Introduction: Erythrokeratodermia variabilis et progressiva (EKVP) is a rare, usually autosomal dominant disorder characterized by co-existence of erythematous to hyperpigmented scaly plaques and stationary or migratory patches symmetrically distributed on the face, buttocks and extremities. Case summary: This report describes an 8-month-old Filipino female infant who initially presented at 13 days old with erythematous scaly patches on the scalp, periorbital, perioral, and genital areas. These patches progressed to multiple erythematous plaques with well-defined erythematous to hyperpigmented border, some topped with hemorrhagic and yellowish crusts and scales on the scalp, face, neck, upper and lower extremities, genital and gluteal area. Histologic examination of the skin showed dense aggregates of neutrophils in the stratum corneum, parakeratosis, mild spongiosis, and irregular acanthosis. There were focal areas of hypogranulosis underneath the areas of parakeratosis; however, other areas showed normal granular cell layer. The dermis showed moderate superficial perivascular lymphohistiocytic cell infiltrates with melanophages. Histopathologic changes were nonspecific but may be consistent with EKVP. Patient was initially treated with IV antibiotics; however lesions continued to progress. She was then started on oral acitretin, resulting to improvement of lesions. Conclusion: A Filipino girl with erythrokeratodermia variabilis et progressiva is reported. The knowledge of this disease and its treatment will allow clinicians to promptly initiate treatment and monitor treatment side effects
Erythrokeratodermia variabilis ;

Background: Psoriasis is a chronic, complex, inflammatory disease that needs safe and effective treatment options to decrease its disease burden.

Objectives: To determine the efficacy and safety of sunflower oil in mild to moderate plaque-type psoriasis at the outpatient department of a tertiary hospital.

Methods: This was an 8-week, single-center, randomized, double-blind controlled trial that compared the efficacy and safety of sunflower oil + placebo cream (Group SO), betamethasone valerate cream + placebo oil (Group BC), sunflower oil + betamethasone valerate cream (Group SOBC) in mild to moderate plaque-type psoriasis. Psoriasis Area Severity Index (PASI) was used to measure the extent of psoriasis by assessing the erythema, induration, scaling, and body surface area involvement. The difference from baseline PASI was recorded. The Dermatology Life Quality Index (DLQI) questionnaire was used to measure the impact of psoriasis on the patient's quality of life.

Results: Fifty-one patients were randomized and blinded to three treatment arms; evaluated at baseline, week 4 and 8. The proportion of patients who achieved PASI ?50 at week 4 was 29% in Group SO, 38% in Group BC, and 60% in Group SO-BC. By week 8, Groups SO and BC achieved 80% while Group SO-BC achieved 93%. There was significant decline of PASI at week 4 and week 8 compared to baseline. The mean percentage change of PASI was highest at Group SO-BC followed by Group BC and lastly Group SO at week 4 and week 8. The mean reduction in score for scaling was significantly higher in Group SO-BC. Mean reduction in induration and erythema was not statistically significant across the three groups. There was 40-50% improvement in DLQI scores in all groups. There were no adverse events.

Conclusion: This study showed that sunflower oil is effective and safe in mild to moderate plaque-type psoriasis.

Sunflower Oil ; Randomized Controlled Trial ; Psoriasis