BACKGROUND

Cutaneous findings are the most common manifestations of abuse. Hence, a thorough dermatologic evaluation is crucial to rule out the possibility of injuries - accidental or intentional. Underreporting and incomplete documentation were also identified research gaps. The objectives of this study are to establish a baseline database, describe trends in the WCPU and ER medicolegal cases, and identify relationships among demographics, cutaneous findings, and injuries.

METHODOLOGY

This is a case-control study conducted in a Tertiary Hospital in the Philippines. Medico-legal records from the emergency room and WCPU during 2019-2023 were retrieved and analyzed.

RESULTS

There were 2,611 WCPU Cases and 9511 ER Cases. Only 2,663 ER Cases (28%) have complete findings. The majority of the physically abused patients in the ER and WCPU perpetrators were adult males. Most WCPU patients were minor females. Only 25% of the WCPU cases were reported within three days. The majority of sexual perpetrators are not strangers to their victims. A significant fraction of sexual abuse is also incestuous. Several significant cutaneous findings suggestive of physical abuse were observed in this study. Intuitively, Gunshot wounds and stab wounds were associated with intentional injuries. Contusion and hematoma were more likely seen in cases of assaults involving accessible areas during altercations – the cheek, eye, eyelid, and nose. Injuries over protected body sites such as the chest and neck also warrant suspicion of intentional injuries. The abdomen, back, and chest were sites of predilection for both GSW and stab wounds.

CONCLUSION

It should be second nature for all physicians to identify dermatologic and demographic cues to rule out possible cases of abuse.

Human ; Physical Abuse ; Rape ; Dermatology

Tuberous sclerosis complex (TSC) is a rare, autosomal dominant multisystem disorder affecting the brain, heart, kidneys, lungs, and skin leading to significant morbidity and mortality. We report a case of TSC and highlight the need for prompt diagnosis and proper surveillance to minimize life‑threatening complications. A 20‑year‑old female presented with facial and ungual papulonodular lesions 4 years after being diagnosed with epilepsy at the age of eight. No family history of genetic diseases was reported. Eight years later, the patient developed recurrent cough, shortness of breath, and blurring of vision. Biopsy of facial and digital nodule showed angiofibroma and ungual fibroma (Koenen tumor), respectively. Chest computed tomography scan revealed extensive cystic lesions diffusely scattered throughout the entire lung parenchyma suggestive of lymphangioleiomyomatosis. Cranial MRI revealed cortical and subependymal tubers, compatible with TSC. The patient had multidisciplinary management. However, her symptoms progressed, and she eventually succumbed to death. Cutaneous lesions such as facial angiofibromas and ungual fibromas along with multisystemic manifestations should alarm the clinician to TSC. Given its highly variable expressivity, awareness of different TSC‑associated signs and symptoms is essential for prompt diagnosis, proper treatment, disease monitoring, and early recognition of TSC complications.
Angiofibroma ; Lymphangioleiomyomatosis ; Tuberous Sclerosis

BACKGROUND

Visible pigmentation abnormalities on the face or body are often perceived as unusual by many, leading to psychological distress for those affected. Cosmetic camouflage may be offered to give immediate satisfaction to patients.

OBJECTIVE

To investigate the effect of cosmetic camouflage in health-related quality of life (HRQoL) of patients with facial dyspigmentation using the Dermatologic Quality of Life Index (DLQI).

METHODS

A quasi-experimental study was conducted among adult patients with facial dyspigmentation. Participants applied a cosmetic camouflage product once daily for four weeks. DLQI scores were recorded before and after the intervention. A non-parametric Wilcoxon signed-rank test was then used to compare the paired DLQI scores.

RESULTS

Thirty subjects were included in the study. The most common diagnosis of facial dyspigmentation was solar lentigo (46.67%). An improvement in the overall mean DLQI score was noted (p valueCONCLUSION

Cosmetic camouflage positively impacts the HRQoL, as evidenced by a significant reduction in DLQI scores. Cosmetic camouflage appears to be an effective adjunctive option for managing the psychological effects of facial dyspigmentation. Further research with larger samples and extended follow-up is recommended to confirm these findings and assess the long-term benefits.

Human ; Health-related Quality Of Life ; Quality Of Life