1.Kaposi sarcoma in an HIV-negative adult male
Ma. Isabela P. Ong ; Maria Jasmin J. Jamora
Journal of the Philippine Dermatological Society 2024;33(Suppl 1):26-26
<p style="text-align: justify;" data-mce-style="text-align: justify;">Kaposi Sarcoma (KS) is a vascular tumor commonly associated with HIV/AIDS. There is unusual presentation of KS in a non-HIV patient, initially diagnosed as small vessel vasculitis. Early recognition and accurate diagnosis are important for the patient’s best management.p><p style="text-align: justify;" data-mce-style="text-align: justify;">
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p><p style="text-align: justify;" data-mce-style="text-align: justify;">A 68-year-old male presented with spontaneous bluish-black patches on his extremities, swelling, pain, and bullae on his toes. Initial workup, including negative ANA and ANCA markers, pointed to small vessel vasculitis, with autoimmune, hematologic, and occlusive diseases considered. Peripheral vascular occlusion was ruled out, and a biopsy showed granulomatous vasculitis. Despite corticosteroid treatment, the lesions worsened. Five months later, the patient developed violaceous papules, plaques, and nodules. A second biopsy confirmed Kaposi Sarcoma (KS) with positive CD34 and HHV-8 stains. Restaining the initial biopsy also revealed KS. Treatment with Doxorubicin was initiated, but the disease progressed, affecting the gastrointestinal system. The patient’s condition deteriorated, and he died from complications of KS.p><p style="text-align: justify;" data-mce-style="text-align: justify;">
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p><p style="text-align: justify;" data-mce-style="text-align: justify;">This case underscores the importance of considering Kaposi Sarcoma in HIV-negative patients with vascular lesions. The initial diagnosis of vasculitis, confirmed by granulomatous changes, delayed the KS diagnosis. Restaining the first biopsy later confirmed the presence of KS from the onset. The extensive skin and gastrointestinal involvement made management with Doxorubicin difficult, leading to a poor outcome.p>
Human
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Male
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Aged: 65-79 Yrs Old
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Sarcoma, Kaposi
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Tumors
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Neoplasms
2.A case report of folliculotropic mycosis fungoides in an adult female
Ma. Isabela P. Ong ; Maria Jasmin J. Jamora
Journal of the Philippine Dermatological Society 2024;33(Suppl 1):30-30
<p style="text-align: justify;" data-mce-style="text-align: justify;">For diagnosis of rare conditions, consistent follow-up on the part of the patient as well as a high index of suspicion on the part of the physician is needed. Evaluation of the management should be done in the event that patients do not respond to treatment.p><p style="text-align: justify;" data-mce-style="text-align: justify;">
p><p style="text-align: justify;" data-mce-style="text-align: justify;">This is a case of a 33 year old female who fifteen months prior, noticed erythematous scaly plaques on her cheeks with mild pruritus. She was treated for psoriasis with Halobetasol ointment and Petroleum Jelly, which had partial resolution. Twelve months prior, she was prescribed Methotrexate, again achieving partial resolution. Biopsy was done suggestive of Folliculotropic Mycosis Fungoides. Methotrexate was increased, and additional medications were prescribed, leading to lesion resolution. However, she was lost to follow-up and experienced worsening symptoms. One month prior, biopsy was repeated and again showed Diffuse Lymphocytic Dermatitis positive for CD3+, CD4+, CD5+, CD8-, CD20-, CD30-, and loss of staining for Pan-T cell markers, CD2- and CD7. She is currently managed with regular sessions of Narrowband UVB.p><p style="text-align: justify;" data-mce-style="text-align: justify;">
p><p style="text-align: justify;" data-mce-style="text-align: justify;">These rare cases are few but more often than not, they are easily missed and when caught are usually progressed and already difficult to treat. Physicians must be vigilant in treating patients, even if they initially diagnose it to be a commonly seen and easily managed disease. Skin Directed therapy is done with PUVA and NBUVB with complete response in 30-70%3. For prognosis, early stages are favorable with a 94% 5 year survival rate, decreasing to 69% after tumor development.p>
Human
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Female
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Adult: 25-44 Yrs Old
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Lymphoma, T-cell, Cutaneous
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Tumors
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Neoplasms
3.A case of an adult female diagnosed and treated for squamous cell carcinoma
Ma. Isabela P. Ong ; Krisinda Clare Dim-Jamora ; Maria Jasmin J. Jamora
Journal of the Philippine Dermatological Society 2024;33(Suppl 1):26-26
<p style="text-align: justify;" data-mce-style="text-align: justify;">This is a case of a 74-year-old female who previously worked as a Metro Manila Aide and presented with a solitary erythematous, well-demarcated mass with hyperkeratosis on the right zygomatic area. It started as a pea-sized erythematous papule three years prior without associated symptoms. The patient self-medicated with Ketoconazole + Clobetasol Propionate cream for five months without improvement. Two months before consultation, the lesion enlarged and developed yellow hyperkeratotic crusts. A biopsy revealed invasive squamous cell carcinoma (SCC). Complete excision with adequate margins was recommended. The patient underwent Mohs Micrographic Surgery and reconstruction with a rotational flap repair. Histopathology of the excised tissue confirmed squamous cell carcinoma. No tumor necrosis or lymphovascular invasion was identified, and all resection margins were clear. Post-surgical management included wound care and medications. The case emphasizes early intervention and histopathological evaluation in managing growths especially in cases where patients have not consulted and self medicated instead.p>
Human
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Female
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Aged: 65-79 Yrs Old
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Mohs Surgery
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Carcinoma, Squamous Cell
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Tumors
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Neoplasms