Hypertrophic lichen planus (HLP) is a papulosquamous eruption presenting with extremely pruritic hyperkeratotic flat-topped papules, plaques, and nodules. This is a case of 38-year-old male who presented with a 2-month history of generalized erythematous-to-hyperpigmented papules, patches, and plaques topped with white-to-gray oyster shell-like scales on a background of hyperpigmented macules and patches. There was no involvement of the conjunctival, otic, oral, and genital mucosae, and palmar and plantar aspects of the hands and feet. Dermoscopy showed reticular pearly white structures corresponding to the Wickham striae, comedo-like openings, blue-gray dots, brownish-black dots, and scales. Histopathologic examination revealed marked compact hyperkeratosis, wedge-shaped hypergranulosis, irregular saw-toothed epidermal acanthosis, scattered dyskeratotic keratinocytes, and superficial perivascular lichenoid infiltrate of lymphocytes, histiocytes, and melanophages. The patient was managed as a case of HLP. He was started on methotrexate 10 mg per week, bath psoralen photochemotherapy (PUVA) three times a week, betamethasone valerate 1mg/g cream twice a day for 2 weeks alternating with tacrolimus 0.1% ointment twice a day for another 2 weeks, 10% lactic acid, emollients, and sunscreen. After 6 months of treatment, there was almost 80% improvement of lesions and relief of pruritus.
Methotrexate

Background: Teledermatology has been widely used during the coronavirus disease 2019 (COVID-19) pandemic to overcome barriers in access to care. The objective of this study was to assess the current knowledge, attitudes, and practices regarding teledermatology among dermatologists in the Philippines. Materials and Methods: This was a cross-sectional and analytical study conducted from January 2022 to April 2022, among Filipino dermatologists using a self-administered online questionnaire. Descriptive statistics was used to summarize the demographics of the participants. The two-sample t-test, Chi-square test, and multiple logistic regression model were used to analyze the data. Results: Out of 113 respondents, 108 (95.5%) had adequate knowledge and a positive attitude toward teledermatology. The majority (110/113, 97.35%) practiced teledermatology. The most commonly used platform was instant messaging applications(78/100, 70.91%), and the most common factor that influenced their practice was patient demands or needs(74/110, 67.27%). Those who did not practice teledermatology cited technological difficulties as the main reason. Conclusion Teledermatology was widely used by Filipino dermatologists to provide remote care during the COVID-19 pandemic. However, to fully utilize its potential and limit potential issues associated with its use even after the pandemic, continuous training and education among dermatologists and a more enabling technological environment may be needed.
Knowledge ; Attitude ; Telemedicine