Philippine Dermatological Society

“Solving Stasis, Uncovering Ulcers”

Patrick P. Lansangan, M.D.

The Jose R. Reyes Memorial Medical Center (JRRMMC) Department of Dermatology, in cooperation with Philippine Dermatological Society, held its continuing medical education (CME), entitled ” Solving Stasis, Uncovering Ulcers: Non-conventional Treatment for Stasis Ulcers”, last July 29, 2020. This time, the institution utilized the use of an online webinar, in its efforts to cope with “the new normal” during the COVID-19 pandemic.  The CME aimed to update the participants with the novel treatment options in the management of stasis ulcers. The lectures were imparted by renowned speakers, considered to be the best in their own field of expertise.

The webinar was moderated by Dr. Kara Melissa T. Torres, JRRMMC’s very own consultant and a PDS dermatopathologist. She was co-hosted by Dr. Bless Noelle Serquiña, a second year resident of the institution.

The event started with a welcoming message to all participants from the esteemed PDS president Dr. Ma. Purita Paz-Lao. Dr. Roxanne Jillan Victoria-Mauleon, a second year resident of the department, presented a case of stasis ulcer treated with platelet-rich plasma. It stirred the inquisitiveness of the participants in managing patients with stasis ulcers.

Dr. Mara Therese Evangelista-Huber, a JRRMMC Dermatology alumnus, a dermatopathologist, and a clinical researcher, discussed the old and the new adjuvant medical therapy for venous ulcers in her lecture, entitled “Get to the bottom of stasis ulcers: Novel therapeutic options for medical management”. She introduced the new ways to treat venous ulceration which includes platelet-rich plasma, sulodexide and statins. In this lecture, she mentioned that PRP is relatively safe for patients with stasis ulcers and may be an alternative for those ulcers that are refractory to therapy. Sulodexide was then discussed, which resulted in a higher proportion of healed ulcers according to a meta-analysis. Lastly, her research entitled “Simvastatin as a novel therapeutic agent for venous ulcers: a randomized, double-blind, placebo-controlled trial” was discussed, focusing on the superior healing rates, shorter healing period and improved patient quality of life versus placebo. In the end, she emphasized that the goal of treatment in venous ulcers is to treat the underlying problem which is often valvular dysfunction or venous obstruction, and to do local treatment of the ulcer, which is to cleanse, dress and compress if not contraindicated. She added that the use of medical adjuvants depends on the patient’s condition and the evidence available. She also highlighted the non-pharmacologic ways to help heal the ulcer and the importance of a multidisciplinary approach in its management.

The lecture series was followed by a discussion on the surgical management of stasis ulcers by Dr. Giovanni Villaruz, the section chief of the Thoracic, Cardiac and Vascular Surgery (TCVS) of JRRMMC. He said that surgical management is considered for stasis ulcers that are refractory to conservative therapy. Its goal is to reduce venous reflux, hasten healing and prevent recurrence. He further discussed each surgical treatment option including debridement, skin grafting, open procedure, subfascial endoscopic perforator vein surgery, catheter based interventional treatment, transilluminated powered phlebectomy, ultrasound guided foam sclerotherapy, deep vein reconstruction, and amputation.

Amidst the COVID-19 pandemic, the JRRMMC Department of Dermatology continues to provide high quality skin care, treatment and management for its Filipino patients. Dr. Zharlah Gulmatico-Flores, JRRMMC Dermatology’s training officer and research coordinator, shared the “JRRMMC COVID-19 Experience” which unveiled the efforts of the department to continue to serve, with its initiative to call for donations to help different departments of the institution and to support the frontliners – doctors, nurses, and paramedic staff of JRRMMC- by providing PPEs, face shields, masks, and gloves. She also showed how the department adapts to the new normal with its online consultations thru teledermatology and how it prepares for its re-opening through the safety guidelines in preventing the transmission of COVID-19. In addition, Dr. Flores proved that learning never stops in the JRRMMC Department of Dermatology, as the consultants and residents continues to hone their knowledge of the best and up-to-date dermatology practices thru online conferences.

The webinar ended with a video tribute to the Philippine Dermatological Society frontliners from the JRRMMC Department of Dermatology family.

It was a productive day, with over 500 participants filled with knowledge and insights from the speakers.

Amidst the adversities in these formidable times in our medical profession, we hope this CME webinar may serve as an inspiration to the consultants and residents of the Philippine Dermatological Society to continue to strive for greatness.