CONTEXT

Accurate diagnosis of onychomycosis is important since misdiagnosis can lead to inappropriate therapy, delayed diagnosis of other nail conditions, and antifungal resistance. Dermoscopy is an emerging diagnostic tool, particularly valuable in the resource-poor settings.

The study aimed to evaluate the accuracy of dermoscopy as a point-of-care tool in diagnosing distal subungual onychomycosis (DSO) at a tertiary hospital.

An observational, prospective, and cross-sectional study was conducted among 22 clinically diagnosed DSO patients using convenience sampling at a tertiary hospital from November 2019 to September 2021.

Participants underwent gross nail examination, dermoscopy, potassium hydroxide (KOH), and periodic acid-Schiff (PAS) examinations.

Sensitivity, specificity, predictive value, and likelihood ratios (LRs) of the dermoscopic patterns were obtained using KOH and PAS results as the reference standard.

Fifty-one nails were submitted but 2 were lost during the processing, leaving 49 nails for analysis. The most common pattern was jagged edge with spikes (65.3%). Individual patterns yielded only low-to-moderate sensitivity (32.4%–73.5%). However, combining all patterns increased sensitivity to 91.2% (95% confidence interval: 76.3–98.1). Ruin appearance showed the highest specificity (100%) and positive predictive value (100%). LRs were not significant enough to draw the conclusions.

Dermoscopy may serve as an on-site, adjunct tool in the diagnosis of DSO, especially when the combination of patterns is considered. Ruin appearance maybe particularly useful in ruling in DSO. However, confirmation using mycological and histopathological tests remains essential.

BACKGROUND

Psoriasis is a chronic, inflammatory disorder of the skin, nails, and joints that develop in genetically predisposed individuals. Despite the low prevalence of pediatric psoriasis, it is not an uncommon condition since one-third of adults with psoriasis had its onset during childhood. At present, published literature on pediatric psoriasis in the Philippines is lacking.

This study aimed to determine the clinicodemographic and healthcare resource utilization profiles of pediatric psoriasis patients.

This is a 4-year retrospective study conducted at a tertiary public hospital in the Philippines utilizing chart review of patients aged 18 years and below, diagnosed with psoriasis.

The average age is 10.68 years while the mean age at diagnosis is 10.35 years. There is female predilection. For the initial psoriasis area and severity index (PASI) scores, 5.26% had mild, 8.77% had moderate, and 33.33% had severe PASI. Majority of the lesions at initial diagnosis were observed on the trunk, followed by extremities and then scalp. Only 5 out of 57 patients were noted to have been triggered by an infection. Eight out of 57 patients had a positive family history. The most common nail finding is onycholysis, followed by pitting and then oil spots and subungual hyperkeratosis. For the comorbidities, 17.5% have atopy-associated conditions. Majority of the patients were given topical anti-inflammatory treatments; 12% were prescribed systemic treatment while only 5.26% utilized phototherapy. The average cost of hospitalization is PHP 17,967.17.

Most of the data gathered and presented in the study are in agreement with published studies on pediatric psoriasis among Asian populations.

BACKGROUND

Social media platforms have become ubiquitous online tools, fundamentally altering how individuals connect, share information, and interact with the healthcare system. Given the inherently visual nature of skin conditions, the quest for dermatologic information has surged in parallel with the exponential growth of social media over the past decade.

This study aimed to characterize Filipino adults who seek dermatology-related health information on social media and to investigate how this information influences their behavior regarding skin, hair, and nail problems.

A descriptive cross-sectional study was conducted in December 2022 using nonprobability, purposive sampling. Data were collected via a validated 16-item online questionnaire distributed across various social media platforms, including Facebook, Twitter, and Instagram. Descriptive statistics were computed from Google Form Responses, saved as a Microsoft Excel sheet.

A total of 263 individuals participated in the online survey. The majority of Filipino adult social media users in this study were female (60.5%), single (92%), possessed high educational attainment (53.6% postgraduate degrees), and belonged to the middle-class income bracket (54%). Facebook was identified as the most commonly used social media platform (94.3%). A substantial proportion, approximately 87.5% (230/263), reported using social media to search for health information pertaining to the skin, hair, and/or nails. Crucially, most of these individuals (80.6%) verified the credibility of the information they received. The information gleaned from social media significantly influenced the majority of respondents (74.1%), with reported changes including starting (52.5%), changing (36.5%), and stopping (20.2%) treatment after seeking dermatology-related health information online. More than half of the respondents (51%) subsequently sought consultation with a board-certified dermatologist.

To the investigators’ knowledge, this is the inaugural local descriptive study exploring the characteristics of Filipino patients who leverage social media as a health information tool for dermatologic concerns. The study provides crucial baseline information on how this digital engagement impacts their perception of disease, influences decisions to seek further evaluation and management, and alters treatment compliance. These findings are poised to significantly benefit both patients and healthcare providers in the Philippines.

BACKGROUND

Skin cancer incidence has risen in recent decades, with excessive ultraviolet radiation exposure being a significant factor, especially among athletes involved in outdoor sports. This study examines differences in knowledge, attitudes, and practices (KAP) regarding sun exposure and protection between urban and rural college track and field athletes.

This cross-sectional study was conducted in the Philippines with 60 college track and field athletes selected through nonprobability convenience sampling. A questionnaire, adapted from two local studies, assessed KAP regarding sun exposure. The final questionnaire was then distributed via Google Forms. Pearson’s correlation assessed the relationships between KAP.

Urban and rural athletes lacked adequate knowledge about sun exposure and protection, though urban athletes had a slightly higher knowledge score. Urban athletes exhibited more desirable attitudes toward sun protection. Both the groups showed inadequate sun protection practices. Social media was the most common source of information.

This study found that while locality does not determine sun protection practices, urban athletes showed more positive attitudes. Greater knowledge was linked to better attitudes but did not always translate into improved practices. Addressing barriers that hinder the application of sun protection knowledge is essential to bridging this gap and promoting consistent sun safety behaviors, especially among athletes who engage in outdoor sports.

INTRODUCTION

Excimer light is a targeted phototherapy that uses 308-nanometer wavelength ultraviolet radiation to treat photoresponsive dermatoses such as psoriasis, vitiligo, and alopecia areata. Ideally, the minimal erythema dose (MED) should be determined to guide the initial treatment dose. However, due to convenience, estimation based on skin phototype is more commonly used.

To determine the MED to excimer light in adult Filipinos using a visual erythema scale.

A prospective interventional, cross-sectional study was conducted among adult Filipinos in a tertiary government hospital in the Philippines. Participants underwent phototesting with six incremental doses of excimer light. MED was defined as the lowest dose that produced uniform, well-defined erythema over the exposed area. Descriptive statistics summarized clinicodemographic data, MED, and adverse events. Fisher’s exact test assessed associations between MED, sex, and skin type.

A total of 149 adult Filipinos with Fitzpatrick skin types III to V were enrolled. MED values ranged from 150 to 400 mJ/cm2, with 200 mJ/cm² being the median and mode (33.56%). No association was found between MED and skin phototype. Sex correlated with MED, with females having higher MEDs than males.

The median MED was 200 mJ/cm2 in Filipino patients with skin types III to V. This may serve as the initial starting dose for phototherapy (except in vitiliginous skin). With the variation in the MED within the population, MED determination is still the ideal method to identify the most appropriate initial treatment dose.

Bowenoid papulosis (BP) is an uncommon yet clinically significant human papillomavirus (HPV)-associated condition that exhibits features of both condyloma acuminata and carcinoma insitu. We report the case of a 24-year-old Filipino male with multiple pruritic, pigmented penile lesions of 5 months’ duration, confirmed histologically as BP. This case underscores the importance of recognizing HPV-related lesions early and initiating appropriate treatment, not only to prevent progression to malignancy but also to limit transmission. The report also highlights the relevance of offering HPV vaccination, particularly to males, and the critical need for screening for other sexually transmitted infections, especially in light of the growing human immunodeficiency virus epidemic in the Philippines, underscoring that the condition itself may be sexually transmitted in nature.

Chronic tophaceous gout is a manifestation of longstanding, untreated hyperuricemia, characterized by monosodium urate crystal deposition in soft tissues and joints. While commonly presenting as nodular or papular tophi, rare morphologic variants such as miliarial gout may occur. We present a case of a 35-year-old Filipino male who presented with classic cutaneous manifestations of chronic tophaceous alongside numerous widespread, milia-like papules containing chalky tophaceous material, consistent with miliarial gout. This distinct and uncommon variant has only been reported in a few cases worldwide. Notably, the patient had a history of prolonged unsupervised corticosteroid use, renal insufficiency, and poor compliance to urate-lowering therapy, all of which may have contributed to the rapid and extensive cutaneous involvement. This case highlights the importance of early recognition of atypical gout presentations and emphasizes the potential role of corticosteroids in modifying disease progression and morphology.

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.

Psoriasis vulgaris and vitiligo are chronic autoimmune skin conditions that affect all races and age groups. Psoriasis presents as erythematous plaques with silvery scales, while vitiligo manifests as symmetric depigmented macules. Their co-occurrence, although documented since 1955, remains relatively rare and underreported in Asian populations. We report the case of a 54-year-old Filipino male, with no known comorbidities who presented with both psoriasis and vitiligo. Skin punch biopsies confirmed the diagnoses of both conditions. During treatment, new vitiliginous lesions appeared over psoriatic plaques, suggesting Koebnerization. We review the current literature to explore possible immunologic and genetic overlaps and provide insights to their treatment.

Neutrophilic dermatosis of the hands (NDH) is an uncommon inflammatory condition recognized as a localized variant of Sweet syndrome, seen in older adults with malignancy or systemic inflammatory disease. We present a rare case of NDH in a 23-year-old male in an unusual location, without the typical associated systemic illness or recent trauma. The patient presented with recurrent, painful erythematous nodules exclusively on the fingers and a violaceous bulla-like plaque on the volar surface of the left index finger. Laboratory tests showed leukocytosis with neutrophilia, elevated erythrocyte sedimentation rate, and normal C-reactive protein levels. Investigations for other underlying causes were unremarkable. Histopathologic examination was consistent with NDH. He was treated with dapsone 50 mg daily, with resolution in 3 weeks, and no recurrence was reported. This case expands the clinical spectrum of NDH. It highlights the importance of considering it in the differential diagnosis of painful hand lesions in younger patients, even in the absence of typical risk factors or systemic involvement.