Clinical and histopathological profile of melanoma patients seen at the Philippine General Hospital: A six-year retrospective study from 2004 to 2009

BACKGROUND: Melanoma is a malignant tumor ranked as the top cause of skin cancer death and is increasing in incidence in most races. Rarity and atypical presentation in Non-Caucasians lead to delayed diagnosis and poor survival rates in these populations. This is the first study in the Philippines to document and describe both clinical and histopathologic profile of melanoma in Filipinos. Data gathered and analyzed may be used as basis for future research on prevention and treatment of this deadly disease among Filipinos.OBJECTIVE: To determine the epidemiology, clinical and histopathologic characteristics of melanoma patients in the Philippine General Hospital.METHODS: Melanoma patient records and biopsies from the Department of Laboratories-Pathology Services and Section of Dermatology- Dermatopathology Unit of the Philippine General Hospital from 2004 to 2009 were reviewed. RESULTS: Fifty-eight melanoma cases were identified. Based on the medical records retrieved, 35% were males and 23% females, while 42% had missing information. Most were in the fifth decade with a mean age of 52.8 years. The most common sites were the feet and trunk. Seven patients had recorded metastasis. The most common histopathologic characteristics noted was presence of angiolymphoid spread (70%), followed by presence of tumor-infiltrating lymphocytes (42%), ulceration (37%), high mitotic rate (35%), neurotropism (14%) and co-existing nevus (2%). Vertical growth phase was seen in 49% while 16% had a radial growth phase.CONCLUSION: Melanoma has a lower prevalence rate in the population studied, but most presented with clinical and histopathologic features consistent with advanced stages.

Randomized controlled trial on the efficacy and safety of virgin coconut oil compared to mineral oil in the treatment of uremic xerosis

BACKGROUND: Uremic xerosis is the most common dermatologic condition present in patients with chronic kidney disease. Emollients were shown to be beneficial and are considered to be the first-line of treatment.OBJECTIVE: To assess the efficacy and safety of virgin coconut oil (VCO) compared to mineral oil as a therapeutic mosturizer for uremic xerosis.METHODS: Adult patients undergoing hemadialysis who have uremic xerosis were randomized using a computer-generated list and were instructed to apply either VCO or mineral oil twice daily on the legs for 4 weeks. Primary outcome measures included investigator-assessed clinical efficacy based on overall dry skin score (ODSS), change in skin hydration (corneometer readings), change in skin lipids (sebumeter readings), and quality of life scores. Secondary outcome measures included patient-assessed efficacy and advent of adverse effects. Overall therapeutic response was determined in which treatment success was defined as total clearance of xerosis or reduction of ODSS score and increased objective measurements (i.e., corneometer and sebumeter readings) plus moderate to marked patient-assessed efficacy, while treatment failure was defined as failure in any one of these parameters.RESULTS: A total of 45 (22 VCO group, 23 mineral oil group) were recruited and 36 (18 VCO group, 18 mineral oil group) completed the study. The majority of patients in both treatment groups showed improved ODSS, corneometer readings, and quality of life scores. Most patients considered both treatment oils to be moderately to markedly effective. Analysis of overall therapeutic response revealed treatment success of 4 out of 22 in the VCO group and 4 out of 23 in the mineral oil group. VCO demostrated a trend to benefit in improving xerotic skin (RRR = 1.0%, 95% CI: -30, 26.3; RR = 0.99, 95% CI: 0.76, 1.3) but results are inconclusive due to the wide confidence interval.CONCLUSION: The application of VCO or mineral oil for 4 weeks may be equally beneficial and safe in improving uremic xerosis. VCO showed a trend to benefit compared to mineral oil in terms of overall therapeutic response but this needs to be confirmed in larger randomized controlled trials.