Annular secondary syphilis with histopathologic features of Granuloma Annulare

@#Syphilis is one of the most common sexually transmitted diseases in the world. It is known as “the great mimicker” due to its varied cutaneous presentations, which can make it challenging to diagnose. We report a case of a 20‑year‑old female presenting with a nonhealing, pruritic, annular plaque on the left malar area of 3‑month duration. She was initially treated as a case of tinea faciei. The lesion was unresponsive to topical antifungals and steroids with continued increase in size and number. Skin biopsy revealed secondary syphilis with histopathologic features of granuloma annulare. Degenerated collagen, not a feature of secondary syphilis, was seen, prompting further studies to confirm the diagnosis of secondary syphilis. Alcian blue stain was negative, which helped rule out granuloma annulare. She was then given benzathine penicillin G 2.4 million U, which led to a significant decrease in the size of the lesion noted 1 week posttreatment. Only postinflammatory hyperpigmentation was noted after 1 month of treatment. Clinically, secondary syphilis may present as an annular lesion that can mimic tinea. This can also present with atypical histopathologic features and an in‑depth investigation is needed to further confirm the diagnosis.

Bullous presentation of Acrodermatitis Enteropathica in three female siblings: A case series

@#Acrodermatitis enteropathica is a rare autosomal recessive disease that results from a defect in zinc metabolism. It is clinically characterized by a phenotypic triad of periorificial and acral dermatitis, diarrhea, and alopecia. Oral zinc therapy gives a rapid excellent clinical response and reduces mortality. We report three female pediatric siblings who presented with periorificial and acral dermatitis, diffuse alopecia, nail dystrophy, irritable mood, and stunted growth. A diagnosis of acrodermatitis enteropathicawas confirmed with markedly decreased levels of serum zinc. The patients were successfully treated with oral zinc sulfate at a dose of 5mg/kg/day for the first two weeks then maintained on a dose at 2mg/kg/day.

A case of a 62-year-old male with Actinomycetoma successfully treated using combined medical and surgical therapy

INTRODUCTION@#Actinomycetoma is a neglected infectious disease that presents with a triad of subcutaneous mass, with sinus formation and seropurulent discharge containing grains. This causes severe functional disability to patients if not treated early and properly.@*CASE REPORT@#We report a case of a 62-year-old adult Filipino farmer diagnosed with actinomycetoma of the left foot. For 8 years, the patient medicated with several antibiotic therapies affording minimal improvement of symptoms. Hence, surgical intervention with combination antimicrobial therapy was done which provided resolution of symptoms, improving the quality of life of the patient.@*CONCLUSION@#Treatment of actinomycetoma must be individualized among patients. Although oral antibiotics became the standard of treatment, combining surgical treatment with oral medications may be considered to ensure effective management of the disease.

Translation and validation of a scale on the health care providers’ Attitudes Towards Persons Living With Leprosy (AT-PLWL)

Introduction@#Leprosy is a chronic, progressive, and complex disease. One of the factors contributing to the quality of case detection and treatment compliance is the attitudes of health care providers towards leprosy patients. Assessment of the attitudes of HCP towards leprosy patients is crucial because this is where leprosy patients base their care-seeking behaviors; hence, the creation of this scale.@*Objectives@#To create and validate a functionally equivalent Filipino translation of the HCP AT-PLWL scale.@*Methods@#A validity study was conducted into two phases. In Phase I, the AT-PLWL scale was translated (forward-back method) into Filipino, which underwent a cognitive debriefing (face validity) and pre-testing to 30 health care providers. In Phase 2, the reconciled forward translation underwent face and content validity and was pilot-tested to 100 health care providers. Reliability, both internal consistency and test-retest, were assessed via calculating Cronbach’s α and intra-class correlation coefficient, respectively.@*Results@#Content and face validity showed that all items in the scale were relevant. Cronbach’s α showed an adequate internal consistency of greater than 0.7 while the intra-class correlation coefficient of responses was greater than 0.80, indicating good correlation.@*Conclusion@#Overall, the final translated Filipino version of AT-PLWL scale is valid and reliable; hence, could serve as a tool to evaluate HCP’s attitudes.