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By: Maricarr Pamela Lacuesta, MD, FPDS

Last February 26, 2016, the Southern Philippines Medical Center (SPMC) Department of Dermatology in coordination with Southern Philippines Chapter Core Group spearheaded the Continuing Medical Education (CME) activity entitled “Leprosy through the looking glass: seeing Hansen’s disease in a new light” at the SMX Convention Center in Davao City.

The inspirational leader and consultant adviser of the Heart in Hand Club (Hansen’s Club) of SPMC, Dr. Claribel Jimenez, gave the welcome remarks and showcased the club’s significant milestones.

Dr. Janice Natasha Ng discussed the case of an atypical presentation of type 2 Lepra reaction in a 39 year old female.  Another resident, Dr. Friend Philemon Liwanag, presented the case of a 30 year old male who had biopsy-documented Histoid leprosy on lesions found over tattoo sites on the upper extremities.

Dr. Karla Phoebe Castaños facilitated the lively discussion between the audience and our guest reactor, Dr. Johannes Dayrit, who gave an exhaustive analysis of the histopathologic and immunohistochemical pearls in delineating ENL from Sweet’s syndrome. Dr. Dayrit also tackled significant clues to the diagnosis of Histoid leprosy and reviewed literature about inoculation leprosy over sites of trauma.

We also had a guest lecturer, Dr. Veronica Magnaye, FPSO-HNS, who shared her expertise on oral mucosal lesions.  Dr. Lalaine Visitacion, Chair of SPMC Department of Dermatology gave the closing remarks.  

This half-day academic endeavour not only increased our understanding and appreciation of Hansen’s disease but more importantly, enabled us to view the disease as well as our key role in its management and control in a new and better perspective.

Moreover, the latter half of the day was devoted to the PDS Life Enhancement Action Program (LEAP) workshop.  The members of the Southern Philippines Chapter gained important viewpoints from the power-packed Acne LEAP sessions of Dr. Rosalina Nadela and Dr. Antonio Sison.    

 

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SPMC Department of Dermatology Consultants and Residents, Southern Philippines Chapter Officers and Members pose with our Guest Reactor, Dr. Johannes F. Dayrit, FPDS

 

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Our guest reactor, the Head of the Dermatopathology Section of Research Institute for Tropical Medicine, Dr. Johannes F. Dayrit, FPDS

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Our guest lecturer and resource speaker for oral mucosal lesions, Dr. Veronica Magnaye, FPSO-HNS

Type 2 Lepra reactions may present in an atypical manner and an example of a rare presentation is ENL simulating Sweet’s syndrome.

  1. Wade-Fite stain or Fite–Faraco stain may be valuable in differentiating Sweet’s syndrome from Sweet’s like ENL lesions.
  2. Histoid leprosy is a rare variant of Lepromatous leprosy which may be missed clinically hence, biopsy findings may be essential in the diagnosis.
  3. Inoculation leprosy is based on the alternative hypothesis that leprosy may be transmitted through abraded or traumatized skin.
  4. The onset of leprosy after and at the site of tattoos may  be suggestive of the possibility of inoculation leprosy through unhygienic and shared needles.
PDS
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