Introduction: Morpheq, also known as localized scleroderma, describes a distinctive inflammatory skin disorder that ultimately leads to sclerosis. It is differentiated from systemic scleroderma by the absence of vasculopathy and organ involvement. Initial erythema may precede the sclerotic stage by a few months causing initial diagnostic confusion. High index of suspicion and knowledge of disease evolution are essential. We report a case of morphea and its progression, the diagnostic approach and the importance of early treatment and long-term monitoring. Case Summary: A 3l-year-old Filipino female who presented with multiple erythematous plagues on the trunk and extremities and arthralgia was initially diagnosed with cutaneous drug reaction. Prompt treatment led to partial relief of symptoms. However, two months later, eruption of multiple ivory-white small patches and plaques were noted on the same affected areas prompting an impression of morphea. Serum markers revealed elevated antinuclear antibody levels and negative anti-Scl70/anti-centromere serum autoantibodies. Skin biopsy showed homogenized thick dermal collagen bundles confirming the diagnosis of morphea. Topical therapy with calcipotriol + betamethasone dipropionate ointment showed remarkable improvement with decrease in erythema and softening of the lesions while adjunct narrowband-UVB phototherapy also provided relief due to its ability to reduce collagen synthesis and cytokine production. Conclusion Morphea may be easily misdiagnosed during the early stages especially if sclerosis ensues late in the disease. Characteristic clinical appearance of erythematous plaques with violaceous borders may not always be present. Histologic examination and serum autoantibodies help exclude other disorders with the same clinical and histopathological spectrum. Treatment is individualized depending on the severity and depth of skin involvement, early treatment and monitoring should be initiated before complications arise.
Scleroderma, Localized ; Fibrosis

Extramammary Paget’s disease (EMPD) is an extremely rare cutaneous malignancy that represents a slow-growing, erythematous, ulcerative or eczematous plaque in areas of the body that possess a high concentration of apocrine glands. It is frequently observed in the genital region of Caucasian females, with the perianal region representing an uncommon site of involvement. Here, we report a case of primary extramammary Paget’s disease in the perianal region of a 55-year-old male, offering new insights into this elusive and poorly understood dermatologic condition.

A 55-year-old male sought consultation for a solitary, well-defined, irregularly shaped, erythematous to violaceous, ulcerated plaque in the perianal area of one-year duration. A clinical diagnosis of primary EMPD was confirmed by histopathologic findings of Paget cells, a cytokeratin 7 positive/cytokeratin 20 negative immunophenotype, and the absence of underlying malignancy. A wide excision with negative margin control and a bilateral V-Y fasciocutaneous advancement flap were performed with good results.

Extramammary Paget’s disease is a rare but insidious dermatologic malignancy often easily disregarded as a benign inflammatory condition. It underscores the need for clinicians to maintain a high index of suspicion to provide an early, accurate diagnosis, leading to a multidisciplinary treatment approach to prevent potential complications.

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

: Pityriasis lichenoides (PL) is an inflammatory papulosquamous condition that exists in a continuous spectrum that consists mainly of pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica (PLC). The condition has been reported to erupt in response to infections, radiocontrast media, medications and vaccines. Most case reports on vaccine-related eruption involve the acute PL, hence, this report aimed to present a case presenting with lesions of the chronic variant. : A 21-year-old female presented with multiple erythematous to hyperpigmented ill defined plaques, some ulceronecrotic, topped with fine scales and excoriations on the upper and lower extremities, periumbilical area and back of 4 months duration, following rabies vaccinations. : Histopathologic findings, including interface dermatitis, parakeratosis, spongiosis, and mixed inflammatory infiltrates, confirmed the diagnosis of PLC. The patient responded well to oral corticosteroids and heliotherapy. PL is rare and requires additional research. The potential role of vaccination as an etiologic agent represented a crucial area of this investigation. Additionally, heliotherapy should be considered as a viable therapeutic alternative when phototherapy is not feasible.. Further research is needed to elucidate the pathogenesis of PL and establish evidence-based treatment protocols.
Pityriasis lichenoides chronica ; Pityriasis lichenoides ; heliotherapy ; vaccine

Introduction: COVID-19 has emerged as a global problem with vaccines being established as one of the best tools in its control. Of particular interest in dermatology are risks and manifestations of cutaneous reactions from such countermeasures, with strides made in documenting and associating skin reactions with vaccines against COVID-19. This study aimed to determine the incidence of cutaneous adverse reactions in recipients of recombinant ChAdOx1-S and inactivated SARS-COV-2 vaccines among healthcare personnel and employees of UERMMMCI. Methods: A cross-sectional study was done were respondents, chosen through randomized stratified cluster sampling, were given a questionnaire to elicit cutaneous adverse effects associated with COVID-19 vaccines. Results: There were198 respondents, of which 29.3% were male and 70.7% were female, with a mean age of 26.07 years. Of these respondents, 72 (36.36%) received recombinant ChAdOx1-S and 126 (63.64%) received inactivated SARS-COV-2 vaccine. For the first dose, cutaneous reactions developed in 6 (8.33%) recipients of recombinant ChAdOx1-S, and 2 (1.59%) recipients of inactivated SARS-COV-2. For the second dose, no reactions followed vaccination with recombinant ChAdOx1-S while 4 (3.17%) reactions developed after inactivated SARS-COV-2 vaccination. Lesions were mostly confined to the injection site presenting with erythema for both vaccine types. One urticarial, widespread reaction was associated with a second dose of inactivated SARS-COV-2 vaccine. Conclusions Adverse reactions to COVID-19 vaccinations have been documented which may be attributed to respective excipients rather than vaccine antigens. Due to the rare occurrence of severe anaphylactic reactions, vaccine use is recommended as they confer protection even to those with prior infections. Documented reactions in this study were observed to be mild and self- limiting similar to larger studies.
Vaccines ; COVID-19 ; Pandemics

Introduction: IgA pemphigus is a rare, distinct variant of Pemphigus characterized by vesiculopustular eruptions mediated by IgA autoantibodies targeting keratinocyte cell surface antigens, desmocollins 1-3 and sometimes desmogleins 1 and 3. Its classical features have been described in literature but atypical cases have also been documented. This report presents such case posing a diagnostic dilemma. Case Report: A 35-year-old female presented with a 16-year history of intermittent eruptions of multiple hyperpigmented, annular and circinate, desquamating plaques and coalescing flaccid pustules on erythematous bases on the scalp, neck, trunk, and extremities. Histopathologic examination revealed subcorneal pustular dermatitis, and direct immunofluorescence was positive for granular intercellular IgG and IgA deposits in the epidermis. Antinuclear antibody test was negative and C3 level was normal. Antibody tests against desmogleins 1 and 3 were both negative. Topical potent corticosteroid therapy resulted in complete resolution of all lesions in three weeks. Conclusion Diagnostic dilemmas arise when laboratory results do not correlate with clinical findings. Findings of IgA autoantibodies in patients with pemphigus-like skin eruptions led to the diagnosis of subcorneal pustular dermatosis type of IgA pemphigus. Dapsone is the treatment of choice although topical potent corticosteroid alone may provide complete remission in some cases, avoiding the potential adverse effects of systemic therapy
Skin Diseases, Vesiculobullous

INTRODUCTION: Common warts are frequent benign cutaneous and mucosal infections. However, recommendations from previous studies have focused on personal and public factors to prevent warts and reduce its transmission. This study aimed to determine the prevalence of common warts and its relation to individual, family, school, public, and occupational factors. METHODS: This is a cross-sectional study wherein the cutaneous surfaces (except the mucosa and genitalia) of residents of Barangay Doña Imelda, Quezon City were examined for the presence of warts. Information on individual, family, school, public, and occupational risk factors was obtained from the respondents themselves, parents or guardian using a data extraction sheet. A PRR of > 1.0 was interpreted as a positive association. Chi-square and Fisher’s exact tests were used to test for significance. A p-value of < 0.05 was considered significant. RESULTS: The prevalence of common warts among 315 residents was 7.6 %. The presence of family (PRR = 6.41, 1.91), school (PRR = 1.68), and occupational (PRR = 1.50) factors increased the risk of developing warts. In contrast, a personal history of warts and public factors were not associated with the development of warts. CONCLUSION The prevalence of common warts is 7.6%, compatible with the results of previous studies. Having a family member with warts, large family size (more than five family members), having at least one closest school friend with warts, and occupation (fish or meat or poultry vendor) increase the risk of developing warts.

Introduction: Bullous pemphigoid (BP) is an acquired autoimmune subepidermal bullous disease characterized by linear depo- sition of IgG and C3 along the basement membrane. It rarely occurs in childhood, especially in adolescence, with only 14 cases identified in literature. Treatment of choice is systemic corticosteroids but other treatment options such as anti-inflammatory antibacterials and methotrexate are available. Case report: A 16-year-old Filipino girl presented with a three-month history of generalized vesicles and bullae. Nikolsky and Asboe-Hansen signs were negative. Histopathology and direct immunofluorescence were consistent with BP. ELISA to BP180 au- toantibody levels was elevated at 135 IU (normal <9 IU). Complete blood count showed leukocytosis with increase in neutrophils. Chest x-ray revealed pulmonary tuberculosis. The patient was given quadruple anti-Koch’s medication (pyrazinamide, rifampi- cin, ethambutol, isoniazid), prednisone, oral erythromycin and topical clobetasol propionate. Complete remission was attained at 10 months and is sustained at the time of writing. Conclusion To establish a definitive diagnosis and appropriate management, BP requires clinical, histopathologic, and immuno- logical correlation. Childhood BP has good prognosis and rapid treatment response, with rare relapses.
Pemphigoid, Bullous

INTRODUCTION: Interdigital pilonidal sinus is an acquired condition secondary to penetration of hair fragments into the skin of the web spaces of the hands commonly observed in hairdressers, and occasionally, among pet groomers. Local literature reports or guidelines to ensure practice of protective measures for this population of workers are currently lacking. CASE SUMMARY: A 24-year old pet groomer consulted due to occasional white hair strands emerging from two openings in the third interdigital space of his dominant hand. Histopathologic examination of the sinus tract showed an acanthotic, hyperplastic epidermis with scale crust, and nodular dermal infiltrates composed of epithelioid histiocytes, plasma cells, lymphocytes, and eosinophils. Transepidermal extrusion of polarizable hair cortical material was also evident establishing the diagnosis of an interdigital pilonidal sinus. Sinusectomy and debridement with healing by secondary intention resulted in an optimal wound closure and full motion of the affected hand after one week and minimal scarring with no recurrence after seven months. CONCLUSION Surgical excision followed by proper wound care is essential to avoid recurrence. In conclusion, since interdigital pilonidal disease is a rare condition, awareness among physicians would lead to accurate diagnosis, optimal treatment, and proper patient education.
occupational diseases ; grooming ; extremities ; Pilonidal sinus

BACKGROUND: Non-invasive devices deivering focused low-frequency ultrasonic waves (FLFUW) that reduce circumference and volume of areas with localized fat are becoming more popular.
OBJECTIVE: To determine whether FLFUW is safe and effective in reducing localized abdominal fat deposit.
METHODS: A randomized double-blind , placebo-controlled  trial was conducted among Filipino adults with localized abdominal fat deposits. The primary outcome  measured was the mean change in abdominal circumference after four weeks of weekly treatments. The secondary outcomes measured were mean change in abdominal fat thickness, patient, weight, serum lipid profile as well as the occurrence of adverse events
RESULTS: There was a significant reduction in the mean abdominal circumference (p=
Human ; Male ; Female ; Adult ; Abdominal Fat ; Adult ; Body Weight ; Double-blind Method ; Lipids ; Obesity ; Ultrasonic Waves

BACKGROUND: Seborrheic dermatitis is a common chronic, relapsing inflammatory skin condition occurring most often on the face, scalp and chest.
OBJECTIVE: To compare the efficacy and safety of 10% guava extract shampoo versus 2% ketoconazole shampoo and clobetasol 0.05% shampoo in the treatment of scalp seborrheic dermatitis.
METHODS: Forty-five patients clinically diagnosed with scalp seborrheic dermatitis were randomized to one of the three treatment groups: 10% guava extract shampoo, 2 % ketoconazole shampoo and 0.05% clobetasol shampoo. Patients were followed-up weekly for two weeks to assess the Seborrheic Area Severity Index (SASI) scores, pruritus score, patient's global assessment of improvement and adverse events.
RESULTS: After two weeks of treatment, there was no significant difference in the three groups in terms of the mean change in SASI scores (p= 0.46, ANOVA), pruritus scores and in the patient's global assessment of improvement, and frequency of adverse events.
CONCLUSION: 10% guava extract shampoo is a safe and effective alternative treatment for scalp seborrheic dermatitis.

Human ; Male ; Aged ; Middle Aged ; Adult ; Clobetasol ; Dandruff ; Dermatitis, Seborrheic ; Ketoconazole ; Pruritus ; Psidium ; Scalp ; Skin ; Treatment Outcome