Comparison between lymecycline with multidrug therapy and standard multidrug regimen (WHO-MDT) in the treatment of multibacillary leprosy patients: a retrospective cohort study.

BACKGROUND: Hansen's disease or leprosy is a chronic, infectious disease that has locally and globally afflicted all populations. Despite standard treatment with multidrug therapy (WHO-MDT), the incidence of drug resistance has been an increasingly prevalent global problem in leprosy management. This study compared the effectiveness between lymecycline with WHO-MDT and standard WHO-MDT in leprosy treatment. METHODS: The research is a retrospective cohort study at a tertiary hospital from January 2011 to July 2021. Pre- and post-treatment bacillary index, presence of new lesions, nerve function impairment, and leprosy reactions were obtained through chart review. RESULTS: The results showed a significant difference in bacteriological index (BI) in both groups at the end of the treatment. However, a higher reduction in BI was noted for the lymecycline group. For the group that took WHO-MDT alone, BI decreased by 0.7 (P < 0.001) whereas patients who took lymecycline and WHO-MDT had a BI difference of 3 (P < 0.001) upon completion of treatment. A significant decrease in the recurrence of lesions (P = 0.006) and nerve function impairment (P = 0.038) was also noted in the lymecycline group whereas there was no significant difference in leprosy reactions between the two groups. CONCLUSION: Lymecycline 600 mg daily for 3 months can be used as an adjunct in cases of leprosy resistance and treatment failure among multibacillary patients. Lymecycline significantly reduced bacillary index, recurrence of skin lesions, and nerve function impairment through its possible immunomodulatory, antiapoptotic, and neuroprotective effects.

Diagnosis and management of basal cell carcinoma: interdisciplinary consensus statements of Jose R. Reyes Memorial Medical Center, a Department of Health Tertiary Hospital in Manila, Philippines.

BACKGROUND: Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Multiple risk factors are associated in the development of BCC, with ultraviolet light and genetics playing major roles. AIMS: The departments of dermatology, medical oncology, ophthalmology, otorhinolaryngology, head and neck surgery, plastic surgery, and radiation oncology of the Jose R. Reyes Memorial Medical Center, Manila, Philippines, have convened and formulated consensus statements on the diagnosis and management of BCC patients seen in the institution. CONCLUSION: The summary of the recommendations is: (1) Surgery is the treatment of choice for BCC. The range of margins (2-4 mm) depends on the type of BCC. (2) Mohs micrographic surgery (MMS) is indicated for high risk BCC. (3) Topical treatment with imiquimod or 5-flourouracil (5-FU) may be used for superficial BCC. (4) Destructive methods (cryotherapy, curettage and electrodessication, photodynamic therapy) may be used for low risk BCC. (5) Medical and/or radiation therapy is advised for cases where surgery is contraindicated or tumor is not amenable to surgery. Metastasis of this malignancy is rare. Follow-up, which may continue up until 2 years, is recommended for high risk BCC.

Split-face comparison of grid fractional radiofrequency vs 1064-nm Nd-YAG laser treatment of periorbital rhytides among Filipino patients.

Despite multiple individual studies proving efficacy of grid fractional monopolar radiofrequency (Grid RF) and near-infrared irradiation 1064-nm long-pulsed neodymium:YAG laser (Laser Genesis), there is a lack of controlled comparative trials between these devices. This study aims to compare the efficacy and safety of Grid RF versus Laser Genesis in the treatment of periorbital rhytides. This is a randomized, single-blind, split-face, prospective study. Eight patients with moderate to severe periorbital rhytides were treated with either Grid RF or Laser Genesis on each side of the face. Photographic and live assessment with the Lemperle Wrinkle Assessment grading scale was compared after 2 months. Difference in scores between Grid RF vs Laser genesis groups after 2 months was not statistically significant (P = 0.244). Each group showed statistically significant improvement months post-procedure (P < .05). Immediate adverse effects and satisfaction scale were similar for both groups (P > .05). At 2 months follow-up, no adverse effects were seen. Grid monopolar radiofrequency (Grid RF) vs near-infrared radiation 1064 nm long-pulsed Nd-YAG laser (Laser Genesis) were equally efficacious, safe, and well-tolerated among patients in the treatment of periorbital wrinkles (P > .05).

Intralesional 5-fluorouracil versus triamcinolone acetonide in the treatment of keloids

BACKGROUND: Keloids are overgrowths of fibrous tissue following cutaneous injuries. They are often symptomatic and troubling cosmetically, with significant psychosocial burden for the patient. A safe, cost-effective alternative treatment for keloids will definitely be beneficial. OBJECTIVES: This study aims to determine the efficacy of intralesional 5-fluorouracil versus triamcinolone acetonide in the treatment of keloids as to reduction of keloid volume, improvement of symptoms and cosmetic appearance. Adverse effects and recurrences between the two treatment groups will likewise be evaluated. METHODS: This is a single-blind, randomized, controlled trial. Fourteen patients with 2 or more keloids on the same site or symmetrically distributed, with no co-existing morbidity and with informed consent, were included in the study. Patients received both intralesional injections of 5-fluorouracil (5-FU, Utoral 50 mg/mL) and triamcinolone acetonide (TAG, Kanolone 10 mg/mL). One keloid was injected with 5-FU and one with TAG. They were submitted to 1-6 treatment sessions with an average interval of 2 weeks between each session. Measurements of keloid volume using alginate impression material and digital photographs were taken before treatment, 2 weeks and 2 months post-treatment. Occurrence of adverse effects, improvement of symptoms, as well as cosmetic outcome, was likewise recorded. RESULTS: Both 5-fluorouracil and triamcinolone acetonide were shown to be effective in the treatment of keloid. Comparing the two, 5-FU statistically proved to be better, by having greater volume reduction, more symptom improvement, and higher scores on patient's assessment of cosmetic outcome. Adverse sequelae were pain, hyperpigmentation, and ulceration which healed in 1 - 2 weeks with topical antibiotic ointment. Corticosteroid side effects such as telangiectasia and atrophy were not appreciated with the 5-FU group. There was no recurrence during the follow-up period of 8 weeks in any of the patients. CONCLUSION: Five-fluorouracil was shown to be effective in reducing keloid volume, improving symptoms of pain and pruritus, and cosmetic outcome, as compared to triamcinolone acetonide. Likewise, it was found to be safe. Adverse effects associated with corticosteroids were not seen. No recurrence was noted two months post-treatment.

Submental fat reduction by mesotherapy using phosphatidylcholine alone vs. phosphatidylcholine and organic silicium: a pilot study.

BACKGROUND: Excess skin and fatty tissues beneath the jaw lead to a double chin deformity. Localized fat deposits in this area are a cause of discomfort and anguish, leading patients to undergo surgical procedures such as liposuction and dermolipectomy to improve the cosmetic effect. Both procedures require anesthesia and an operating room setting and are quite expensive. Fearful of extensive surgery and its complications, patients and physicians seek less invasive methods. Mesotherapy with phosphatidylcholine and other cocktails have been used to treat localized fat deposits. However, there are few published articles regarding its effectiveness and some are even anecdotal. OBJECTIVE: This study aims to determine the efficacy of phosphatidylcholine alone vs. phosphatidylcholine and organic silicium in submental fat reduction. METHODS: Twelve patients with submental fat deposit with no coexisting morbidity and with informed consent were included in the study. They were submitted to one to five treatment sessions with an average interval of 2 weeks between each session. The medication administered was injected, either pure phosphatidylcholine or a combination of phosphatidylcholine and organic silicium. Baseline measurements of submental fat using vernier caliper and digital photographs of the patients were taken during each treatment session. The occurrence of adverse effects was likewise noted. Results Among the 12 patients, 11 completed the treatment course, and 1 was excluded from the study because of failure to follow up. Both phosphatidylcholine and a combination of phosphatidylcholine and organic silicium were equally effective in reducing submental fat deposits. There was no significant difference as to the rate and degree of reduction. Significant reduction in the thickness of submental fat was achieved after three treatment sessions. Adverse reactions in both groups were mild and transitory ranging from heavy sensation, localized heat, nodulations, and slight bruising that abated 3 to 5 days after treatment. Limitations As of this writing, information on the use of both phosphatidylcholine and organic silicium for mesotherapy of localized fat such as the submental area is scarce. The exact mechanisms of action of both treatments are likewise unknown. Ultrasound and histopathological changes were not documented. The study did not involve a double-blind, placebo-controlled design, and the sample size was small. CONCLUSION: Mesotherapy using phosphatidylcholine vs. phosphatidylcholine plus organic silicium was similarly effective in reducing submental fat. There was no significant difference between them in terms of rate and degree of reduction. Optimal reduction of submental fat was achieved after three treatment sessions. Adverse reactions were few, mild, and transitory. Therefore, both regimens are safe, efficacious, cost-effective, and can be used as alternatives to invasive surgical procedures.

Scrotal leiomyoma presenting as angiokeratoma of fordyce

Scrotal Leiomyoma is an extremely rare benign tumor originating from the tunica dartos muscle. It usually presents as a solitary, painless, unilateral, slow growing mass that is occasionally pedunculated. We report a case of a 31-year-old man, presenting clinically with multiple papules resembling Angiokeratoma of Fordyce but with a histopathologic diagnosis of Scrotal Leiomyoma. Scrotal Leiomyoma has not been reported to present clinically in this manner and our report is probably the first of its kind.