Erythema elevatum diutinum (EED) is a rare, chronic leukocytoclastic vasculitis characterized by erythematous to violaceous plaques and nodules, typically on extensor surfaces like the hands, elbows, and knees. It results from immune complex deposition in blood vessels, leading to inflammation and fibrosis. EED is often associated with infections, autoimmune disorders, or hematologic malignancies, but can also occur idiopathically. Although globally documented, EED is extremely rare in the Philippines, particularly in adolescents, highlighting its significance in local literature.

A 14-year-old Filipino female presented with a 5-month history of asymptomatic, skin-colored papules on her right elbow, gradually spreading to both elbows and knees, with occasional mild pruritus and knee joint pain. Past medical and family history were unremarkable. After temporary relief from an unrecalled cream prescribed by a private dermatologist, she was referred for skin punch biopsy, which revealed spongiotic epidermis with papillary dermal edema, moderate inflammatory infiltrates, eosinophilic inclusion bodies, and nuclear dusts surrounding the blood vessels, consistent with EED. The patient was treated with dapsone 50 mg/day, clobetasol propionate ointment twice daily for two weeks, and cetirizine 10 mg as needed for pruritus, resulting in clinical improvement.

This case highlights the extreme rarity of EED in the Philippines, particularly in adolescents. It emphasizes the need to consider EED in chronic papular eruptions and demonstrates the effectiveness of dapsone and topical steroids in managing the condition. Early diagnosis and timely intervention are crucial for preventing disease progression and improving patient outcomes, as seen in this case.

Human ; Female ; Adolescent: 13-18 Yrs Old ; Adolescent ; Erythema Elevatum Diutinum ; Leukocytoclastic Vasculitis

BACKGROUND

Skin diseases and mental disorders are often correlated. However, the prevalence of this association among outpatients is not well-documented, especially in the Philippines. This study investigated the complex relationship between skin conditions and potential mental disorders, aiming to enhance patient care through a more comprehensive, integrated treatment approach.

OBJECTIVES

To determine the relationship between skin diseases and probable mental disorders among outpatients seen at the dermatology department of a tertiary government hospital in the Philippines.

METHODS

This descriptive, cross-sectional study included 298 participants. Socio-demographic and clinical profiles were gathered, and a validated screening tool was used to identify probable mental disorders. Analytical statistics were employed to assess the relationship between socio-demographic and clinical profiles, skin diseases, and symptoms suggestive of a mental disorder.

RESULTS

The study results revealed no significant association between specific skin diseases and mental disorders. However, significant correlations were noted between certain sociodemographic and clinical factors—such as employment status, residence, educational attainment, birth order, disease severity, and disease duration—and the presence of probable mental disorders.

CONCLUSION

The results emphasized the critical role of clinical and sociodemographic factors in determining mental health outcomes in dermatology settings. Incorporating mental health screenings into standard dermatological care enables healthcare providers to greatly improve patient outcomes, providing a more comprehensive and holistic treatment approach.

Skin Diseases ; Mental Disorders ; Outpatients