AIM: To report two cases whose decreased visual acuity was the first symptom of leukaemia and optical coherence tomography (OCT) allowed identification and localization of the retinal lesions.METHODS: Retrospective, interventional, case reports. RESULTS: One case of lymphoblastic acute leukaemia and chronic lymphoid leukaemia were diagnosed following decreased visual acuity. OCT showed macular serous detachment in the first case. The second case presented hypo fluorescent retinal infiltrates which appeared as hyper reflective lesions by OCT. Retinal changes disappeared and visual acuity was recovered following complete remission of the neoplasm.CONCLUSION: OCT is a valuable, non invasive diagnostic tool permitting detection, localization and follow-up of ocular dissemination of neoplasms.

Female ; Granuloma, Foreign-Body ; chemically induced ; pathology ; Humans ; Industrial Oils ; adverse effects ; Middle Aged ; Scalp ; pathology ; Scalp Dermatoses ; chemically induced ; pathology

· AIM: To determine the influence of topical anaesthetic drops, age and central corneal thickness (CCT) in the determination of intraocular pressure (IOP) by non contact tonometry (NCT). · METHODS: Ninety-three eyes from 47 patients were examined for CCT and lOP by NCT before and after the instillation of topical anaesthetic drops.· RESULTS: Average age was 66.4 (SD 16, range 34 to 88years-of-age). Thirty one patients were female and 16 were male. Average basal IOP was 16.0 mmHg (SD 4.0, range 8.5to 26.1). IOP pressure one minute after topical anesthesia instillation was 15.0 mmHg (SD 3.8, range 7.7 to 26.7), and 14.9 mm Hg (SD 3.9, range 7.6 to 26.3) five minutes after the instillation. The differences were statistically significant for the 0 to 1 minute lapse (P=0.0007) and for the 0 to 5minute lapse (P=0.0003), but not for the 1 to 5 minute lapse (P=0.27) (Student's t test for paired data). Average CCT before topical anaesthetic drops was 565.4 microns. Simple linear regression analysis demonstrated absence of significant variation between age and IOP changes and between CCT and IOP changes,· CONCLUSION: Our study confirms that the instillation of topical anaesthetics causes a reduction in IOP, which is progressive during the first 5 minutes after instillation. This IOP reduction does not seem to be associated with basal CCT or age.

Introduction: Squamous cell carcinoma (SCC) is a rare complication of long-standing discoid lupus erythematosus (DLE). The reported risk factors associated with the malignant transformation include chronic inflammation, scarring, immunosuppression, and the dysfunctional healing already evident in discoid lesions. If underdiagnosed and left untreated, this may lead to higher rates of recurrences, metastases and death. Objective: The main objective of this article is to report the diagnosis and management of a DLE-associated SCC on the upper lip of an elderly Filipino female. A short discussion on the pathogenesis and treatment of this disease entity is also presented.ugs/topical medications, family history and accompanying systemic symptoms were reviewed and analyzed. Case: A 78-year-old female, pawid maker, developed a rapidly growing verrucous tumor measuring 4.0 x 2.0 x 2.0 cm from a depigmented atrophic plaque located on the upper lip. Initial histopathologic findings were consistent with SCC and DLE. Considering the tumor size and the challenging anatomical location, the surgical oncology and plastic surgery team carried out a wide excision with 5 mm margin of the entire upper lip mass and surrounding plaque, followed by lip reconstruction. Biopsy findings of the excised mass were consistent with the initial findings. Three months post-operation, there was significant wound healing with no recurrences. Conclusion: Although the incidence is rare, SCC occurring in DLE is considered to be high-risk and should warrant early recognition and prompt treatment. In this paper, the authors also highlight the use of a standard wide excision in lieu of Mohs Microscopic Surgery as an alternative option where resources are limited.
surgical flaps ; Lupus Erythematosus, Discoid ; Carcinoma, Squamous Cell

Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare, asymptomatic skin condition characterized by verrucous, hyperpigmented papules, and plaques. It predominantly affects the nipple and areola, often bilaterally. Less than 50 cases have been reported worldwide, with only 39% showing unilateral breast involvement. In the Philippines, a single medical literature from 2014 describes two cases of adolescent‑onset NHNA. We report a rare case of a 40‑year‑old, Filipino woman with a 1‑year history of a mildly pruritic, solitary, well‑demarcated, irregularly shaped, black papule that progressed into a plaque on her right areola. There was suspicion of cutaneous malignancy due to some of the clinical features of the lesion and lack of response to initial treatment. With a correlation between clinical presentation and histopathologic findings, the features were consistent with NHNA. This is a benign skin condition that can mimic and must be differentiated from malignant tumors. Various treatment modalities were described in different medical literatures, some resulting in recurrence or treatment failure, but there is no standard management for this condition. Skin biopsy is crucial to rule out malignancy in cases presenting with persistent and progressively solitary pigmented lesions that do not respond to topical medications. The usual treatment options based on literature include various topicals, lasers, and surgical procedures. In our case, clobetasol propionate ointment was used. While most published cases show varied responses to topical corticosteroids, the result in our case was significant.
Nipples ; Clobetasol ; Nipples

Purpose: This study was performed to evaluate the long-term evolution of continence and patient’s quality of life after surgical treatment for obstetric fecal incontinence. Methods: A prospective longitudinal study was conducted including consecutive patients who underwent sphincteroplasty for severe obstetric fecal incontinence. The first phase analyzed changes in continence and impact on quality of life. The second phase studied the long-term evolution reevaluating the same group of patients 6 years later. Degree of fecal incontinence was calculated using the Cleveland Clinic Score (CCS). Quality of life assessment was carried out with the Fecal Incontinence Quality of Life scale. Results: Thirty-five patients with median age of 55 years (range, 28 to 73 years) completed the study. Phase 1 results: after a postoperative follow-up of 30 months (4 to 132 months), CCS had improved significantly from a preoperative of 15.7 ± 3.1 to 6.1 ± 5.0 (P < 0.001). Phase 2 results: median follow-up in phase 2 was 110 months (76 to 204 months). The CCS lowered to 8.4 ± 4.9 (P = 0.04). There were no significant differences between phases 1 and 2 in terms of quality of life; lifestyle (3.47 ± 0.75 vs. 3.16 ±1.04), coping/behavior (3.13 ±0.83 vs. 2.80 ±1.09), depression/self-perception (3.65 ±0.80 vs. 3.32 ± 0.98), and embarrassment (3.32 ± 0.90 vs. 3.12 ± 1.00). Conclusion Sphincteroplasty offers good short-medium term outcomes in continence and quality of life for obstetric fecal incontinence treatment. Functional clinical results deteriorate over time but did not impact on patients’ quality of life.

Acrodermatitis enteropathica is a rare autosomal recessive disease that results from a defect in zinc metabolism. It is clinically characterized by a phenotypic triad of periorificial and acral dermatitis, diarrhea, and alopecia. Oral zinc therapy gives a rapid excellent clinical response and reduces mortality. We report three female pediatric siblings who presented with periorificial and acral dermatitis, diffuse alopecia, nail dystrophy, irritable mood, and stunted growth. A diagnosis of acrodermatitis enteropathicawas confirmed with markedly decreased levels of serum zinc. The patients were successfully treated with oral zinc sulfate at a dose of 5mg/kg/day for the first two weeks then maintained on a dose at 2mg/kg/day.
Zinc ; Blister

BACKGROUND/AIMS: Increased osteoclast activity is a pivotal finding in osteoporosis. This increase is mediated via the mevalonate-to-cholesterol pathway, which is involved in producing the intermediates required for osteoclast activity. D-003, a mixture of high molecular weight sugarcane wax acids, has been shown to inhibit cholesterol synthesis prior to mevalonate production, resulting in a reduction of bone loss and resorption in ovariectomized rats. Moreover, previous studies have demonstrated that short-term D-003 treatment reduces urinary excretion of deoxypyridinoline/creatinine in postmenopausal women. METHODS: We performed a double-blinded, placebo-controlled study to investigate the effects of D-003 (10 mg/day) treatment for 3 years on bone mineral density (BMD) in 83 postmenopausal women with low BMD. RESULTS: Over 3 years, D-003 treatment increased lumbar spine BMD (5.1%, p < 0.01) and improved osteoporosis-related quality of life scores as compared with placebo-treated controls. D-003 was also well tolerated; the frequency of adverse events in the bone, joints, or muscle with D-003 treatment (p < 0.05) was lower than in the placebo group. CONCLUSIONS: D-003 treatment (10 mg/day) for 3 years increased lumbar spine BMD and produced clinical improvements in postmenopausal women with low BMD. Further studies, however, will be required to confirm these results.
Absorptiometry, Photon ; Adult ; Aged ; Analysis of Variance ; Bone Density/*drug effects ; Bone Density Conservation Agents/*administration & dosage/adverse effects ; Cuba ; Double-Blind Method ; Fatty Acids/*administration & dosage/adverse effects ; Female ; Femur Neck/*drug effects/radiography ; Humans ; Lipids/blood ; Lumbar Vertebrae/*drug effects/radiography ; Middle Aged ; Osteoporosis, Postmenopausal/blood/*drug therapy/psychology/radiography ; Quality of Life ; Questionnaires ; Time Factors ; Treatment Outcome

No abstract available.
Dengue* ; Hemorrhage* ; Humans

No abstract available.
Dengue* ; Hemorrhage* ; Humans