Dr. Bryan Ko Guevara

21/09/2025

A 30-year old male patient came in the clinic with erythematous plaques and vesicles (1st image).

Common differential diagnosis includes bullous tinea/fungal infection. However, a skin punch biopsy from the patient’s arm (2nd image) revealed a suprabasal separation of the skin that is seen in an uncommon autoimmune disease.

✍🏻Diagnosis: Pemphigus Vulgaris, which is an autoimmune condition that causes blisters to form on your skin and mucous membranes.

👀An accurate diagnosis is through a skin biopsy with an immunofluorescence test.

🔬 Should you need a skin biopsy, consult a board-certified dermatologist/dermatopathologist.

21/09/2025

Throwback 2018 at Taipei, Taiwan 🇹🇼

International fellows all over the region took the Dermatopathology exam of the Asian Academy of Dermatology & Venereology at Taipei, Taiwan.

I was blessed to pass with distinction this board exam thanks to all my dermpath mentors all over the world, especially Dr. YH Wu (Taiwan).

Seven years after my first (our of the three) dermpath boards, I read cases daily that can range from easy to difficult (see the succeeding images that are examples from today’s batch of slides)

📌 Why do I use a microscope as a dermatologist? 🔬

As I am practicing both dermatology and dermatopathology, I am able to see a patient with a skin lesion (rash, mole, or skin growth), biopsy it and examine it under a microscope.

Also, I receive skin specimens from dermatologists, surgeons, or any other doctor to aid them by providing a diagnosis for their respective patients.

An accurate diagnosis by your doctor will lead a better treatment plan for you. So, don’t hesitate to get a skin biopsy… it’s only a quick and minor procedure done in a clinic! 🏥

📌 How to be a dermatopathologist?

After medical school, choose a residency program (for dermatology or pathology) then obtain a board certification on either. Afterwards, pursue a dermatopathology fellowship and another board certification after completing it.

📌 How many board certifications to pass?

Two = Dual board certifications for Dermatology (or Pathology) AND Dermatopathology.

📍 For me, I took and passed four board examinations in both dermatology and dermatopathology given by the following:

✅ Philippine Dermatological Society 🇵🇭

✅ Dermatopathology Society of the Philippines 🇵🇭

✅ International Committee for Dermatopathology-European Union of Medical Specialists (Frankfurt, Germany) 🇩🇪

✅ Asian Academy of Dermatology and Venereology (AADV)’s Dermatopathology Exam (Taipei, Taiwan)🇹🇼

‼️ Can you guess the diagnoses for the 2nd to 4th photos? ❓❓

🔍Click the images below to see the answers.

12/09/2025

A patient came in with multiple plaques all over her body and was managed as “ring worm” or tinea, and was prescribed with antifungal therapies by her previous physician.

Persistence of her lesions prompted consult with me and I performed a skin punch biopsy, which eventually confirmed the diagnosis of leprosy or Hansens disease.

Patient was started with multidrug therapy with excellent response.

09/09/2025

What is alopecia universalis?

Alopecia universalis (AU) is a condition characterized by the complete loss of hair on the scalp and body. It is an advanced form of alopecia areata, a condition that causes round patches of hair loss.

Although the exact cause of AU is unknown, it is thought to be an autoimmune condition in which the person's immune system mistakenly attacks the hair follicles.

As an immunodermatologist, I treat patients by using safe treatment options that focus in modulating the immune system.

Thank you to my patient and her mother for their consent to post these pictures.

09/09/2025

05/09/2025

29/08/2025

"Success is peace of mind, which is a direct result of self-satisfaction in knowing you made the effort to become the best of which you are capable." – John Wooden

📸 (while patiently waiting for his wife getting a procedure at the clinic)

📍 Southeast Dermatology

24/08/2025

Clinic schedule for Iloilo clinic:

✅ Aug 25-27 (Mon-Wed).

📝 Strictly by appointments only. No walk-in.

☎️ For appointments:

📍 Southeast Dermatology Iloilo
One Global Center Iloilo Business Park
Iloilo city
📞 09189049888

18/08/2025

Proud to be part of this team for bringing great speakers and attendees together for the 1st Psoriasis Conference in collaboaration by the PDS Immunodermatology and Photodermatology Subspecialty groups.