ABSTRACT
Introduction@#Cryptococcosis is an opportunistic fungal infection caused by Cryptococcus neoformans. This systemic fungal infection affects 6 to 13% of patients with acquired immunodeficiency syndrome (AIDS). Only 10% of patients with this condition develop cutaneous manifestations.@*Case Summary@#A 20-year-old male, newly diagnosed case of HIV (Human Immunodeficiency Virus), presented with multiple skin-colored molluscum contagiosum-like umbilicated papules on the face, neck and both arms. Lesions increased in number rapidly and were associated with respiratory distress. Histopathologic examination revealed findings of opportunistic fungal infection suggestive of cryptococcosis. Serum Cryptococcal Antigen Latex Agglutination System (CALAS) test was also positive. Patient was then diagnosed as a case of cryptococcosis and was a candidate for intravenous amphotericin B. However, before the planned medication was given, the patient experienced severe respiratory distress and expired several hours later.@*Conclusion@#Molluscum-like skin lesions may be a telltale sign of a disseminated opportunistic fungal infection, including Cryptococcosis. Early diagnosis followed by prompt and aggresive treatment would improve outcome and survival of the patient.
Subject(s)
Cryptococcosis , Acquired Immunodeficiency Syndrome , HIVABSTRACT
Background@#Human Immunodeficiency Virus (HIV) infection/Acquired Immunodeficiency Syndrome (AIDS) remains a major challenge worldwide. Physicians have a crucial role in the struggle against HIV/AIDS and must be equipped with proper knowledge, attitude and practices (KAP). No study has been done to assess the KAP of dermatologists related to HIV-AIDS.@*Objective@#The study’s objective was to determine the KAP of Philippine Dermatological Society (PDS) members related to HIV/AIDS.@*Methods@#A cross-sectional study was done among PDS members from February to November 2017 utilizing a questionnaire consisting of socio-demographic questions and KAP questions related to HIV.@*Results@#Out of 210 participants, 71.43% show good working knowledge, 60.95% show negative attitudes, 55.71% show bad practices related to HIV/AIDS. Members aged 29 to 37 years old, having worked as dermatologists for 1 to 8 years, and having worked in the health care sector for 1 to 8 years have better working knowledge on HIV/AIDS. Although with lesser duration of work as dermatologist, these members have more positive attitudes towards HIV/AIDS. These findings may be attributed to greater exposure to HIV cases and better ability to access information by internet among younger dermatologists. Gender is not significantly associated with KAP related to HIV/AIDS. Practice related to HIV/AIDS is not significantly associated with any demographic variables. Bad working knowledge related to HIV/AIDS is associated with negative attitude and bad practices. This can be attributed to insufficient training in the field of HIV/AIDS.@*Conclusion@#Majority of PDS members show negative attitudes, bad practices, but good working knowledge related to HIV/AIDS.
Subject(s)
HIV , Acquired Immunodeficiency Syndrome , Knowledge , Attitude , DermatologistsABSTRACT
Introduction@#There are very few reported incidences of juvenile dermatomyositis in the Philippine setting.@*Case Summary@#This is a case of a 9-year-old female from Batangas City, who came in with a 3-year history of multiple non- tender, non-pruritic erythematous papules which started on the dorsal aspect of the metacarpophalangeal (MCP) and interphalangeal joints of the hands, with some progressing into plaques on the face and extremities. No other associated symptoms such as fever, cough, colds or weakness were noted. Three months prior to consult, there was persistence of the above-mentioned lesions with body weakness described as difficulty getting out of bed and climbing stairs. Consult with a dermatologist and rheumatologist was done. A skin punch biopsy showed hyperkeratosis of the stratum corneum. There was focal vacuolar alteration of the basal cell layer with thickening of the basement membrane zone. The papillary dermis showed pigment-laden macrophages, a calcified nodule, fibrosis, and a sparse perivascular inflammatory infiltrate of lymphocytes. There was also thickening of the basement membrane zone on Periodic acid-Schiff stain. Both clinical and histopathological findings point to Juvenile Dermatomyositis.@*Conclusion@#Juvenile Dermatomyositis requires prompt diagnosis for proper treatment and prognostication. This entails extensive diagnostic procedures such as skin punch biopsy, muscle enzymes such as CK-MB and CK- MM, and blood tests. Co-management with a pediatric rheumatologist is highly advised for initiation and regulation of oral corticosteroids as well as vitamin supplementation.