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.

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.