Philippine Dermatological Society

PDS CME: Taking the Bullae by the Horns

Event: PDS CME: Taking the Bullae by the Horns

Date: April 28, 2021

Venue: Teleconference

Moderator: Katrina Canlas-Estrella, MD, FPDS

Welcome Remarks: Noemie Salta-Ramos, MD, FPDS

Case Presenter: Rosanna Ledesma, MD

Reactor/Speaker: Clarisse Garcia-Mendoza, MD, FPDS

Closing Remarks: Chittina De Ocampo-Santiago, MD, FPDS

Total Number of Attendees: 774

Take Home Pearls:

  • Should immunotherapy be stopped for AIBDs during the pandemic?
    • Low risk (generally well/no exposure): maintain current medications
    • High risk (elderly/severe AIBD/high dose/multiple treatments): adjust to lowest effective dose
  • How are these medications adjusted?
    • Topical steroids, prednisone < 10mg/day, dapsone, doxycycline, colchicine: may be continued
    • Prednisone > 10mg/day: may be reduced slowly
    • AZA, MMF, MTX, cyclosporine:
      • If (-) COVID, maintain at lowest effective dose
      • If (+) COVID, temporarily stop
  • Can AIBD patients get vaccinated?
    • AIBD patients may be vaccinated if condition is stable or not in severe flare
    • Modification is recommended for those taking MTX and cyclosporine:
      • MTX: hold for 1 week after each vaccine dose
      • Cyclosporine IV: administer at least 1 week after each vaccine dose

The May PDS CME, in partnership with the University of the East Ramon Magsaysay Memorial Medical Center, started off with our moderator, Dr. Katrina Canlas-Estrella greeting everyone with a warm welcome before proceeding to the opening remarks by Dr. Noemie Salta-Ramos. Dr. Ramos expressed her pride and gratitude towards the PDS community with how they have shown great support to our colleagues that have been personally affected by the ongoing pandemic. She also reiterated the need for persevering with learning opportunities for all current and budding dermatologists today.

Without much ado, Dr. Rosanna Ledesma, a second-year UERM resident, presented a patient with bullous pemphigoid who was carefully assessed and managed through teledermatology. This was then followed by a lecture concerning autoimmune blistering diseases (AIBD) in the background of COVID-19 by Dr. Clarisse Garcia-Mendoza. She discussed the current recommendations regarding immunotherapy in these patients versus the risk of COVID-19 infection. Various considerations were presented including identifying the risk classification of AIBD patients, vaccination concerns, as well as any adjustments needed in their maintenance medication in achieving disease control with minimal iatrogenic immunosuppression. Additionally, Dr. Mendoza also touched upon utilizing teledermatology to its fullest when dealing with these patients. The emphasis on strengthening communication with patients via online correspondence and the possibility of coordinating with different institutions to facilitate the diagnostic and therapeutic needs of our patients were elaborated on. The open forum that followed gave rise to multiple queries and clarifications regarding specific management and monitoring for AIBD patients. Step-by-step instructions on how to submit specimens for antibody testing were also carefully explained by Dr. Mendoza. The discussion came to a close with the final remarks being given by Dr. Chittina De Ocampo-Santiago highlighting the potentially great success of teledermatology in addressing the needs of our patients.

Indeed, “to take a bull by the horns” means to confront a problem with clear, direct, and confident action. Applying this in the difficult times brought about by the pandemic, we must employ all available means to help and guide our patients.

Photo Documentation

Dr. Katrina Canlas-Estrella as moderator
Welcome remarks being given by Dr. Noemie Salta-Ramos
Case presentation of bullous pemphigoid by Dr. Rosanna Ledesma
Lecture on autoimmune blistering disorders in the background of the COVID-19 pandemic by Dr. Clarisse Garcia-Mendoza
Closing remarks and awarding of certificates by Dr. Chittina De Ocampo-Santiago