Botryomycosis is a rare pyogenic disease that presents with chronic suppurative and granulomatous skin lesions, commonly caused by Staphylococcus aureus. We report a case of botryomycosis presenting similarly to mycetoma, secondary to the emerging cutaneous pathogen Staphylococcus simulans. A 46â€Âyear-old female who previously worked in a wet market presented with a 13-year history of suppurative papules on a gradually enlarging right foot, and pain on ambulation. She had no systemic symptoms or co-morbidities, and does not recall preceding trauma. Physical examination showed brawny edema of the right foot with multiple sinus tracts draining purulent discharge. The clinical diagnosis at presentation was mycetoma. Magnetic resonance imaging showed a soft tissue mass involving the right foot and ankle with osseous destruction. Biopsy revealed suppurative granulomatous dermatitis; staining with Grocott methenamine silver did not highlight fungal elements. Potassium hydroxide mount of the purulent discharge did not show grains or hyphal elements. Tissue cultures showed growth of co-trimoxazole-susceptible Staphylococcus simulans. The patient was managed as a case of botryomycosis and treated with co-trimoxazole for 12 months. There was a significant decrease in right foot circumference along with scarring and resolution of associated pain. Repeat biopsy showed no evidence of infection. This is the first reported case of botryomycosis in the Philippines as well as the first report citing Staphyloccocus simulans as a causative agent. Botryomycosis is an important differential in patients clinically presenting as mycetoma. Animal pathogens may need to be considered as etiologic agents in at-risk patients with chronic subcutaneous infections.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Mycetoma

Vulvar intraepithelial neoplasia (VIN) is a dysplastic condition of the squamous epithelium of the vulva. There are two types of VIN: high-grade squamous intraepithelial lesion of the vulva and VIN differentiated type (dDVIN). Management includes excision, laser ablation, and topical therapy. An excisional procedure used in VIN is simple local excision and partial or total skinning vulvectomy. Despite treatment, its recurrence is high. A G5P5 (5004) woman in her 60s presented with vulvar pruritus and vulvar pain of 2 years. She was treated for cervical adenocarcinoma Stage IB1 with surgery and complete radiotherapy 27 years prior. She was diagnosed twice with vulvar dysplasia 12 and 21 years after the diagnosis of cervical malignancy, both times presenting as vulvar pruritus. She was subsequently managed with vulvectomy with bilateral groin node dissection and with wide local excision, respectively. A 3 cm × 2 cm well-circumscribed, irregular erythematous plaque at the introitus’s 11–1 o’clock region was noted on physical examination. She was managed as a case of recurrent VIN III and underwent wide local excision and distal urethrectomy with split-thickness skin graft. The final histological examination of the submitted specimen showed human papillomavirus-associated classic VIN II.

Human ; Female ; Middle Aged: 45-64 Yrs Old

OBJECTIVE

This study aims to determine the prevalence of menopausal symptoms among Filipino perimenopausal women aged 43–48 years in a rural community setting.

METHODS

This is a cross-sectional study conducted in a rural community. A self-administered, validated Women’s Health Questionnaire, Filipino version, was given to 232 women aged 43–48 years. Data were analyzed using STATA 16.1/IC.

RESULTS

Nearly 32% of respondents reported a negative impact of symptoms on their quality of life (QOL). The highest was seen in the physical/somatic (PS) domain followed by the vasomotor/menstrual and emotional/anxiety domains. Overall, majority of the scores reflect a good QOL.

CONCLUSION

Filipino women in the rural community remain to have good QOL despite experiencing menopausal symptoms. A minority experience symptoms that negatively influence their QOL and most of these were in the physical/somatic domain. Education regarding awareness, treatment options, and expectations during perimenopause is important. Timely intervention can continue to improve the QOL of these women.

Human ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Perimenopause ; Quality Of Life

A 46-year-old male presented with an erythematous papule progressing into a vegetative plaque on the right cheek that resolved with cribriform scarring. Eight months after, a similar looking erythematous papule appeared on his left cheek. This papule rapidly progressed into a vegetative plaque within a week, and was associated with a pain score of 7 out of 10. Histopathology of the second lesion revealed suppurative dermatitis with diffuse dense infiltrates composed mostly of neutrophils. Cultures revealed few colonies of Enterobacter cloacae which was inconclusive. Pathergy test was negative. High dose systemic corticosteroids were started, with an observed rapid reduction of pain, inflammation, and ultimately resolution of the lesion with formation of cribriform scarring, confirming a case of vegetative pyoderma gangrenosum. It is important to note that not all inflamed and purulent lesions are infectiousneutrophilic dermatoses should always be considered.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Pyoderma Gangrenosum ; Face ; Glucocorticoids

Xeroderma pigmentosum (XP) is a rare DNA repair disorder characterized by sensitivity to sunlight and predisposition to cutaneous malignancies. There are various types, including the Variant type, which does not manifest with acute sunburn reactions. This results to the development of multiple malignancies that are often discovered at late stages, making management more challenging. This is a case of a 54-year-old Filipino female presenting with multiple basal cell carcinomas (BCCs) on several areas of the face and advanced cutaneous squamous cell carcinoma (cSCC) on the right zygomatic area, treated with imiquimod 5% cream and external beam radiation therapy, respectively. There was an excellent response of the BCCs to imiquimod 5% cream and good tumoral response of the SCC to radiation therapy, with tolerable side effects, highlighting the use of these palliative treatment modalities for XP patients with multiple, unresectable, or difficult-to-treat cutaneous malignancies.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Xeroderma Pigmentosum ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Imiquimod ; Radiation Therapy ; Radiotherapy