BACKGROUND

Ultraviolet radiation (UV) imposes significant negative consequences upon excessive exposure. It is a common misconception in darker skin types that there is no need for photoprotection, hence studies have been done on other adjuncts of photoprotection. Cocoa is naturally-occurring antioxidant rich in flavanols that absorbs UV radiation and scavenge reactive oxygen species.

OBJECTIVE

The study aimed to determine the UVB photoprotective activity through minimal erythema dose determination of 100% cocoa powder versus chocolate flavored powder drink.

METHODS

This study was a randomized, double-blind controlled trial, wherein sixty (60) Filipino subjects aged 18 years old to 59 years old with Fitzpatrick skin type IV-IV were equally divided into two groups using computer generated randomization. Group I received 100% cocoa powder, one (1) tablespoon dissolved in hot water daily for 12 weeks, while Group II received chocolate flavored drink powder, one (1) tablespoon dissolved in hot water daily for 12 weeks. Minimal erythema dose (MED) were assessed for both groups at baseline, week 6 and week 12. Laboratory testing for fasting blood sugar (FBS), blood urea nitrogen (BUN), creatinine, SGPT and SGOT was done baseline and at week 12.

RESULTS

In the 100% cocoa powder group, the mean MED increased from baseline to week 6 at an average of 5.5% (p-value 0.64) which were not statistically significant, while from baseline to week 12 an statistically significant increase in mean MED was noted at 21% (p-value < 0.01). These results showed that there is significant photoprotective activity of 100% cocoa powder for intake of 12 weeks as compared to 6 weeks. In the chocolate flavored powder drink, MED remained unchanged. No significant adverse clinical symptoms and laboratory test changes were seen in this study.

CONCLUSION

Intake of 100% cocoa powder for 12 weeks have significant photoprotective activity compared to baseline among Filipinos with Fitzpatrick skin type IV-V. While chocolate flavored drink powder has no such effect.

Human ; Plants ; Cocoa Powder ; Chocolate

Multiple Familial Trichoepithelioma (MFT) is a subtype of trichoepithelioma that begins during childhood as asymptomatic skin colored nodules predominantly on the central area of the face. It is a rare benign tumor of follicular differentiation associated with syndromic disorders and with mutations on the following genes: PTCH, 9p21 and CYLD. Overlap features between trichoepitheliomas and basal cell carcinomas may be present clinically and histopathologically. Hence, the importance of clinicopathologic differentiation between both as treatment options and prognosis varies.

We have a 52 year old male who presented with multiple asymptomatic, coalescent, flesh colored papules and nodules on the face and on the bilateral ears that started during childhood with gradual progression in size. Dermoscopy revealed thin arborizing vessels, milia-like cysts on a whitish background. History of similar lesions are noted among eight of his family members. Skin biopsies were taken on two nodules which showed tumor islands of basaloid cells with peripheral palisading, surrounded by fibrous stroma, characteristic papillary mesenchymal bodies and presence of keratin filled cysts. Genetic testing was advised and the planned course of action for the patient is to undergo ablative carbon dioxide laser combined with topical imiquimod cream to minimize recurrence.

This case highlights the relevance of multiple biopsy sites to rule out other differential diagnoses presenting with leonine facies and syndromic disorders associated with multiple familial trichoepitheliomas. Genetic testing is recommended but presumptive diagnosis may be made through positive family history, clinical and histopathologic features.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Multiple Familial Trichoepithelioma ; Familial Cylindromatosis

Vascular malformations are aberrant proliferations of blood vessels that may present at birth or develop subsequently. Capillary malformations (CMs) represent the most common category of vascular malformations. They generally present as localized discoloration, including port-wine stains (PWSs) and telangiectasia. Certain PWSs, especially those affecting the V2 dermatome, may give rise to pyogenic granulomas or other epithelial or mesenchymal hamartomas.

We present a case of a 46-year-old male with a 5-year history of a solitary, progressively enlarging firm papule on an erythematous patch or “birthmark” on his left cheek. Despite infrequent manipulation, there were no reports of bleeding or any associated symptoms, including pain, pruritus, and thrills. The patient sought consultation for cosmetic reasons and wanted to have the lesion removed. Hence, an excision biopsy revealed a well-defined proliferation of mature thick and thin-walled vessels, lined by a single layer of endothelial cells, surrounded by dysmorphic and irregularly arranged vessels consistent with arteriovenous malformation with capillary malformation.

Capillary malformation (CM) is the most common form of vascular malformation. Fifty percent of port-wine stains (PWSs), which is the most common (CM) in children, are in the face area innervated by the second branch of the trigeminal nerve. Arteriovenous malformations manifest in the advanced stages of PWSs and, alongside pyogenic granuloma, represent underreported histological changes inside mature PWSs, especially in the face area innervated by the second branch of the trigeminal nerve (V2).

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Port-wine Stain ; Arteriovenous Malformations