PACCD’s 3rd Scientific Symposium
On June 23,2016 Thursday – PACCD held its third scientific symposium entitled: “Common Bullous Skin Diseases: Clinical Diagnosis Laboratory and Management”. The event was once again mounted at the Occupational Safety and Health Center, North Ave. cor Agham Rd., Diliman, Quezon City. The lecture concentrated on the viral varieties of this subset of diseases, specifically: Pemphigus, Bullous Pemphigoid, Epidermolysis Bullosa Acquisita, Pemphigoid Gestationis and Cicatricial Pemphigoid. The content was specifically targeted at practical approaches in diagnoses and management for the more seasoned dermatological practitioners. Although the academic weight of the lecture is undeniable; the occasion felt more like a guided series of enlightened anecdotes from a wise Professor whose focus is to aid his audience through the intricacies of these diseases. Some tips he imparted were:
- Always examine the oral mucosa. This may aid in your diagnosis; as well as signal a possible medical emergency. Fasting Blood Sugar is important ( do not hesitate to refer to a diabetologist) since oral steroids, more often than not, are a required component of management.
- Antibiotics, although not a mainstay of management, must be prescribed immediately if secondary bacterial infection is detected ( i.e. fever).
- Recurrent seborrheic dermatitis uncharacteristically present beyond the v-delineation at the back may indicate a concomitant venereal disease. While unexplained pruritic papules at the extremities may require a rule-out for HIV.
- Visual evidence of Bullous Diseases indicate an immediate management via oral steroids based on bodyweight with a tapering dosing schedule. Non-response after 1 month to the latterregimen requires a biopsy – preferably by a dermatopathologist or immunopathologist( St. Luke’s has one) so a conclusive diagnosis can be arrived at, with the eventual prescription of required immunosuppressives.
- For patients who are financially challenged; laying on banana leaves had been found to be soothing for these wound-types.
- Oral steroids may be prescribed to pregnant patients. No infant mortality had ever been reported due to oral prednisone, or thereabouts. Only side-effects reported were Small for Gestational Age babies and premature birth.
- Ramon R. Briones, M.D.