Scleredema is an uncommon condition of unknown etiology that is characterized by dermal mucinosis and mild sclerosis. It is a symmetrical, diffuse, non-pitting induration of the skin commonly associated with an antecedent febrile illness, diabetes mellitus or paraproteinemia.This is the case of an obese, middle-aged adult female with type 2 diabetes mellitus on oral hypoglycemic medication, who presented with an ill-defined, diffuse erythema and non-pitting induration of the skin on the posterior neck and upper back. It has been estimated that as many as 2.5%-14% of diabetic patients have scleredema. This subset of patients may be under-reported as a consequence of subtle onset and under- recognition. Even lithe prognosis of scleredemadiabeticorum is usually benign, it is important that this condition is recognized since it may have systemic involvement that can lead to complications.

Human ; Female ; Middle Aged ; Diabetes Mellitus, Type 2 ; Erythema ; Hypoglycemic Agents ; Obesity ; Paraproteinemias ; Prognosis ; Scleredema Adultorum ; Sclerosis ; Skin ; Diabetes Mellitus ; Mucinoses

BACKGROUND: This is the first study to assess the level of sun awareness among Filipinos, and the need for a formal campaign to promote sun protection.
OBJECTIVE: To assess the knowledge, attitude and practices concerning

Objectives: Leprosy is a chronic granulomatous infection caused by the obligate intracellular organism Mycobacterium leprae. Current diagnostic tests for confirmation and treatment monitoring such as slit skin smear and biopsy are invasive and require time for processing, reading, and interpretation. Dermoscopy is a technique that allows the visualization of structures not readily seen by the naked eye. It can be performed at the point of care, providing a non-invasive link between clinical and histopathologic examination. This study aimed to determine the dermoscopic findings and associated clinicopathologic findings of the different forms of leprosy. Methods: A cross-sectional study was conducted. All new and follow-up patients aged 19 years old and above clinically diagnosed with leprosy were invited to participate in the study during the three-month investigation period. Clinical and dermoscopic photographs of representative skin lesions were taken, and a review of slit skin smear and histopathology results was done. Data analysis was performed using Stata SE version 13. The association between dermoscopic findings and the following parameters: anatomic location, Ridley-Jopling classification, WHO classification, treatment duration, and average bacteriologic index were analyzed using Fisher’s exact test. The level of significance was set at 5%. Results: A total of 57 lesions were included. Linear vessels (p=0.031), structureless areas (p=0.008), and globules (p=0.002) were found to be significantly associated with the anatomic location. Decreased hair was found to be significantly associated with treatment duration (p=0.038). No significant associations were found between dermoscopic findings and Ridley-Jopling classification, WHO classification, and ABI. Eight biopsies taken at the time of dermoscopy were reviewed, with all sites showing structureless or globular areas corresponding to the presence of granulomas on histopathology (100%). No other notable associations were observed. Conclusion Dermoscopy is a potentially useful tool to aid in the diagnosis and treatment monitoring of leprosy. Limitations of this study include the small sample size, the preponderance of subjects in the lepromatous pole, and assessments by a single trained dermoscopist. A longer study duration including a larger number of newly diagnosed leprosy patients is recommended.
Leprosy ; Dermoscopy

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

Background: Dermoscopy enhances detection of basal cell carcinoma (BCC), especially for the pigmented subtype common among Asians. However, there is limited data on dermoscopic features of BCC in Filipinos. Objectives: The objective of this study is to describe the clinicopathologic profile and dermoscopic features of BCC in Filipinos seen in a tertiary care clinic. Methods: A cross-sectional study was conducted in the Philippines from November 2019 to December 2021 in a tertiary care clinic. Fifty-three (53) lesions suspicious for BCC were analyzed using dermoscopy prior to histologic confirmation. Fifty (50) biopsy-proven BCC lesions were included in the analysis. Results: Lesions were more commonly seen in females (72.50%), and located on the head and neck (88%). The most common histopathologic subtype was nodular (74%). The most common dermoscopic features were large blue-gray ovoid nests (86%) and ulcerations (70%). Conclusion The most common BCC type among the study participants was nodular, with large blue-gray ovoid nests and ulceration seen on dermoscopy.
carcinoma, basal cell ; dermoscopy

Topical corticosteroids (TC) are among the most commonly prescribed topical agents and are used to treat various dermatoses. This study aimed to determine the prevalence, factors associated and reasons patients inappropriately use TC. Incidence of AE and risk of the development of AE due to inappropriate TC. Out-patient dermatology patients in a tertiary hospital in the Philippines were screened for TC use and interviewed using a questionnaire. Descriptive analysis and logistic regression to determine odds ratios were done. Out of 801 patients recruited, 260 (32%) used TC. Among those who used TC, 147 (56.53%) inappropriately used TC. Among the factors associated with inappropriate use of TC were: 1) Diagnosis of dermatitis as primary dermatosis (OR = 2.82, 95% CI 0.497, 1.276), 2) Lack of awareness of the FDA advisory (OR = 2.1, 95% CI 1.245, 3.601), 3) Lack of knowledge that TC cannot be applied for prolonged periods (OR = 5.5, 95% CI 3.201, 9.334), and 4) Lack of knowledge that TC use can result into AE (OR = 4.5, 95% CI 2.637, 7.657). Relatives and friends as source of information (OR=437, 95% CI 25.997, >1000), procurement (OR=60, 95% CI 3.081, >1000) and instruction (OR=337, 95% CI 19.827, >1000) were highly associated with inappropriate use. Twenty-two percent of those who inappropriately used TC self-medicated upon recommendation by family and friends. Hypopigmentation was the most common AE. There is a 3.8 times (OR= 3.8, 95% CI: 1.918, 7.662) likelihood for a person who has inappropriately used TC to have an AE as compared to a person who has appropriately used TC. There is a need to educate the general public regarding proper TC use. Patient encounters at the clinic may be a good opportunity to reinforce guidelines on the use of TC.
Adrenal Cortex Hormones ; Philippine