Body dysmorphia and selfie behavior of Filipino patients with and without mild acne vulgaris: A descriptive cross-sectional study

Background@#Acne vulgaris (AV) is a chronic inflammatory skin condition that is non-life-threatening but may cause significant psychological morbidity regardless of severity. An extreme case of this is depicted in body dysmorphic disorder (BDD), which is often an undiagnosed condition presenting with excessive preoccupation of perceived flaws not observable by others. With the increasing popularity of social media throughout the years, there has been budding researches exploring its psychological implications, particularly on “selfies” and its possible association with self-image and body dysmorphia.@*Objectives@#To compare body dysmorphic symptoms and selfie behavior between patients with mild AV versus those without AV. Methods This is a single-center, cross-sectional study among patients with mild AV and those without AV seen through a teledermatology platform of a tertiary hospital from April to June 2022. @*Results@#A total of 207 patients were included in this study – 107 patients with mild AV and 100 patients without AV. A significantly higher proportion of BDD symptoms was seen in patients with mild AV using either Body Dysmorphic Disorder Questionnaire-Dermatology Version (BDDQ-DV) (31%) and Dysmorphic Concern Questionnaire (DCQ) (14%). No significant difference was noted in terms of selfie behavior between the groups. @*Conclusions@#BDD symptoms were significantly more prevalent in patients who have mild AV despite having lesions that are negligible and clinically not apparent. This highlights the importance of dermatologists’ knowledge that BDD may cause distress and impairment and should be taken into consideration in terms of management. Interestingly, selfie behavior of patients with mild AV and without AV had no significant difference.

Large basal cell carcinoma in a 101-year-old Filipino female: A case report

Introduction@#Basal cell carcinoma (BCC) is the most common type of malignancy worldwide. The incidence of BCC is positively associated with increasing age; thus, centenarians, defined as those aged 100 years and above, become a vulnerable population to developing malignancy. As a person ages, risk factors such as chronic sun exposure, ionizing radiation, and immunosuppres- sion induce mutations that contribute to tumor formation. Impaired DNA repair capacity in response to carcinogens and immune function dysfunction also increases BCC risk in the elderly. Currently, studies among centenarians with high-risk basal cell car- cinoma treated with surgical interventions are limited.@*Case report@#Presented herewith is a case of a 101-year-old female with a 15-year history of hyperpigmented, hyperkeratotic plaque over the right malar area and a one-year history of progressive pain (PS 10/10) and enlargement of the lesion, forming an ulcerated, hyperpigmented tumor. Laboratory workup showed normal findings. Histopathology was signed out as a pigmented nodulocystic basal cell carcinoma. Moh’s micrographic surgery (MMS) and cheek advancement flap were performed with good wound healing and no perioperative complications.@*Conclusion@#Despite the limited options of medical and physical management due to decreased life expectancy of centenar- ians, MMS remains the standard of therapy in high-risk BCC. MMS with reconstructive surgery is generally a safe and effective modality with no increased risk of peri- and post-operative complications.

Syringocystadenoma Papilliferum arising from a nevus sebaceus mimicking squamous cell carcinoma in a Filipino female: A case report

Introduction@#Syringocystadenoma papilliferum (SCAP) is a relatively rare benign adnexal skin tumor which can manifest in a variety of clinical forms. Nearly one-third of cases are known to develop within a pre-existing nevus sebaceus (NS). The peculiar feature of this case was the appearance of a large exophytic tumor within a congenital verrucous plaque, which raised the suspicion of a malignant transformation. This is a case of a young Filipino adult with an unusual presentation of syringocystad- enoma papilliferum in a nevus sebaceus mimicking squamous cell carcinoma.@*Case report@#A 27-year-old Filipino female presented a persistently enlarging exophytic pedunculated cribriform tumor within a congenital verrucous plaque on the left temporal area. The tumor started to appear when she was 20 years old. One month prior to consult, it rapidly increased in size and bled on gentle manipulation. She has neither comorbidities nor any family history of a similar condition. Her physical examination was normal, with no palpable lymphadenopathies. The biopsy showed syringo- cystadenoma papilliferum on a nevus sebaceus. She underwent carbon dioxide (CO2 ) laser excision under local anesthesia. The procedure was uneventful and the patient is on regular follow-up and close monitoring for any possible malignant change or recurrence.@*Conclusion@#A case of syringocystadenoma papilliferum on a nevus sebaceus mimicking squamous cell carcinoma in a Filipino female treated with carbon dioxide laser excision was presented. The unusual presentation of SCAP can mimic malignancy and histopathologic evaluation is warranted to rule out malignant transformation for proper management.

A randomized controlled study on the efficacy and safety of zinc oxide 20% ointment versus salicylic acid 15% + lactic acid 15% ointment in the treatment of patients with Verruca vulgaris in a tertiary hospital

Background@#Verruca vulgaris are scaly, rough papules or nodules caused by the human papilloma virus.@*Objective@#To determine the efficacy and safety of topical zinc oxide ointment versus topical salicylic acid + lactic acid ointment as treatment among patients with verruca vulgaris.@*Methods@#This randomized, double-blind, 6-week study involved 29 patients with verruca vulgaris in a tertiary center who received zinc oxide 20% ointment or salicylic acid 15% + lactic acid 15% ointment applied daily and occluded with LeukoplastTM tape. Evaluation was done every two weeks.@*Results@#There was significant decrease in number of warts in the zinc oxide group (p=0.004), while it was not significant in the salicylic acid+lactic acid group (p=0.392). Comparison between the two groups was not significant (p>0.05). Both zinc oxide (P=0.000) and salicylic acid+lactic acid groups (P=0.025) had significant decrease in size of warts from baseline to 6th week of observation. No significant differences were observed between the two groups in terms of adverse events such as erythema (P>0.05), edema (P>0.05), tenderness (P>0.05), and scaling (P>0.05); however, itching was significantly higher at 4th week in the salicylic acid+lactic acid group B (16.7%). Among the zinc oxide group, 100% would recommend the treatment, while only 71.4% would recommend salicylic acid+lactic acid. The satisfaction levels of zinc oxide group were also statistically higher than salicylic acid+lactic acid group (p=0.000).@*Conclusion@#Zinc oxide 20% ointment is a safe and effective option for the treatment of verruca vulgaris especially among patients that would prefer non-traumatic measures in the removal of their warts.

Idiopathic follicular mucinosis in a 32-year old Filipino man successfully treated with narrow-band UVB: A case report

INTRODUCTION@#Follicular mucinosis is a rare skin condition, which can present as an idiopathic benign condition or as a secondary symptom of a malignant disorder, most commonly mycosis fungoides. Since its first description in 1957, only 90 cases have been reported worldwide. This condition is characterized by erythematous infiltrated plaques with scaling, sometimes with follicular prominence on the head and neck. Definitive diagnosis is made histologically.@*CASE@#A 32-year old male presented with a 3- year history of recurrent scaling with eruption of pruritic erythematous papules and plaques over the face, neck and chest. Different local treatments (topical corticosteroids, antifungal cream and moisturizers) were ineffective. Overall, he was healthy. Histopathological examination of the lesion showed typical histological picture of follicular mucinosis. Alcian blue stain was positive. The patient was successfully treated with narrowband UVB (NB-UVB) therapy with no recurrence of lesions after one- month follow-up.@*CONCLUSION@#Idiopathic follicular mucinosis is a benign condition with localized involvement and excellent prognosis. However, long-term follow-up and monitoring is recommended because of its association with malignancy. Follicular mucinosis is a rare dermatosis, characterized histologically by the presence of mucin deposits within the hair follicle and sebaceous glands.1 There are three clinical types determined. The first and the most common type occurs as an idiopathic benign disorder, typically seen in young patients. The second type affects people 40-70 years of age and has a more chronic course. The third type usually occurs in the elderly and presents with widespread lesions. It can arise as a secondary symptom of a malignant disorder, most commonly mycosis fungoides.

A pilot study on the safety and efficacy of Abelmoschus Esculentus (Okra) 5% extract in the treatment of non-bullous impetigo among paediatric patients at Jose R. Reyes Memorial Medical Center, Department of Dermatology

INTRODUCTION@#Impetigo Is a common, contagious, superficial skin infection most commonly presenting as erythematous crusting papules and pustules on the face and or extremities. The pathogens usually implicated in this skin disease are gram- positive organisms including Staphylococcus aureus, and less frequently, group A β-hemolytic Streptococcus pyogenes. In JRRMMC, Department of Dermatology, this disease always ranks in the top 1 O most common skin diseases annually. Treatment options for this disease include topical and oral antibiotics depending on the condition's severity. Mupirocin and Fusidic acid are considered as gold standard in the treatment of impetigo.

Upper lip squamous cell carcinoma arising from discoid lupus erythematosus treated with standard wide excision

@#Introduction: Squamous cell carcinoma (SCC) is a rare complication of long-standing discoid lupus erythematosus (DLE). The reported risk factors associated with the malignant transformation include chronic inflammation, scarring, immunosuppression, and the dysfunctional healing already evident in discoid lesions. If underdiagnosed and left untreated, this may lead to higher rates of recurrences, metastases and death. Objective: The main objective of this article is to report the diagnosis and management of a DLE-associated SCC on the upper lip of an elderly Filipino female. A short discussion on the pathogenesis and treatment of this disease entity is also presented.ugs/topical medications, family history and accompanying systemic symptoms were reviewed and analyzed. Case: A 78-year-old female, pawid maker, developed a rapidly growing verrucous tumor measuring 4.0 x 2.0 x 2.0 cm from a depigmented atrophic plaque located on the upper lip. Initial histopathologic findings were consistent with SCC and DLE. Considering the tumor size and the challenging anatomical location, the surgical oncology and plastic surgery team carried out a wide excision with 5 mm margin of the entire upper lip mass and surrounding plaque, followed by lip reconstruction. Biopsy findings of the excised mass were consistent with the initial findings. Three months post-operation, there was significant wound healing with no recurrences. Conclusion: Although the incidence is rare, SCC occurring in DLE is considered to be high-risk and should warrant early recognition and prompt treatment. In this paper, the authors also highlight the use of a standard wide excision in lieu of Mohs Microscopic Surgery as an alternative option where resources are limited.

Gorlin syndrome in a 48-year-old Filipino woman: A case report

INTRODUCTION@#Gorlin syndrome is a rare autosomal dominant disorder characterized by a wide range of developmental abnormalities and a predisposition to neoplasms. The estimated prevalence is 1/57,0001 to 1/256,0002. Main clinical manifestations include multiple basal cell carcinomas, odontogenic keratocysts, skeletal abnormalities, ovarian fibromas and other disorders.@*CASE@#A 48 year old woman presented with multiple brown-black to skin-colored pearly macules, papules and nodules over the scalp, face, neck, trunk, upper and lower extremities. Histological examination at 2 sites revealed basal cell carcinoma. This was accompanied by findings of odontogenic keratocysts, palmar pits, posterior falx calcification, exotropia and multiple myoma uteri. Electrodessication with curettage of superficial basal cell carcinomas (< 1 cm.) was combined with wide excision of nodular basal cell carcinomas on the left temporal area (followed by rotational scalp flap reconstruction), right lateral breast, left inframammary area, right and left anterior thigh.@*CONCLUSION@#Gorlin syndrome is a hereditary condition affecting various organ systems. Management requires a multidisciplinary approach and regular medical surveillance is required.

Keratoacanthoma on an epidermal nevus in a Filipino male

@#Keratoacanthoma is a cutaneous tumor that most often presents as a solitary lesion in middle-aged to elderly, light-skinned individuals on sun-exposed areas. It is characterized by rapid growth and may be followed by spontaneous involution. This is a case of a seventy-year-old Filipino male who had a one month history of a solitary nodule that suddenly appeared on an epidermal nevus. Histopathologic diagnosis revealed a keratoacanthoma.