Prevalencia de patologías cutáneas en el adulto mayor de 80 años: análisis de dos comunas del sector Norte de Santiago, Chile / Prevalence of skin diseases in elderly population from two counties in the north area of Santiago, Chile

Los problemas de salud en los adultos mayores son una preocupación a nivel mundial. Sin embargo, existen muy pocos estudios de la prevalencia de patologías cutáneas en la población geriátrica. El objetivo de esta investigación fue analizar la prevalencia de patologías cutáneas en la población geriátrica mayor de 80 años en dos comunas del Área Norte de Santiago, Chile. Una muestra representativa de casos de las dos comunas fue seleccionada para el análisis, con un sistema de muestreo por conglomerado estratificado. Ochenta y cuatro adultos mayores de 80 años fueron entrevistados y su Piel fue examinada. Se realizó el test de chi cuadrado para el análisis estadístico. La edad promedio de la muestra fue de 86,6 años con un 68% de mujeres (87,05 :+ 4,76) y 32% de varones (85,55 :+ 4(52). En el examen físico, todos los individuos examinados tenían a lo menos tres patologías cutáneas por persona, con un promedio de 7,25 +1 1,26 patologías cutáneas por adulto mayor. Las patologías cutáneas más comunes en los adultos mayores fueron lentigos (78%), xerosis (73%), queratosis seborreicas (71%), patologías por fotodaño (71%), puntos rubí (62%), onicomicosis (42%). Dentro de los tumores de Piel se observaron 6 keratosis actínicas, 3 carcinomas baso celulares, 1 carcinoma espinocelular; 1 melanoma maligno. Las patologías cutáneas clasificadas por grupo de patologías más frecuentes fueron: tumores benignos (89%), patologías asociadas a la exposición solar (85%), xerosis (73%), patologías del pie (71%) y enfermedad varicosa (45%). No se observaron diferencias significativas entre varones y mujeres en cuanto a las patologías. Este estudio contribuye a la identificación de problemas de Piel de la población geriátrica de nuestro país y enfatiza la importancia de realizar campañas de educación en salud en población geriátrica en Chile.

Geriatric health care has become a worldwide concem, but relatively few studies are available about geriatric skin diseases. The purpose of this study was to analyze the prevalence of skin diseases in over-80 population from two counties in the north area of Santiago, Chile. A representative sample of houses with over 80 people were selected to participate in the study according to a stratified random sampling design 84 individuals were interviewed and their skin was examined by a dermatology resident. A Chi square test was performed for the statistical analysis. The average age of the sample was 86.6, 68% females (87.05 + 4.76) and 32% males (85.55 :+ 4.52). The physical examination of all individuals showed at least three skin disorders per individual, with an average of 7.25 :+ / .26 skin disorders per person. The most common cutaneous disorders were lentigos (78%), xerosis (73%), seborrheic keratosis (71%), photodamage (71%), angiomas (62%), onychomycosis (42%). A prevalence of 6% of skin cancer tumors was found (6 actinic keratosis, 3 basal cell carcinoma/squamous cell carcinoma/malignant melanoma). The most frequent group of skin disorders were benign tumours (89%), skin disorders associated to UV exposure (85%), xerosis (73%), feet disorders (71%) and varicose disease (45%). No statistical differences between gender were found. This study contributes to the identification of skin problems of elderly people in our country and emphasizes the importance of health education in the geriatric population in Chile.

Asociación inversa entre enfermedad de Alzheimer y cáncer / Inverse relationship between Alzheimer's disease and cancer

The increase in life expectancy is accompanied by a concomitant increase in the prevalence of age related disorders, including neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, and various types of cancers. We here report epidemiologic findings suggesting thatthe development of the Alzheimer and a history of cancer are inversely related. The inverse relationship was found when all cancer types were analyzed and also when skin cancers (bothmelanomas and those with good prognosis, that constitute 50% of all cancers) were analyzed separately. In addition, in a population study we found that this inverse relationship was found with dementia of the Alzheimer type and mixed dementia, but not with vascular dementia, suggesting that the association is only with degenerative diseases. We discuss possible explanations for this inverse relationship, among them, the possibility that a common biological mechanism might be regulated in opposite directions in neurodegenerative diseases and cancer.

Dermatosis liquenoides / Lichenoid dermatoses

Las Dermatosis Liquenoides son un grupo de enfermedades frecuentes en Dermatología. La palabra liquen produce confusión a los dermatólogos, pues es utilizada indistintamente para definir un patrón histopatológico de infiltrado linfocítico en banda en la membrana basal, así como también un patrón clínico de pápulas violáceas aplanadas y brillantes. Considerando su frecuencia, es conveniente que los dermatólogos se encuentren bien familiarizados con estos conceptos en orden a realizar diagnósticos precisos y así otorgar tratamientos adecuados a estos pacientes.

Lichenoid dermatoses are a group of diseases frequently seen in dermatology. The word lichen tends to confuse dermatologists because this term describes a histopathological pattern characterized by a band-like lymphocytic infiltrate in the basal membrane, as well as a clinical pattern of flat, violet, shiny papules. Given the high number of patients suffering from this disorder, it is advisable for dermatologists to be well familiarized with these concepts in order to give an accurate diagnosis and suitable treatment.

Eficacia y seguimiento en el largo plazo de pacientes con psoriasis vulgar moderada a severa en tratamiento con infliximab (Remicade®) / Efficacy of infliximab in patients with moderate and severe psoriasis treated with infliximab (Remicade®)

Background: Psoriasis has a moderate or severe course in 25% of patients, requiring systemic therapy that is not always successful. Infliximab is a human-murine monoclonal anti tumor necrosis alpha (TNF-a) antibody. This mediator has a role in the pathogenesis of psoriasis. Aim: To evaluate the use of infliximab in psoriatic patients resistant to conventional therapies. Material and Methods: An open prospective study including eight patients with extensive plaque or erythrodermic psoriasis. They were treated with infliximab 5 mg/kg/dose on weeks 0,2 and 6. Patients were evaluated every 2 weeks for a median lapse of 50.1 weeks. Physical examination, PASI scores (Psoriasis Area Severity Index) and a photographic control, were done in each visit. Results: All the patients responded in the first 10 weeks of follow-up. The mean reduction in PASI score was 86.6%. Six patients received fourth infusion of infliximab at 37.3 weeks, on average. The most common adverse events were pruritus and headache. Conclusions: This group of patients with extensive plaque or erythrodermic psoriasis resistant to conventional therapies, had a good response to infliximab.