BACKGROUND

Superficial mycoses are one of the most common skin conditions encountered in the outpatient clinics, causing significant morbidity amongst patients. Since these are highly prevalent diseases of the skin, the general practitioner should be able to manage uncomplicated cases, with no need for evaluation by a specialist.

OBJECTIVES

The study aimed to determine the knowledge, attitudes, and practices of Filipino medical interns on the management of superficial cutaneous mycoses using a self-administered questionnaire. This may help identify possible gaps in knowledge, as well as obstacles these future clinicians may encounter when managing superficial mycoses. This in turn may assist in the development or improvement of dermatology training among medical students and continuing medical education programs amongst non-dermatologist physicians.

METHODS

This is a descriptive cross-sectional study among medical interns of the Philippine General Hospital to investigate their knowledge, attitudes, and practices regarding the management of superficial mycoses. Eligible participants were asked to complete an online self-administered survey questionnaire which assessed their capacity to recognize and manage uncomplicated superficial mycoses, and determined their attitudes regarding dermatology training in medical school.

RESULTS

The study included 170 medical interns, with majority having only 1-4 weeks of cumulative duration of dermatology training in medical school. Many of the participants (67.1%) had inadequate overall knowledge scores, but this was not significantly associated with their cumulative duration of dermatology training, as well as with their frequency of encounters with superficial mycosis patients. Most deem dermatology training (92.4%) and learning about the management of superficial mycoses (91.2%) during medical school very important. Majority are interested in attending more courses or training in the subject. Recommendations to improve medical school training on superficial mycoses include more practical approach in dermatology modules, integration of dermatology electives in medical school, and longer duration of dermatology modules/rotations during medical school.

CONCLUSION

While knowledge scores of medical interns were not significantly associated with the duration of their dermatology training during medical school as well as their encounters with patients with superficial mycoses, it is shown that they have low confidence scores regarding management of superficial mycoses. They deem that learning more about this disease and dermatology in general is vital to their medical education and are desirous of more training in this subject. Recommendations to improve medical school training on superficial mycoses include dermatology modules, rotations or electives in medical school. Additionally, better training during medical school, and formulation of clinical practice guidelines specific to cutaneous mycoses were recommended to improve healthcare delivery for patients with such diseases.

Human ; Dermatomycoses ; Dermatology ; Diagnosis

Nodular syphilis with a granulomatous inflammatory histopathologic pattern is an uncommon cutaneous presentation of secondary syphilis which could pose a diagnostic challenge for clinicians and pathologists alike.

A 33-year-old male diagnosed with HIV presented with a 5-week history of asymptomatic generalized erythematous papules and nodules with overlying scales, with involvement of the palms and soles. Histopathologic examination of a nodule from the forearm revealed non-caseating granulomas in a background of a mixed cell inflammatory infiltrate composed of lymphocytes, epithelioid and foamy histiocytes, plasma cells, neutrophils, and multinucleated giant cells. Warthin-Starry Stain revealed spirochetal organisms, while Fite-Faraco and Periodic Acid-Schiff stains were negative for acid-fast bacilli and fungal elements, respectively. Rapid plasma reagin (RPR) was reactive (1:256). Patient was given a single dose of benzathine penicillin G 2.4 million units intramuscularly, with noted complete resolution of skin lesions as well as an 8-fold decrease in RPR titers.

Nodular lesions are an uncommon cutaneous manifestation of secondary syphilis, and the associated histopathologic finding of granulomatous inflammatory pattern is also unusual, posing a diagnostic challenge. With the increasing prevalence of syphilis, especially among HIV patients, dermatologists, dermatopathologists, internists, and infectious disease specialists should be aware of such presentations of syphilis.

Human ; Male ; Adult: 25-44 Yrs Old ; Syphilis