Dyskeratosis Congenita ; Dermoscopy

Introduction: Acne vulgaris is a common dermatologic disorder caused by follicular epidermal hyperproliferation, excess se- bum production, inflammation, and Cutibacterium acnes (C. acnes). The mangosteen fruit rind contains large amount of xantho- nes, which has high antimicrobial activity against C. acnes. Objectives: To compare the efficacy and safety of mangosteen 1% extract gel versus benzoyl peroxide (BPO) 5% gel in the treat- ment of mild to moderate acne vulgaris. Methods A total of 60 participants with mild to moderate acne or a rating of 2 or 3 in the Investigator’s Global Assessment (IGA) for acne were randomized to receive either mangosteen 1% extract gel or BPO 5% gel applied on the face twice daily over an 8-week period. Primary outcomes measured in the study were clinical remission graded as “clear” or “almost clear” (rating of 0 or 1) based on the IGA and any adverse reaction.
Acne Vulgaris ; Benzoyl Peroxide

The Psoriasis Foundation of the Philippines, Inc. (PFPI), is a non-profit organization in Davao City. The organization was founded in 1997 by dermatologists from Mindanao, with Dr. Carlos Pacheco as the founding president. In the same year, the PFPI was registered at the Securities and Exchange Commission (SEC). The foundation was established with the goal of improving the quality of life of patients with psoriasis. Its founders believed that they can achieve these goals by: 1. facilitating patient access to medical consultations and medications for psoriasis; 2. carrying out activities that provide social and financial support to patients and their families, and 3. promoting the conduct of research that can be used to improve the management of psoriasis. In order to do this, the PFPI partnered with the Southern Philippines Medical Center (SPMC) Department of Dermatology as it caters to numerous dermatological patients covering the Visayas and Mindanao region. With this, the PFPI was able to garner a wider grasp of psoriasis patients as well as the opportunity to work closely with their health care providers and aid patients not only medically but also in addressing various aspects of their well-being. This led to the establishment of the Psoriasis Club. The Psoriasis Club currently has at least 30 members, composed of patients who have been diagnosed with psoriasis in the SPMC Department of Dermatology Clinic. The club holds monthly meetings and functions as a support group for patients and their family members, along with their healthcare providers. This has led to better monitoring of patients, increase in compliance to treatment, and stronger patient-doctor relationships. Further, the club has been able to build and strengthen relationships among psoriasis patients and their families, thereby increasing the size of their social support team. The club also implemented livelihood programs such as soap-, candle-, and Christmas decor-making in order to provide patients with skills and offer them financial security. In addition, the SPMC Department of Dermatology organizes fundraising events (e.g. postgraduate courses or conferences, advance movie screenings, pop-up thrift shops) every year to raise funds for psoriasis patients in order to generate revenue for their livelihood and medications. The PFPI, together with the Philippine Dermatological Society, celebrates World Psoriasis Day every October. This annual event is attended by patients with psoriasis, family members, and healthcare workers. It is a time when patients are given an opportunity to share their personal health experiences to dispel stigma and myths regarding psoriasis. It also impels the lay people to partner with them as they lobby for better access to health care and affordable treatments. The event also provides entertaining activities and offers free dermatological consultations. In 2015, the PFPI, in partnership with the SPMC Department of Dermatology, also started the Psoriasis Registry (PsoReg) in Davao City to keep track of psoriasis patients’ disease progression or improvement. This registry contains the sociodemographic information, clinical profiles, efficacy or failure of treatment, and quality of life among patients with psoriasis in a tertiary government hospital and private dermatology clinics. The PsoReg also aims to facilitate further studies in the disease, influence health policies, and promote the creation of a unified national registry for the country. Currently, the PFPI is under the leadership of Dr. Victoria P. Guillano. As a partner institution of PFPI, the SPMC Department of Dermatology provides support to the foundation, especially in terms of human resources, financial assistance, and technical expertise from its pool of consultants, residents and health staff. Since the establishment of the PFPI, efforts toward improving psoriasis healthcare have been geared towards lobbying for the inclusion of psoriasis in the list of subsidized medical cases by the Philippine Health Insurance Corporation (PhilHealth). This is done with the help of Rep. Scott Davies Lanete, MD, who principally authored the House Resolution 1818 that would make treatment readily available for patients with psoriasis. In 2019, the PFPI received a pharmaceutical company-funded grant that enabled the foundation to implement project Psoriasis Health Innovations (Psor-HI). This project aims to link the patients, healthcare providers, and policy makers to develop and strengthen dermatologic care for psoriasis patients. Through this project, the PFPI was able to easily reach patients and their families in Davao City, Zamboanga City, Tagum City, and Cebu City. Psor-HI was able to connect with municipal health workers, allied medical professionals, and general practitioners in these areas and connect them to the PFPI where they were able to provide vital information on psoriasis and its appropriate management. In addition, health workers with limited access to specialized dermatologic care were properly guided and enhanced their capacities to provide the best care for their psoriasis patients. The PFPI plans to engage local partners in the community in the future to strengthen patient engagement. Since psoriasis is currently not included in the health programs of the Department of Health (DOH), the PFPI envisions the integration of psoriasis education in the list of non-communicable diseases being addressed and monitored by the DOH. The PFPI will continue to be an active advocate in the achievement of accessible and affordable health services for patients with psoriasis.

Harlequin ichthyosis (HI) is a rare type of congenital keratinization disorder that, when left untreated, usually leads to early neonatal demise. A clinical diagnosis of HI is considered when a patient presents with thick plate-like scaling of the skin together with eclabium, ectropion, and nasal hypoplasia. The diagnosis can be confirmed by genetic testing to determine mutation in the adenosine triphosphate-binding cassette A12 (ABCA12) gene. Early administration of systemic retinoids to promote desquamation and emollients to control excessive scaling and dryness of the skin lead to better prognosis in most cases of HI. We present the case of a 4-year-old male with HI who has been successfully managed with bland emollients and systemic acitretin therapy, which we started when he was 1 year old.
Acitretin

Harlequin ichthyosis (HI) is a rare type of congenital keratinization disorder that, when left untreated, usually leads to early neonatal demise. A clinical diagnosis of HI is considered when a patient presents with thick plate-like scaling of the skin together with eclabium, ectropion, and nasal hypoplasia. The diagnosis can be confirmed by genetic testing to determine mutation in the adenosine triphosphate-binding cassette A12 (ABCA12) gene. Early administration of systemic retinoids to promote desquamation and emollients to control excessive scaling and dryness of the skin lead to better prognosis in most cases of HI. We present the case of a 4-year-old male with HI who has been successfully managed with bland emollients and systemic acitretin therapy, which we started when he was 1 year old.
Ichthyosis, Lamellar