Hypopigmented mycosis of fungoides in an eight-year-old girl managed with narrowband ultraviolet B therapy

Mycosis fungoides presenting with hypopigmented lesions is an uncommon variant, which is usually described among dark-skinned patients. We report a case of hypopigmented mycosis fungoides in an eight-year-old girl who has responded favorably to narrowband-ultraviolet B therapy. The disease mimics several benign inflammatory skin conditions, hence, a high clinical suspicion is warranted in patients presenting with widespread hypopigmentation.

The misadventures of a traveler: Penicilliosis in a Filipino with HIV-AIDS

We report a case of penicilliosis in a Filipino man with HIV-AIDS who presented with skin-colored and erythematous to hyperpigmented, umbilicated papules and nodules on the face, trunk, and extremities associated with fever, lymphadenopathy, and anemia. The diagnosis was made through skin biopsy and fungal culture, which showed characteristic paintbrush-like hyphae and conidiophores. The patient was treated with intravenous amphotericin B at 0.6 mg/kg/day for 14 days followed by oral itraconazole 200 mg twice daily for 10 weeks resulting to flattening of lesions with hyperpigmentation, and prevention of appearance of new lesions. Resolution of fever, lymphadenopathy and improvement of anemia were also noted. He was placed on maintenance regimen with itraconazole 200 mg once daily to prevent relapse. Early diagnosis and appropriate management is important because mortality of disseminated disease is high if diagnosis and treatment are delayed.

Cutaneous cytomegalovirus infection presenting as persistent plaque on the nose in an HIV-AIDS patient

Cytomegalovirus (CMV) rarely manifests as cutaneous lesions in immunocompromised patients. Only 25 cases have been reported since 1991. It causes latent infection among exposed individuals but reactivation may occur in immunocompromised patients causing encephalitis, pneumonitis, colitis, retinitis and congenital fetal infection. Cutaneous manifestations of CMV infection usually present with various skin lesions such as ulcers, erosions, erythematous morbilliform rash, vesicles and bullae. We report a case of cutaneous CMV infection in an HIV-AIDS patient presenting as a persistent ulcerated plaque on the nose. The lesion slowly evolved into a plaque which partially destroyed the right alar rim. Skin punch biopsy showed perivascular giant cells with large eosinophilic inclusions resembling an owl's eye consistent with CMV infection. He was subsequently diagnosed with CMV retinitis because of blurring of vision and findings of retinal necrosis on fundoscopy. Oral valganciclovir 1800mg/day was given for 21 days. Significant thinning and drying of the plaque with no further progression of ulceration of the alar rim were noted.

An unusual presentation of secondary syphilis in an 18-year-old man

INTRODUCTION: Secondary syphilis is a sexually transmitted infection characterized by localized or diffuse mucocutaneous lesions, often with generalized lymphadenopathy with laboratory evidence consistent with syphilis. Condolyma latum is one of the many forms of secondary syphilis and is noted to occur commonly on moist intertriginous areas of the body such as the axilla, web spaces of the toes, genital and perianal regions. CASE REPORT: An 18 year-old man presented with a four-month history of few erythematous pruritic plaques on the penile shaft and multiple moist plaques involving the scalp, face, anterior neck, nape, axilla,anterior abdomen, upper and lower extremities, and scrotum. There are few erythematous scaly patches noted on the palms and soles. Serologic testing confirmed a diagnosis of syphilis and the patient tested negative for human immunodeficiency virus infection. The patient was given a single dose of intramuscular benzathine penicillin G 2.4 million units, with noted flattening of all lesions upon follow-up three months later. CONCLUSION: Condylomata lata, although most commonly found on moist intriginous areas of the axilla, web spaces of the toes, genital and perianal regions, can also involve less commonly affected areas such as the scalp, face, anterior abdomen, and the extremities. A high index of suspicion therefore is warranted to differentiate it from other cutaneous diseases and to prevent progression of the disease by initiating appropriate antibacterial therapy.

Seabather's eruption in two triathletes at Samal Island, Davao, Philippines

Seabather's eruption (SBE) is characterized by pruritic erythematous papules on the covered areas of the body that appear within 24 hours after exposure to seawater. SBE is known to be caused by the planula of a thimble jellyfish (Linuche unguiculata) or a sea anemone (Edward siellalineata). We report cases of two adult male triathletes who developed pruritic erythematous papules on the chest and back after a swim training along the coastal waters of Samal island, Davao City. Examination of samples of the seawater revealed multiple planulae or larval forms of cnidarians. The histopathologic examination revealed moderately dense superficial and deep perivascular and periadnexal inflammatory infiltrates consisting predominantly of lymphocytes, few eosinophils and neutrophils. Treatment with a short course of systemic corticosteroids proved beneficial in both patients. A review of published literature regarding this interesting aquatic sports dermatosis was also conducted.

A preliminary study on the mosquito repellent effect of tea tree (Melaleuca alternifolia) oil

BACKGROUND: Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF) are now considered as major health problems in the Philippines. N,N,-dietyl-3-toluamide (DEET) is recognized as the most effective against Aedes aegypti. However, the concern about its use have underscored the need to find a safer alternative repellent.OBJECTIVES: This study aims to determine and compare the repellent activity of tea tree (Melaleuca alternifolia) oil against Aedes aegypti with 7% DEET using a double-blind controlled experimental trialMETHODOLOGY: Twenty healthy subjects were allocated systematically by alternate assignment into three treatment groups (Control vs. Tea Tree oil, control vs. 7 percent DEET, Tea Tree oil vs DEET). All subjects were exposed to Aedes aegypti for 5 minutes every hour for 8 hours and the number of mosquitoes biting/landing were recorded and compared for each treatment groupRESULTS: Fifty percent tea tree oil has a repellent activity against Aedes aegypti and its efficacy is comparable to 7% DEET. Both treatments were equally effective in repelling mosquitoes for 7 hours. No cutaneous reactions to both repellents were notedCONCLUSION: The efficacy of tea tree oil is comparable to 7% DEET and is recommended as an alternative natural mosquito repellent.