Complementary and alternative medicine for skin diseases: Knowledge, attitudes and practices of Philippine-based dermatologists

BACKGROUND: The ubiquity of complementary and alternative medicine (CAM) mirrors patient interest and use. Nonetheless, many physicians are still hesitant to recommend and use CAM.Objective: To determine the knowledge, attitudes and practices of Philippine-based dermatologists regarding CAM.METHODS: This was a cross-sectional survey using a self-administered questionnaire. An in-depth interview was conducted among selected respondents.RESULTS: A total of 148 dermatologists responded. Most had adequate knowledge (58.78%) and a positive attitude about CAM (81.08%). Most respondents reported patient interest in CAM (70.95%) and recommended CAM (87.24%) for dermatologic conditions. Among respondents who recommended CAM, most recommended CAM as a complement to conventional treatment (73.76%) rather than as an alternative. Personal CAM use was reported by 30.41%. A positive attitude about CAM was directly related to increased likelihood of recommending CAM to patients (p=0.00) and to personal use of CAM (p=0.003).CONCLUSIONS: Respondents generally had a positive attitude about CAM and were open to recommending CAM as a complement to conventional treatment for dermatologic conditions.

Kaposi sarcoma in an HIV-negative Filipino man

INTRODUCTION: Kaposi sarcoma (KS) is a multicentric, vasoproliferative tumor. Human herpes virus 8 has been demonstrated to have a direct role in its development. Classic Kaposi sarcoma is seen in HIV-negative, elderly men, often of Jewish or Mediterranean lineage.CASE REPORT: A 78-year-old, HIV-negative man presented with a 4-year history of multiple nodules and plaques on both lower extremities. Histologic findings were consistent with nodular Kaposi sarcoma. Immunohistochemistry studies showed CD34+ cells. Tumor cells stained positive for HHV-8 latent nuclear antigen. As palliative treatment, the patient underwent external beam radiotherapy.CONCLUSION: Classic Kaposi sarcoma tends to run an indolent course. Progression of skin lesions however, can lead to immense discomfort and disfigurement. As there is no definitive treatment algorithm for KS, management decisions should be made judiciously to choose the most effective treatment that will cause the least morbidity.