Congenital divided nevus of the eyelids is a rare form of melanocytic nevus which involves contiguous portions of the upper and lower eyelid margins unilaterally, hence the term ‘kissing nevus’. While usually present at birth, these nevi may also appear later in life. When the mass enlarges, it may cause cosmetic issues to the patient, as well as functional problems such as mechanical ptosis, ectropion, and epiphora.

We report three cases of congenital divided nevus of the eyelids, all presenting with unilateral upper and lower hyperpigmented lid masses since birth. The first case had an upper lid mass measuring 11 mm x 19 mm, and a lower lid mass measuring 55 mm x 47 mm, with both masses extending into the palpebral conjunctiva, and causing severe ptosis and corneal neovascularization due to chronic irritation. The second case presented with hyperpigmented masses at the lateral third of the right upper eyelid measuring 8 mm x 17 mm and of the lower eyelid measuring 9 mm x 15 mm on the lower lid with lashes growing through the masses. There was extension of the mass into the palpebral conjunctiva. The third case presented with a 23 x 18 mm hyperpigmented, well-circumscribed, verrucated mass at the medial half of the upper eyelid crossing the eyelid margin, and a 15 x 13 mm lesion at the medial third of the lower lid with the same characteristics, with small crusty lesions and clotted blood. All three patients underwent excision biopsy with lid reconstruction using full thickness skin grafts from the supraclavicular area. Six months postoperatively, the first case underwent a repeat full thickness skin graft due to graft contraction, and also received two sessions of fractional carbon dioxide (CO2 ) laser, two sessions of intralesional triamcinolone injections, and silicone gel application with further improvement of graft healing and scarring. The second case also underwent two sessions of intralesional steroid injection for scar management. During follow-up, which spanned 13 months for the first case, 10 months for the second case, and two months for the third case, improved functional and cosmetic outcomes were observed.

This case series highlights the outcomes of the most common surgical technique done for congenital divided nevi of the eyelids. Congenital divided nevi are usually diagnosed clinically and malignant degeneration is rare, hence lid reconstruction may be done without frozen section. The cases in the series were treated due to cosmetic and functional purposes, hence the importance of continuous post-operative follow-up to monitor for graft dehiscence, scar development, recurrence of the mass, malignant degeneration, and development of lid malposition. Additional procedures for scar management, such as CO2 laser and intralesional steroid injections, may be necessary to further enhance outcomes in complex cases. All three cases in this series exhibited improved functional and cosmetic outcomes post-operatively, with significant reduction in ptosis and scarring. Longterm follow-up revealed satisfactory recovery with minimal complications, with no recurrence nor malignant degeneration.

Human ; Male ; Female ; Adult: 25-44 Yrs Old ; Young Adult: 19-24 Yrs Old ; Nevus ; Nevus, Pigmented

Bullous pemphigoid (BP) is the most common autoimmune blistering disease primarily characterized by tense blisters and occasionally with urticarial plaques, affecting the skin and mucous membranes. These are caused by autoantibodies against BP180 and BP230 which target antigens on the basement membrane zone. The diagnosis relies on the integration of clinical, histopathological, immunopathological, and serological findings. The management depends on the clinical extent and severity. We present in this article a literature review and the clinical consensus guidelines of the Immunodermatology Subspecialty Core Group of the Philippine Dermatological Society in the management of BP.
Pemphigoid, Bullous

INTRODUCTION: The NCR had amassed 752,668 cases of COVID-19 as of September 2021, the highest among the regions in the Philippines. This study aimed to determine the correlation between population, population density, age, and sex with the number of cases among local government units (LGU) in the National Capital Region (NCR). METHODS: The data for population, population density, age, and sex distribution of the LGUs of NCR were retrieved from the 2015 Philippine census while the data for cases were from DOH’s COVID-19 Tracker. Pearson correlation coefficient was computed to determine the correlation between population, population density and cases. Phi and Cramer’s V statistic were computed to determine associations between sex, age groups, and cases. RESULTS: There was little or no correlation between population density and number of cases (r = 0.236) but was good (r = 0.905) when Quezon City was excluded for being an outlier. There was good correlation between population and number of cases (r = 964, p < 0.001). There was very weak to no association between sex and number of COVID-19 cases. There was a statistically significant moderate association between age and COVID-19 cases (f = 0.145, p < 0.001). CONCLUSION The study has shown that population density and population have a good correlation with the number of COVID-19 after Quezon City was removed as a data point. There is a moderate association between age and number of COVID-19 cases. There is a very weak to no association between sex and COVID-19 cases.

INTRODUCTION: Noise-induced hearing loss (NIHL) attributed to occupational noise exposure is one of the most common causes of permanent hearing impairment. In the Philippines, road traffic remains the biggest source of noise. The authors aimed to determine the prevalence of NIHL among traffic enforcers in Quezon City and quantify their occupational noise exposure levels. METHODS: Traffic enforcers were recruited via convenience sampling and screened using a questionnaire and otoscopic examination. Participants underwent pure tone audiometry and those found to have hearing loss were classified as “indicative” or “suspected” NIHL. Audiometric measurements of noise levels in areas where the traffic enforcers were assigned were taken using a calibrated smartphone application. RESULTS: “Indicative of NIHL” was highest in the 41 to 50-year age group and “suspected NIHL” was highest in the 31 to 40-year age group. “Indicative of NIHL” was highest among those working for 1 to 5 and 11 to 15 years in the right ear (25%) and 11 to 15 years in the left ear (30%). “Suspected NIHL” was highest among those working for 6 to 10 years. The average noise levels from the different areas measured at different times ranged from 79.0 to 82.5 dB. CONCLUSION “Indicative of NIHL” is more prevalent in the older age group while “suspected NIHL” is more prevalent in the middle age group. The prevalence of “indicative of NIHL” is highest among those in service for 1 to 5 and 11 to 15 years while “suspected NIHL” is highest among those in the service for 6 to 10 years. The average noise level measurements were within the safe values suggested by WHO.
Audiometry, Pure-Tone ; Hearing Loss, Noise-Induced ; Noise, Occupational