Erythrodermic psoriasis is the least common and most severe variant of psoriasis manifesting as erythema and scaling affecting more than 75% body surface area. Infections, such as COVID-19, are proposed triggers due to provoking immune responses that can progress into a hyperinflammatory state. We present a case of a patient with a history of psoriasis evolving into an erythrodermic form after infection with COVID-19 virus.

A 50-year-old female, clinically diagnosed with plaque type psoriasis for 12 years, sought emergency consult then was admitted due to persistence of generalized erythematous scaly plaques, with accompanying skin and joint pains as well as high grade fever. Definitive diagnosis was done with clinicopathologic correlation including dermoscopy and skin punch biopsy. The patient’s Psoriasis Area and Severity Index (PASI) was 70.2, indicating severe score. SARS-COV-2 RT-PCR was done, revealing a positive result for the causative agent of COVID-19. A multidisciplinary approach to treatment was done with dermatology, rheumatology, and infectious disease services. Medications include antibiotics, antimetabolites, pain medications, and topical steroids. The patient was discharged then would follow-up with the dermatologist with phototherapy and with the rheumatologist. After completing treatment, most lesions have recovered.

Erythrodermic psoriasis is a severe and uncommon form of psoriasis that may be exacerbated by various infections such as COVID-19. Proper history, physical examination, and use of diagnostic procedures can aid in pinpointing the cause of the disease which will be indispensable in managing such patients.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Covid-19 ; Erythroderma ; Dermatitis, Exfoliative ; Psoriasis

BACKGROUND: There is a paucity of local literature focusing on childhood psoriasis.
OBJECTIVE: To describe the clinico-demographic profile of childhood psoriasis patients seen in the Philippine General Hospital (PGH) dermatology outpatient clinic.
METHODS: Records of psoriasis patients aged 18 and below seen at the PGH dermatology outpatient clinic from January 2004 to December 2009 were reviewed.
RESULTS: A female preponderance of childhood psoriasis with a male-to-female gender ratio of 1:2 was found. Mean age of onset was earlier in males (7.89 ± 5.77) than females (12.27 ± 5.35) (p-value = 0.026). Chronic plaque type psoriasis was most frequent (71.43%), followed by guttate (16.67%), erythrodermic (7%) and pustular psoriasis (5%). The scalp (61.9%) was the most common overall initial site of onset followed by the trunk (50%). Nail involvement was seen in 29% while 11.9% had joint involvement. Topical steroid application was the most commonly used treatment.
CONCLUSION: This retrospective study reveals a female predominance of childhood psoriasis in the Filipino population. The most common overall initial site of onset is the scalp and the most frequent psoriasis phenotype overall is plaque-type psoriasis.

Human ; Male ; Adolescent ; Ambulatory Care Facilities ; Dermatology ; Exanthema ; Hospitals, General ; Nails ; Phenotype ; Philippines ; Psoriasis ; Scalp ; Skin Diseases, Vesiculobullous

The underdiagnosis of depression and anxiety in the medical complications, improve compliance to treatment, and facilitate the "appropriate" use of health care resources.

OBJECTIVES: To determine the prevalence of depression and/or anxiety in the in-patient medically ill and to validate the Hospital Anxiety and Depression Scale (HADS) for Filipinos.

METHODS: To aid clinicians, the Hospital Anxiety and Depression Scale (HADS), a 14-item self-report questionnaire was validated in this cross-sectional study of 710 medically ill in-patients, to be able to determine how well it identified depression and anxiety against the criterion of a diagnostic psychiatric interview and to determine the optimal cut-off score of the HADS for Filipinos with the use of the Receiver Operating Characteristics (ROC).

RESULTS: The prevalence of depression was 26.9% anxiety was 14.3%, and the 'mixed diagnosis' of both was 13.7% among the medically-ill. The overall prevalence was 54.9%. The results showed that the optimal cut-off score for the HADS/ HADS-P is a score of 11, with a sensitivity of 75%, specificity of 70% and PPV of 75%.

CONCLUSION: The HADS/ HADS-P will provide clinicians with a reliable, valid and practical screening tool for identifying the two most common clinical problems in the medically ill, depression and anxiety. The HADS/ HADS-P can serve as a guide for clinicians towards the diagnosis of depression and anxiety, but it cannot be the sole basis for diagnosis.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Depression ; Self Report ; 4-amino-4'-hydroxylaminodiphenylsulfone ; Anxiety ; Anxiety Disorders ; Depressive Disorder ; Sensitivity And Specificity

Calcitonin ; blood ; Fluorine ; adverse effects ; Humans ; Occupational Exposure ; adverse effects ; Osteocalcin ; blood

Animals ; Gene Amplification ; Genes, myc ; Humans ; Lymphoma, B-Cell ; genetics ; metabolism ; pathology ; Mutagenesis, Insertional ; Proto-Oncogene Proteins c-myc ; metabolism ; Translocation, Genetic

Mature Cystic Teratomas of the ovary are the most common ovarian tumors in both adolescents and reproductive-age women. This case report shows a rare case of squamous cell carcinoma arising from a mature cystic teratoma in a 59-year-old postmenopausal woman. Malignant transformation occurs in 1% of all cases of mature cystic teratomas and due to its rarity, there is no established protocol regarding optimal diagnosis and management. Preoperative diagnosis was difficult due to non-specific symptoms such as abdominal mass and abdominal pain present in this patient. The surgery was planned based on the large size of the tumor on imaging, menopausal age and a family history of breast cancer in the family. She subsequently underwent Total Abdominal Hysterectomy with Bilateral Salpingo-oophorectomy, Frozen Section, Bilateral Lymph Node Dissection, lnfracolic Omentectomy and Right Internal Iliac Artery Ligation. Final diagnosis was confirmed post operatively with the final histopathologic report. This report would show that proper risk assessment and preoperative planning would optimize management of even rare cases of malignant tumors.

Human ; Female ; Middle Aged ; TERATOMA

Objective: This study aims to determine the minimum waist circumference and visceral fat values by ultrasonography that will identify adult urban Filipinos at risk for metabolic syndrome. Methodology: This is an observational , analytical , cross-sectional study among executive health checkup patients at the Makati Medical Center. Criteria for metabolic syndrome was based on the 2009 revised criteria proposed by the International Diabetes Federation (IDF), World Heart Federation, International Atherosclerosis Society and National Heart, Lung and Blood Institute (NHLBI). Visceral fat thickness (VFT) was measured by ultrasonography. Waist circumference (WC) was taken as the circumferential measurement of the area at the midpoint between the lower border of the last rib and the iliac crest. Results: Three hundred eleven patients aged 40-65 year s old were enrolled in the study. Forty-seven percent were females and 53 percent were males. Based on the revised criteria for metabolic syndrome, 45.9 percent had metabolic syndrome. Ninety-one were males and 52 were females. For males , the minimum VFT associated with the metabolic syndrome was 17.70 mms, with a mean of 59.39 mms, and the minimum waist circumference associated with metabolic syndrome was 82.50 cms with a mean of 99.74 cms. For females, the minimum VFT associated with the metabolic syndrome was 10.70 mms, with a mean of 47.77 mms, and the minimum waist circumference was 78.00 cms, with a mean of 92.68 cms. In general, the VFT showed a strong and significant correlation with the waist circumference (r = 0.709, p < 0.01), and a weak but significant correlation with the other components of the metabolic syndrome: elevated FBS, elevated TG, elevated BP and low HDL (r = 0.226, 0.267, 0.200 and 0.146, respectively, p < 0.01). In both males and females, the VFT showed a strong and significant correlation with the waist circumference (r = 0.625 and 0.698 respectively, p < 0.01). However, among females, the VFT showed a weak but significant correlation with the other four parameters for metabolic syndrome (r = 0.261, 0.382, 0.259 and 0.260; p = < 0.01), and a very weak or no correlation with the other parameters for metabolic syndrome among males (r = 0.177, 0.101, 0.081 and 0.140; p = < 0.01). The minimum cut-off values for waist circumference were 98 cms and 91 cms for males and females, respectively. The minimum cut-off values for VFT were 62 cms and 48 cms for males and females, respectively. Conclusion: The results of the study showed that in both male and female adult urban Filipinos, the visceral fat values obtained by ultrasonography are weak predictors to identify their risk for metabolic syndrome. Among male adult urban Filipinos, the waist circumference is a weak predictor to identify risk for metabolic syndrome while for female adult urban Filipinos, the waist circumference is a moderate predictor to identify the risk for metabolic syndrome. The minimum waist circumference cut-off values for males and females obtained in this study were higher than the current cut-off values. The cut-off values for visceral fat thickness obtained by ultrasonography for males and females were also higher than the available Korean cut-off values.

Cardiomyopathy, Hypertrophic ; complications ; Down Syndrome ; complications ; Humans ; Infant, Newborn ; Male

Objective To investigate the cell-type-specific enhancer (CTSE) in HPV16 and its variation in cervical carcinoma. Methods CTSEs were detected by polymerase chain reaction (PCR) in 58 cervical carcinoma from Shaanxi province; in addition variation of CTSEs was analyzed through single-strand conformation polymorphisms (SSCP). Results HPV16 CTSEs were detectable in 34 of 58 (57%) specimens and mutant rate was 41%(14/34) and the main mutations of chosen randomly variant CTSE (CTSEv) happened at YY1 binding sites in addition to glucocoticoid response elements (GRE). Conclusion CTSE in some specimens of Shaanxi province was obviously different from that in HPV16 wild type and variant CTSE might affect the transcriptional regulation of LCR on viral P97, which regulates over-expression of viral oncogenes in cervical carcinoma.

On the base of element and metabolism balancing,the mathematic model of the human-like collagen expression phase with recombinant Escherichia coli BL21 was developed and the unknown parameters in the model were estimated with the method of nonlinear optimization.The model was in agreement with the growth kinetics and the metabolic kinetics,and the key calculated parameters of ?h,?p and mx were 1.173 mol?C-mol-1,293.814 mol?C-mol-1 and 17.878 mol?C-mol-1?h-1 respectively.This model could preferably predict the macroscopic reaction rates,and in the synthesis phase of human-like collagen,the specific growth rate should be controlled at 0.04 h-1 with controlling glucose feeding rate to gain the highest specific production rate of human-like collagen.