Philippine Dermatological Society

Interesting Case: Endless Possibilities: When an Ulcer Is Not Just An Ulcer

On June 24, 2020, the Southern Philippines Medical Center Department of Dermatology hosted its first Interesting Case Presentation via Webinar entitled “Endless Possibilities: When an Ulcer Is Not Just An Ulcer”.

This event was jumpstarted by the department’s Continuing Medical Education Head, Dr. Karen Lee Alabado-Laurel, who also acted as moderator throughout the program’s entirety. This was followed by the opening remarks  rendered by the beloved PDS president, Dr. Purita Paz-Lao.

Dr. Rea Tarro-Dapiton, a second year resident presented the first case, that of an adult patient presenting with a chronic ulcer. This patient had undergone a series of both medical and surgical consults and treatments but with no apparent improvement hence dermatology consult was finally sought. Dr Dapiton then proceeded to describe in detail the management approach utilized by Dermatology which led to the complete healing of the ulcers. Thereafter, a case reaction was given by Dr. Niña Gabaton, one of the expert pediatric dermatologists in SPMC. She extensively discussed the clinical variants, recently proposed diagnostic criteria and the disease associations of pyoderma gangrenosum (PG). Evidence-based updates in the approach and management of a patient with PG were also reviewed.

The second case was presented by Dr. Maynie Bambi Lugasan, a 3rd year Dermatology resident. In contrast to the first case, this was a 16-year old’s chronic struggle with relapsing ulcers. Dr. Lugasan walked the audience through with the history of the patient as well as the evolution of the lesions and symptoms. She then described the subsequent follow-ups and the several treatment modalities employed which eventually led to a successful clinical remission.

A reaction to the case was delivered by Dr. Jennifer Aileen Ang-Tangtatco, a pediatric dermatologist of SPMC and a certified wound specialist of the American Board of Wound Management. She gave an in-depth discussion and up-to-date information on the associated conditions, recommended laboratory work-up, and the several treatment options for PG in the pediatric age group. Moreover, she discussed a concise and practical approach to the management of non-healing ulcers.

Following the string of lectures, a video presentation on the COVID-19 Southern Philippines experience was shown. To cap off the event, Dr. Karen Lee Alabado-Laurel gave the audience an overview of the current statistics of COVID-19 cases in Visayas and Mindanao.

Overall, the event was attended by 650 participants, which has proven that as Dermatologists living in a time of pandemic, we still strive to learn in order to provide the best possible service to our fellowmen while embracing an attitude of thanksgiving. And just like how chronic ulcers can be healed in time with patience and proper management, we also live in the hope that as we continue to stand united through prayer and unwavering service, we shall soon see our healing as a nation.