptomatic of neurological symptoms despite the melanocytic deposits in the central nervous system.

Human ; Female ; Child ; Amygdala ; Cerebellum ; Dermatologists ; Dermis ; Epidermis ; Hair ; Melanocytes ; Melanosis ; Mitosis ; Neurocutaneous Syndromes ; Neurologists ; Nevus ; Nevus, Pigmented ; Scalp ; Skin Neoplasms