Perineurioma (PN) is an uncommon benign tumor originating from the peripheral nerve sheath and composed solely of perineurial cells. Most PNs occur sporadically and are typically described as painless masses. This report presents an atypical case of extraneural or soft tissue PN (ESTP) in a 37-year-old Filipino female with a history of trauma. The patient presented with a 5-month history of a gradually enlarging nodule on her right thumb accompanied by localized dull pain. Physical examination revealed the presence of an ill-defined, slightly erythematous, firm, movable, and tender nodule. Histopathological analysis demonstrated characteristic features of ESTP, including spindled cells arranged in a whorled pattern. Immunohistochemical staining for epithelial membrane antigen was positive, while S-100 staining was negative, which confirmed the diagnosis. The nodule was successfully excised without any complication. There was no recurrence observed during the 4thmonth postexcision. This case highlights the importance of considering ESTP as a potential diagnosis for painful masses following trauma and suggests a possible association between ESTP and trauma. Surgical excision remains the preferred treatment option for ESTP, and recurrences are infrequent.

Human ; Female ; Adult: 25-44 Yrs Old ; Nerve Sheath Neoplasms

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

BACKGROUND

Mycetoma is a chronic, progressively destructive granulomatous infection caused by fungi (eumycetoma) or bacteria (actinomycetoma). It is recognized by the WHO as a neglected tropical disease. Despite its presence globally, the incidence and burden in the Philippines remain poorly documented.

OBJECTIVES

To determine the prevalence, clinicodemographic profile, and outcomes of mycetoma diagnosed at the Jose R. Reyes Memorial Medical Center - Department of Dermatology from January 2014 to December 2024.

METHODS

A retrospective chart review was conducted among patients diagnosed clinically and confirmed either microbiologically and/or histopathologically with mycetoma. Data collected included age, sex, occupation, risk factors, lesion characteristics, causative agent, diagnostic method, treatment, and outcomes.

RESULTS

Four cases of actinomycetoma were identified, all with pedal involvement. The majority were male (75%) and over 40 years old. One patient had an agricultural occupation. Most were from outside Metro Manila. Histopathologic confirmation was present in all cases. Three patients were lost to follow-up. Only the patient treated for over 12 months achieved clinical improvement.

CONCLUSION

Mycetoma remains a rare but significant disease in the Philippines. Findings support existing literature on male predominance, pedal localization, and the importance of prolonged antimicrobial treatment. Greater surveillance, early diagnosis, and follow-up strategies are essential.

Human ; Male ; Female ; Middle Aged: 45-64 Yrs Old ; Adult: 25-44 Yrs Old ; Mycetoma ; Actinomycetoma

Hailey-Hailey Disease (HHD) is a rare, chronic skin condition characterized by relapsing episodes and spontaneous remissions, significantly affecting patients’ quality of life, especially in severe cases. Due to its rarity, there are no established evidence-based treatment guidelines or extensive clinical trials. This case report highlights the rapid improvement of HHD in a 55-year-old Filipino woman treated with a combination of 5-fluorouracil and excimer phototherapy, suggesting that this treatment approach may be an effective alternative for managing the disease.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Hailey-hailey Disease ; Pemphigus, Benign Familial

Lupus vulgaris is a form of cutaneous tuberculosis (CTB) caused by Mycobacterium tuberculosis (MTB). It is characterized by a usually solitary, long-lasting skin lesion that most commonly develops on the head or neck, especially the nose, cheek, earlobe, or scalp.

A 69-year-old elderly, Filipino female presented with a 20-year history of progressively growing erythematous ulcerative plaques on the right arm and ear, with associated mild pruritus and pain. She appeared to be immunocompetent and had no clinically apparent underlying focus of TB infection. Tuberculin skin test (TST) showed a positive reaction and histopathologic examination revealed a chronic granulomatous dermatitis that is focally positive for acid-fast bacilli (AFB). She was given anti-koch’s therapy with subsequent resolution of the lesions.

The case report presents a rare instance of lupus vulgaris (LV) in a Filipino woman, characterized by large, ulcerative plaques on her body with no apparent infection source, emphasizing the need for early detection and Quantiferon-TB Gold (QFT-G) testing for diagnosis.

Human ; Female ; Aged: 65-79 Yrs Old ; Lupus Vulgaris

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

Introduction: Cushing syndrome caused by application of topical corticosteroids is rarely reported. Systemic side effects like suppression of hypothalamic-pituitary-adrenal axis, growth retardation in children and iatrogenic Cushing syndrome can occur even in small doses of potent topical steroids.1 Case Summary: This is a case of a 3-month old female who was referred to our department due to generalized erythema with desquamation. History revealed that the patient had recurrent eczema and the mother applied an over-the-counter medication containing Ketoconazole+Clobetasol 10mg/500mcg per 7-gram cream thrice daily for ten weeks. The estimated topical steroid applied weekly was around 8.5 grams and at time of admission, the patient had been exposed to approximately 50 grams of a potent topical corticosteroid. The patient presented with fever, irritability, and had positive Nikolsky sign thus managed as a case of staphylococcal scalded skin syndrome associated with topical steroid – induced iatrogenic Cushing syndrome. Unfortunately, patient’s condition worsened and with progressive pneumonia, she expired on the 23rd hospital day. The fatal outcome was due to SSSS which was complicated by progressive pneumonia and topical steroid – induced iatrogenic Cushing syndrome. The complex interplay of these features eventually led to sepsis and death. Conclusion This case highlights the risks related to abuse of potent steroid-containing preparations and the importance of education to prevent severe and catastrophic outcomes of injudicious steroid use.
Staphylococcal Scalded Skin Syndrome