ARTETA, Ezekiel T.

Group A (Dermatology Rotator August 9 to 15, 2013)

Name Age/Sex Chief Complaint History of Present Illness Physical Examination Assessment Plan
Resident/s In-
Charge
Simborio, Ma. Cecilia 25/F Papule Three weeks PTC, patient experienced sudden
appearance of papules on her Left armpit, with
associated norturnal pruritus. Salicylic Acid was
applied without resolution. Consult was then
done at a private clinic wherein she was
prescribed with Itraconazole OD and
Betamethasone dipropionate cream. She
followed doctors orders with good compliance.
Days after, papules also became evident on the
patients groin area, then at her right armpit
and both hands, also associated with nocturnal
pruritus.
Persistence of the symptoms prompted
consult.
(+) multiple, erythematous,
well-defined, papules,
topped with exfoliation,
measuring 0.2x0.2 to 0.4-
0.4 cm on bilateral axillae,
inguinal, gluteal and dorsum
of bilateral hands and feet.
Scabies Infestation Cetirizine 10mg/tab, 1
tab BID for 1 week
Permethrin 5% lotion,
apply neck down and
leave it for 5-10 hours,
then rinse. Repeat after
1 week
Simultaneous treatment
of all household
members
Proper decontamination
TCB after 1 week
Dr. Manalo-Sacil
Pecenio, Kent Ervin 3/M Papule Three months PTC, patient had multiple,
erythematous, well-defined papules on his
abdomen, associated with nocturnal pruritus.
Patient would scratch the lesions producing
excoriations.
2 months PTC, similar lesions were seen on the
genitalia, groin and buttocks. Still no consult
done or topicals applied.
1 month PTC, lesions were seen on the
interdigital webs of both hands, and on the
axillae.
4 days PTC, patient sought consult and was
prescribed with Permethrin lotion. Persistence
prompted consult.
(+) multiple, erythematous
to hyperpigmented, well-
defined papules with
excoriation, measuring
0.1x0.1cm to 0.2x0.2cm in
the interdigital webs of both
hands and feet, axillae,
abdomen, groin and
buttocks.
Scabies Infestation Cetirizine 5mg/5ml
syrup, 2ml BID for 1
week
Permethrin 5% lotion,
apply neck down and
leave it for 8-10 hours,
then rinse thoroughly.
Repeat after 7 days
Simultaneous treatment
of all household
members
Proper decontamination
Mild soap
TCB after 1 week
Dr. Domingo
Santiago, Roberto 37/M Papules and
Plaque
3 weeks PTC, patient noted erythematous
papules on his left medial thigh and right side
of the abdomen, associated with nocturnal
pruritus. Patient seek consult at a local
Healthcare center wherein he was prescribed
with Loratadine 10 mg/tab ODHS, with relief of
the pruritus, but persistence of the lesion.
3 days PTC, symptoms persisted now with
erythematous papules on his right medial thigh
and right side of the neck. He was advised to
seek consult to a dermatologist, prompting this
consult.
(+) multiple, erythematous,
well-defined plaques and
papules topped with
excoriation, measuring
0.1x0.1 to 3x5 cm on
bilateral hands and legs,
gluteal, genitalia, lower
abdomen, neck, nape, and
back.
Scabies Infestation Cetirizine 10mg/tab, 1
tab BID for 1 week
Permethrin 5% lotion,
apply neck down and
leave it for 8-12 hours,
then rinse thoroughly.
Apply once a week for 2
weeks
Simultaneous treatment
of all household
members
Proper decontamination
Mild soap
Emollient
TCB after 1 week
Drs. Rosal-
Patricio/
Rolimpandoei



Name Age/Sex Chief Complaint History of Present Illness Physical Examination Assessment Plan
Resident/s In-
Charge
Urbano, Luisa 65/F Plaque 8 years PTC, patient noted the appearance of
solitary well-defined skin-colored papule, not
associated with necrosis and telangiectasia in
the left nasolabial fold. The lesion was
associated with mild pruritus. No consult done,
patient self-medicated with Kati-alis 2x/day for
2 years with no improvement.
2 years PTC, patient noted the lesion increased
in width, accompanied with central atrophy,
telangiectasias, and rolled border with mild
pruritus. Patient self-medicated with Kati-alis
with no improvement.
2 months PTC, persistent lesion prompted
consult at PGH dermatology. Diagnosis was
undisclosed and was recommended a biopsy.
1 week after that, a biopsy was performed with
the result of Nodular Basal Cell Carcinoma.
Patient was referred to St. Lukes Hospital for
Mohs surgery. However, due to financial
constraints, opted to seek consult first to our
institution.
(+) Solitary erythematous to
hyperpigmented well-
defined plaque with central
atrophy and nodules with
rolled border, measuring
2x1 cm on left nasolabial
fold.
Basal Cell Carcinoma
(Nodular)
For referral to Dr. Cruz
(August 15, 2013)
Mild cleanser
TCB as scheduled
Drs. Ramos/
Kison/ Aulia
Lopez, Jonathan 67/M Vesicles and
papules
2 weeks PTC, patient noted sudden appearance
of papules on his left neck area, associated with
pruritus, patient self-medicated with Vicks
ointment, without resolution of the pruritus.
No consults done.
Days after, the papules evolved into vesicles,
also associated with pruritus and progression of
the lesion from the neck area to the chest area.
Some of the vesicles spontaneously ruptured
later topped with crusting.
1 week PTC, patient self-medicated with
Amoxicillin 500mg/tab OD but without relief.
Persistence prompted consult.
(+) multiple, erythematous,
well-defined papules and
vesicles on erythematous
bases, some with
excoriation and crusts,
measuring 0.2x0.2 to
0.4x0.4 cm on his nape,
shoulder, and left chest (C3-
C4, left)
Herpes Zoster (C3-
C4, left)
Cetirizine 10mg/tab, 1
tab BID for 1 week
Paracetamol + Vitamin B
complex TID x 1 week
Vitamins A,C,E + Zinc OD
Mupirocin 2% ointment
BID x 1 week
NSS compress BID
Mild soap
Advised isolation
TCB after 1 week
Drs. Kison/
Domingo
Catubig, Michaella 9/F Papule 5 months PTC, parent noticed white-colored
papules over the trunk of the patient
associated with pruritus.
2 months PTC, the patient was brought to a
dermatologist due to persistence of the lesion.
She was prescribed with Imiquimod 5% cream
3x/week, with poor compliance. The lesions did
not subside, and progressed in number, also
associated with pruritus, hence consult.
(+) multiple, well-defined,
white-colored papules,
measuring 0.2x0.2 cm to
0.3x0.3cm over the trunk
Molluscum
Contangiosum
For EXT (Left trunk on
August 14, 2013 1PM
and Right trunk on
August 16, 2013 8AM)
Mild soap
TCB on scheduled dates
Dr. Lacaba




Name Age/Sex Chief Complaint History of Present Illness Physical Examination Assessment Plan
Resident/s In-
Charge
Ogena, Esperanza 56/F Plaque 6 months PTC, the patient noted multiple
erythematous patches with scaling, associated
with pruritus over the palms. The patient self-
medicated with mentholated oil and cream
that there would be a burning sensation upon
application, which further aggravated the
lesions.
5 months PTC, the patient noted similar lesions
over the feet. She began to apply Petroleum
jelly PRN which did not relieve the lesion. Over
time, the lesions thickened and fissures were
noted. Due to the progression of the condition,
the patient sought consult.
(+) multiple ill- to well-
defined slightly
erythematous plaques with
scaling and fissures,
measuring 1x1cm to
2.5x2.5cm over the palms
and soles
Fissured eczema KOH (-)
Cetirizine 10mg/tab, 1
tab BID for 1 week
Sodium fusidate +
Betamethasone
dipropionate ointment
BID x 1 week
Keep area cool and dry
Advised double gloving
Urea lotion BID
Mild soap
TCB after 1 week
Drs. Maballo/
Lacaba
Pontejos, Prince Andrei 7/M Papule Almost 1 month PTC, patient had erythematous
pustules, associated with pruritus over the
scalp. Amoxicillin powder was applied with
resolution of the lesion, from multiple pustules
to plaques, also associated with pruritus.
However, as the lesions resolve, new pustules
grow. Persistence prompted consult.
(+) multiple, well-defined,
erythematous papules,
topped with yellowish
crusts, measuring 0.2x0.2cm
over the scalp
Bockharts Impetigo,
resolved
Cetirizine 5mg/ml, 2.5ml
BID for 1 week
Mupirocin 2% ointment
BID x 1 week
Safeguard soap

Dr. Baraan
Libanan, Julita 65/F Papule 20 years PTC, patient noted the appearance of
solitary well-defined skin-colored papule on her
Right lateral neck, which is not associated with
pruritus or tenderness. No consults done, no
medications applied.
Lesions gradually increase in numbers and size
to the whole neck area and some become
hyperpigmented. Persistent lesions prompted
consult.
(+) multiple, well-defined,
skin-colored to
hyperpigmented
pedunculated papules,
measuring 0.1x0.1 to
0.4x0.4 cm on the neck area
Acrochordon For ECT, neck area, on
Aug. 16, 2013; 8:00AM
Mild soap
TCB as scheduled

Drs. Lie/ Aulia
Papule 20 years PTC, patient noted the appearance of
solitary, well-defined hyprpigmented papule on
the neck, which is not associated with pruritus.
Lesions gradually increase in numbers, which
prompted consult.
(+) multiple, well-defined,
hyperpigmented, flat-
topped papules, measuring
0.1x0.1 to 0.2x0.2 cm on the
neck area
Verruca Plana
Quite, Grace A.



31/F Nodule 30 years PTC (since
birth), patient had
solitary, well-defined,
hyperpigmented nevus
on the forehead, which
is not associated with
pruritus or tenderness.
No consult done, no
medications applied
1 year PTC, patient
noted the two
lesions increase in
size, became more
hyperpigmented,
and now associated
with mild pruritus
and occasional
tenderness.
Persistence of the
lesions prompted
consult.
(+) few, well-defined,
hyperpigmented regular
border, dome-shaped
nodules with hair,
measuring 0.5x0.5 to
0.6x0.6cm on the forehead.

(+) symmetry
(+) cobblestone-like surface
(+) hair
Congenital
Melanocytic Nevus
For referral to ENT
Mild cleanser
TCB as scheduled

Drs. Kison/ Aulia
Nodule 20 years PTC, patient
noted the appearance
of solitary, well-defined,
hyperpigmented nevus
on the forehead, also
not associated with
pruritus
Compound
Melanocytic Nevus

Name Age/Sex Chief Complaint History of Present Illness Physical Examination Assessment Plan
Resident/s In-
Charge
Villamor, Marion Jake 4
months/
M
Patch 1 month PTC, parent noted appearance of
multiple erythematous papules on the patients
neck area, associated with pruritus. Consult
was done at a Public hospital (Fabella) wherein
Vitamin A ointment (Vandol) was prescribed
OD before bath, with good compliance.
However, there was no relief of the lesion.
Patient applied warm compress over the lesion,
with resolution, but with growth of new
papules.
3 days PTC, the papules evolved into bullae,
associated with pruritus. Patient only applied
warm compress with eruption of the bullae to
patches 1 day PTC. However, persistence of the
lesion prompted consult.
(+) multiple, erythematous,
ill-defined patches, topped
with scaling on the neck
area.
Intertrigo Miconazole +
Hydrocortisone cream
BID x 1 week
Zinc oxide cream every
diaper change
Keep area cool and dry
Mild soap
TCB after 1 week

Drs. Maballo/
Rolimpandoei
Papules 2 days PTC, patient noticed the appearance of
multiple, well-defined, erythematous papules
on gluteal area. No consult done, no
medications taken. Persistent lesions prompted
consult
(+) multiple, well-defined,
erythematous papules,
measuring 0.1x0.1cm on the
gluteal area
Diaper dermatitis