Knowledge, attitudes, and practices on teledermatology among dermatologists in the Philippines

Background@#Teledermatology has been widely used during the coronavirus disease 2019 (COVID-19) pandemic to overcome barriers in access to care. The objective of this study was to assess the current knowledge, attitudes, and practices regarding teledermatology among dermatologists in the Philippines.@*Materials and Methods@#This was a cross-sectional and analytical study conducted from January 2022 to April 2022, among Filipino dermatologists using a self-administered online questionnaire. Descriptive statistics was used to summarize the demographics of the participants. The two-sample t-test, Chi-square test, and multiple logistic regression model were used to analyze the data.@*Results@#Out of 113 respondents, 108 (95.5%) had adequate knowledge and a positive attitude toward teledermatology. The majority (110/113, 97.35%) practiced teledermatology. The most commonly used platform was instant messaging applications(78/100, 70.91%), and the most common factor that influenced their practice was patient demands or needs(74/110, 67.27%). Those who did not practice teledermatology cited technological difficulties as the main reason.@*Conclusion@#Teledermatology was widely used by Filipino dermatologists to provide remote care during the COVID-19 pandemic. However, to fully utilize its potential and limit potential issues associated with its use even after the pandemic, continuous training and education among dermatologists and a more enabling technological environment may be needed.

Skin cancer in a public tertiary hospital in Manila, Philippines from 2015 to 2019: A retrospective study

Introduction@#The true incidence of skin cancer, as well as the clinico-demographic and histopathologic profile of skin cancer patients in the Philippines, has not been established. To the authors’ knowledge, no similar studies have been published in recent years.@*Objectives@#To determine the clinico-demographic and histopathologic characteristics of histopathologically-proven skin cancer Filipino pa- tients in a Philippine public tertiary hospital.@*Methods@#This study included 121 patients with histopathologically-proven skin cancers from January 2015 to December 2019 in the dermatology and pathology departments of a public tertiary hospital in Manila, Philippines. Retrospective chart review and descriptive data analysis were conducted for this study.@*Results@#Of the 121 cases, the common skin cancers included basal cell carcinoma (54%), squamous cell carcinoma (27%), cutaneous lymphoma (7%), and melanoma (6%). The mean age was 63 ±16 years. There was a slight female preponderance (56%). The most commonly affected area was the head and neck region (73%). Most cases (54%) were clinically diagnosed by dermatologists, while the remaining patients were seen by non-derma-tologists. Thus, the concordance between clinical diagnosis and histopathologic confirmation was 62% in basal cell carcinoma, 50% in cutaneous lymphoma, 29% in melanoma, and 24% in squamous cell carcinoma. Overall, the skin cancer lesions amongst the patients were significant at the time of diagnosis, with a median length of 20 mm and a median width of 18.5 mm.@*Conclusion@#Basal cell carcinoma is the most common skin cancer (54%), followed by squamous cell carcinoma (27%). The head and neck was the most commonly affected region at 73%. Due to the low concordance of clinical and histopathologic confirmation, referral to a dermatologist is necessary to improve clinical accuracy. In the public tertiary hospital setting, whole-body skin examination should be a part of the initial derma- tology screening to catch small skin cancers. A system to ensure regular follow-up of skin cancer patients should be initiated to optimize early detection of recurrence and subsequent treatment as necessary.

The role of skin punch grafting with platelet-rich plasma injection on stable segmental vitiligo

@#Vitiligo is a non-communicable, chronic skin condition that has psychosocial effects for the patient. The case of an otherwise healthy skin phototype IV Filipino male with a two-year history of stable vitiligo is presented here. Three sessions of skin punch grafting and platelet-rich plasma injection under local anesthetic were done on the patient three months apart, resulting in excellent cosmetic results and patient satisfaction.

The role of skin punch grafting with plasma-rich plasma injection on stable segmental vitiligo

@#Vitiligo is a non-communicable, chronic skin condition that has psychosocial effects for the patient. The case of an otherwise healthy skin phototype IV Filipino male with a two-year history of stable vitiligo is presented here. Three sessions of skin punch grafting and platelet-rich plasma injection under local anesthetic were done on the patient three months apart, resulting in excellent cosmetic results and patient satisfaction.

Procedural dermatology in the COVID-19 era: an online survey of the Philippine Dermatological Society members and practical recommendations for safe practice

@#BACKGROUND: The novel COVID-19 (Coronavirus Disease 19) predisposes the general population to a high risk of infection. The 106 million population of the Philippines would be considered an at-risk group due to the high density of the populace in cities. As the situation in each country differs during this era of the COVID-19 pandemic, this paper aims to give practical recommendations for safe procedural dermatology practice in the Philippine setting after the lifting of the government-mandated quarantine. METHODS: An online survey was conducted among Philippine Dermatological Society members. The survey was sent electronically on March 22, 2020. RESULTS: A total of 466 or 42% of the PDS’s 1100 current members replied to the survey. The top 10 procedures performed among the respondents are: 1. Electrocautery (N=437, 94.38%), 2. Chemical peeling (N=422, 91.13%), 3. Laser & energy based device treatment (N= 341, 73.65%), 4. Botulinum toxin injection (N=323, 69.76%), 5. Excision (N=263, 56.80%), 6. Acne surgery (N=176, 38.01%), 7. Injectable Filler (N=171, 36.93%), 8. Cryotherapy (N=145, 31.32%), 9. Platelet rich plasma injection (N=111, 23.97%) and 10. Scar revision (N=85, 18.36%). The majority of the respondents have access to personal protective equipment (PPE) such as surgical masks (N=457, 98.7%), face shields (57.67%), goggles (46.00%), protective gown (42.76%) and bonnets (32.83%). Before the government quarantine, the majority (N=375, 81.17%) of respondents see patients on a firstcome, first-serve system. Only 18.83% (N=87) see patients only by appointment. Regarding teledermatology, most respondents answered that they would advise patients to do digital consultation with only a minority responding they would not consider doing teledermatology. CONCLUSIONS: In the Philippine setting, the best ways to prevent COVID infection inthe procedural dermatology setting include: 1. Education of staff and patients on proper exposure prevention and sanitation measures. 2. Ensuring the correct usage of PPE. 3. Ensuring physical distancing and reducing patient wait times by scheduling visits on an appointment basis. 4. Sufficient protocols must be made for sanitation before and after each patient visit. 5. Teledermatology in pre-procedure consults and post-procedure follow-ups would reduce the risk of COVID-19 transmission for both patient and physician.