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1.
Arch. argent. pediatr ; 120(2): e75-e79, abril 2022. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1363969

ABSTRACT

La morfea lineal en golpe de sable es una entidad dermatológica caracterizada por la inflamación esclerosante y progresiva del tejido cutáneo en la región frontal y/o en el cuero cabelludo. La cefalea y las crisis convulsivas son dos de los síntomas extracutáneos más frecuentes y están causados por el crecimiento subyacente de la lesión. Es importante un diagnóstico temprano para frenar la progresión e intentar evitar las complicaciones secundarias, principalmente neurológicas. El diagnóstico se basa en el cuadro clínico y el estudio histológico, que permite la confirmación definitiva. El tratamiento de elección es la terapia combinada con corticoides orales y metotrexato. Aun con el tratamiento farmacológico adecuado, esta patología puede presentar un curso recidivante y dejar secuelas a largo plazo. Se presenta el caso de una niña en quien se realizó un diagnóstico rápido de esta enfermedad, a pesar de un cuadro clínico inespecífico. Fue tratada con metotrexato oral con buena respuesta, sin efectos secundarios.


Linear morphea in coup de sabre is a dermatological entity characterized by progressive, sclerosing inflammation of the skin tissue in the frontal region and on the scalp. Headache and seizures are two of the most frequent extracutaneous symptoms and they are caused by the growth of the lesion towards underlying structures. An early diagnosis is important to stop cranial progression and try to avoid secondary complications, mainly neurological. The diagnosis is relied on compatible clinical signs and a pathological study that allows a definitive confirmation. The treatment of choice is combination therapy with oral corticosteroids and methotrexate. Despite an adequate pharmacological treatment, this pathology can present a recurrent course and cause long-term sequelae. We present the case of a girl who was diagnosed quickly, despite a not very noticeable symptoms. She has been treated with oral methotrexate with a good response, without side effect


Subject(s)
Humans , Female , Child , Scleroderma, Localized/complications , Scleroderma, Localized/diagnosis , Scleroderma, Localized/drug therapy , Methotrexate , Disease Progression , Headache
2.
An. bras. dermatol ; 97(1): 75-88, Jan.-Feb. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1360077

ABSTRACT

Abstract This article will address the main aspects of skin manifestations associated with COVID-19, based on a review of the literature published to date. Since the beginning of the pandemic, more than 1,500 articles have been published on the subject. Regarding the pathophysiology, it is believed that the same mechanisms responsible for the disease in the main target organs also act in the skin, although they are not yet fully elucidated. The actual frequency of dermatological manifestations remains uncertain - it can range from 0.2% to 45%, being close to 6% in systematic reviews. Pioneering studies of large case series conducted in European countries and the USA provide the first information on the main skin manifestations associated with COVID-19 and propose classifications regarding their clinical presentation, pathophysiology, as well as their frequencies. Although there is yet no consensus, maculopapular eruptions are considered the most frequent presentations, followed by erythema pernio-like (EPL) lesions. Manifestations such as urticaria, vesicular conditions and livedo/purpura/necrosis are rare. The time of onset, severity, need for specific treatment and prognosis vary according to the clinical presentation pattern. The increasing histopathological description of skin conditions can contribute to the diagnosis, as well as to the understanding of the pathophysiology. Also, in the dermatological field, the relationship between COVID-19 and androgens has been increasingly studied. Despite all the generated knowledge, the actual biological meaning of skin manifestations remains uncertain. Therefore, the exclusion of the main differential diagnoses is essential for the correlation between skin manifestation and COVID-19.

3.
An. bras. dermatol ; 97(1): 14-21, Jan.-Feb. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1360096

ABSTRACT

Abstract Background: Mucocutaneous adverse events are common during anticancer treatment, with variable consequences for the patient and their therapeutic regimen. Objective: To evaluate the most common adverse events, as well as the drugs associated with their appearance and the consequences for cancer treatment. Methods: A retrospective study was carried out through the analysis of patients treated at the Clinical Dermatology Unit of a public oncologic hospital. Results: A total of 138 patients with 200 adverse events were evaluated. The most commonly identified adverse events were nail and periungual changes (20%), papulopustular eruptions (13%), acneiform eruptions (12%), hand-foot syndrome (6.5%), hand-foot skin reaction (6%), and xerosis (6%). The most frequently associated antineoplastic treatment groups were classical chemotherapy (46.2%), target therapy (32.3%), and other non-antineoplastic drugs used in neoplasia protocols (16.5%). Of the total number of patients, 17.4% had their treatment suspended or changed due to a dermatological adverse event. Study limitations: Retrospective study and analysis of patients who were referred for specialized dermatological examination only, not allowing the assessment of the actual incidence of adverse events. Conclusion: A wide variety of dermatological manifestations are secondary to antineoplastic treatment with several different drugs resulting, not rarely, in the interruption or modification of therapeutic regimens.

4.
Iatreia ; 34(4): 335-346, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1350833

ABSTRACT

RESUMEN El trauma punzante que genera un tatuaje altera la barrera física e inmunológica que proporciona la piel, con lo cual se favorece el ingreso de microorganismos patógenos y el riesgo de sufrir diferentes complicaciones infecciosas. Las condiciones en las que se realiza el tatuaje y el cumplimiento de las normas de bioseguridad son determinantes en prevenir este riesgo, sin embargo, se trata de una práctica de difícil vigilancia y control debido al vacío normativo existente. El auge de los tatuajes permanentes en la sociedad contemporánea se acompaña de un incremento en la frecuencia de sus complicaciones, que suelen ser leves y autoresolutivas, pero también pueden causar graves secuelas y poner en riesgo la salud del paciente tatuado. En la presente revisión se incluyen los principales aspectos normativos y epidemiológicos de los tatuajes, así como las manifestaciones dermatológicas de las infecciones asociadas, su clasificación etiológica y su aproximación diagnóstica y terapéutica.


SUMMARY Puncturing the skin with a tattoo needle damages the immunological and physical barrier. This facilitates the entry of pathogenic microorganisms and the risk of suffering infectious complications. The circumstances around the procedure, sanitary conditions and biosecurity standards are determinants of this risk; however, it is a practice with surveillance and control challenges due to the existing regulatory gap. Because of the significant rise in decorative tattoos among contemporary society, there has been an increase in complications, some are mild and usually resolve on their own, but there are others that leave sequelae and put the health of tattooed patient at risk. This review article includes main local tattooing regulations and epidemiological aspects, as well as dermatological manifestations of infections, their etiological classification, diagnostic and therapeutic approach.


Subject(s)
Humans , Skin , Tattooing , Infections
5.
An. bras. dermatol ; 96(5): 605-608, Sept.-Oct. 2021. graf
Article in English | LILACS | ID: biblio-1345135

ABSTRACT

Abstract Five cases of telogen effluvium undergoing resolution are shown, with the presence of frontal, bitemporal, and occipital hair regrowth. Diagnosing acute telogen effluvium after the end of the active phase can be challenging, especially when the pull test is negative. The differential diagnosis includes alopecia areata and traction alopecia. Clinical signs of hair regrowth after telogen effluvium can help in the diagnosis. The frontal and temporal areas have more telogen hairs and are more affected. On the occipital area, hairs seem to have the same behavior. The acute telogen effluvium triad during resolution is proposed: frontal fringe, temporal recess and occipital fringe.


Subject(s)
Humans , Alopecia Areata/diagnosis , Acute Disease , Diagnosis, Differential , Alopecia/diagnosis , Hair
6.
Rev. medica electron ; 43(4): 1069-1078, 2021. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1341536

ABSTRACT

RESUMEN La crioterapia es el conjunto de procedimientos que utilizan el frío en la terapéutica médica. Emplea diversos sistemas y tiene como resultado la disminución de la temperatura de la piel; produce una destrucción local de tejido de forma eficaz y controlada. El objetivo de este trabajo fue realizar una actualización para exponer los aspectos esenciales sobre formas de empleos, indicaciones, complicaciones y contraindicaciones. Existen varios métodos de aplicación de la crioterapia, que incluyen las técnicas de congelación de spray o aerosol y con aplicadores, el método criosonda, y el uso de termoacoplador. Está indicada en varias entidades, entre las que se encuentran la queratosis seborreica y actínica, lentigos solares, carcinoma basocelular y espinocelular in situ. Las complicaciones más observadas son vesicoampollas, hiperpigmentación e hipopigmentación, y las contraindicaciones comunes son intolerancia al frío, tumores con bordes no delimitados o con pigmentación muy oscura, en localizaciones cerca de los márgenes de los ojos, párpados, mucosas, alas nasales y el conducto auditivo. El dominio de los métodos de aplicación e indicaciones es indispensable para elegir la conducta adecuada; de esta forma se evitan complicaciones y efectos colaterales.


ABSTRACT Cryotherapy is the whole of procedures that use cold in medical therapy. It uses various systems and results in a decrease in skin temperature, leading to a local destruction of tissue in an effective and controlled way. The objective of this work is to make an update to expose the essential aspects on the ways of use, indications, complications and contraindications. There are several cryotherapy application methods that include spray or spray freezing techniques and applicators, the cryoprobe method, and the thermocoupler use. It is indicated in several entities, and among the most frequent are seborrheic and actinic keratosis, solar lentigo, basal cell and squamous cell carcinomas in situ. The most observed complications are vesical blisters, hyperpigmentation and hypopigmentation, and the most common complications are: cold intolerance, tumors with non-delimited borders or very dark pigmentation, located near the margins of the eyes, on eyelids, mucous membranes, nasal wings, and on the ear canal. The mastery of the signs and application methods are essential to choose the appropriate behavior against the disease: side effects and complications are avoided that way.

7.
Medicina (B.Aires) ; 81(4): 546-554, ago. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346505

ABSTRACT

Resumen Las urgencias dermatológicas constituyen un motivo de consulta frecuente en los departamentos de urgencias. Con el objetivo de determinar la prevalencia de las consultas por urgencias dermato lógicas, describir las mismas, analizar la coincidencia entre los diagnósticos recibidos por los pacientes, en los casos que realizaron dos consultas por el mismo cuadro, y analizar el comportamiento de las variables de acuerdo al subsector del sistema de salud en el cual fueron atendidos: subsector público, y subsector privado, se realizó un estudio prospectivo, observacional, analítico, de corte transversal y multicéntrico. Se incluyeron 2801 pacientes. La prevalencia de las consultas por urgencias dermatológicas en adultos fue de 15% en el mismo período horario (subsector público: 10.6% y subsector privado: 22.5%, p < 0.05). Motivó la consulta una enfermedad infecciosa en el 35.5%, alérgica en el 29.6% y neoplásica en el 8.6%. Se hospitalizó el 0.7% de los pacientes. El 31.7% de los pacientes había realizado consultas previas. En estos casos se encontró coincidencia entre los diagnósticos realizados en el 80.7% de los atendidos de forma precedente por un médico dermatólogo, y el 52.6% de los evaluados por médicos no dermatólogos. La alta prevalencia de las consultas por urgencias dermatológicas y las diferencias existentes en la probabilidad de recibir un diagnóstico apropiado de acuerdo con la especialización del profesional interviniente, muestran la importancia de la presencia de un médico con formación en dermatología en el área de urgencias.


Abstract Dermatological emergencies are a frequent reason for emergency departments consultation. In order to determine the prevalence of dermatological emergencies, to describe the kind of dermatological diseases that present as emergencies, to analyze the coincidence between the diagnoses received by the patients in those cases with a previous consultations for the same cutaneous manifestation, and to analyze the behavior according to the health system segment in which they were attended: public segment and private segment; a prospective, ob servational, analytical, cross-sectional and multi-center study was carried out. Two thousand eight hundred one patients were included. The prevalence of consultations for dermatological emergencies in adults was 15% in the same time period (public segment: 10.6 and private segment: 22.5%, p < 0.05). The consultation was due to an infectious disease in 35.5%, allergic in 29.6% and neoplastic in 8.6%; 0.7% of patients were hospitalized. In 31.7% of patients who had a previous consultation, a coincidence was found between the diagnoses made in 80.7% of those attended by a dermatologist, and 52.6% evaluated by non-dermatologist physician. The high prevalence of dermatological consultations and the existing differences in the probability of receiving an appropri ate diagnosis according to the specialization of the intervening professional, show the importance of the presence of dermatology-trained physicians in the emergency area.


Subject(s)
Humans , Adult , Skin Diseases/diagnosis , Skin Diseases/epidemiology , Dermatology , Argentina/epidemiology , Cross-Sectional Studies , Prospective Studies , Emergencies
8.
Arch. méd. Camaguey ; 25(3): e7079, 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1285182

ABSTRACT

RESUMEN Fundamento: el síndrome de Gianotti-Crosti también llamado acrodermatitis papular de la infancia es un exantema infrecuente, que se presenta por lo general en niños entre uno y seis años de edad. Dado que estos pacientes son llevados a su pediatra, es fundamental el conocimiento de las características de este síndrome. Objetivo: conocer un paciente con diagnóstico de síndrome de Gianotti-Crosti, también llamado acrodermatitis papular de la infancia. Presentación del caso: paciente de 18 meses que presentó un exantema pápulo-vesicular asintomática de distribución simétrica en cara, nalgas y superficies extensoras de las extremidades precedido de fiebre. Que duró dos semanas y cedió sin tratamiento. Conclusiones: debe sospecharse la enfermedad en niños con exantema pápulo-vesicular de distribución simétrica en cara, nalgas y superficies extensoras de las extremidades, asintomático y auto limitado.


ABSTRACT Background: the Gianotti-Crosti syndrome, also known as popular acrodermatitis of childhood, is an uncommon rash that usually occurs in children between 1 and 6 years old. Given that these patients are usually brought to their pediatrician, it is essential to know the characteristics of this syndrome. Objective: to show a patient with Gianotti-Crosti syndrome or popular acrodermatitis of childhood. Case report: an 18-month-old female patient, with asymptomatic papulo-vesicular reaction, symmetrically distributed on the face, buttocks and extensor surfaces of the extremities, preceded by fever. It lasted two weeks and disappeared without treatment. Conclusions: the entity should be suspected in children between 1 and 6 years old with asymptomatic papulo-vesicular eruption, symmetrically distributed on the face, buttocks and extensor surfaces of the extremities, asymptomatic and self-limited.

9.
An. bras. dermatol ; 96(3): 346-348, May-June 2021. graf
Article in English | LILACS | ID: biblio-1285064

ABSTRACT

Abstract Paracoccidioidomycosis is an endemic systemic mycosis caused by Paracoccidioides brasiliensis complex and P. lutzii. It is a rare disease in non-HIV-induced immunosuppressed individuals. In organ transplant recipients, it is more frequently associated with immunosuppression after kidney transplantation. In a liver transplant patient, only one case has been published in the literature to date. The present report comprises the case of a 47-year-old female patient with disseminated skin lesions associated with signs and symptoms of systemic involvement of paracoccidioidomycosis that manifested one year after liver transplantation and under an immunosuppression regimen with tacrolimus and mycophenolate mofetil.


Subject(s)
Humans , Female , Paracoccidioides , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/diagnostic imaging , Kidney Transplantation , Liver Transplantation/adverse effects , Transplant Recipients , Middle Aged
10.
An. bras. dermatol ; 96(3): 332-345, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1285074

ABSTRACT

Abstract The study of skin, the science of dermatology, has undergone significant transformations throughout the centuries. From the first descriptions of skin diseases in Egyptian papyri and in Hippocratic writings to the first treatises on dermatology, important individuals and discoveries have marked the specialty. In the 18th and 19th centuries, the specialty consolidated itself as a field of medical study based on the first classifications of dermatoses, diagnostic methods, and drug treatments. In the 20th century, the scientific and technological revolution transformed dermatological practice, incorporating new therapeutic resources, as well as surgical and aesthetic procedures. In the face of such a vigorous process, it is important to provide a historical synthesis for the medical community to recognize and understand the origins that supported one of the most relevant specialties in the current medical scenario.


Subject(s)
Humans , History, 15th Century , History, 16th Century , History, 18th Century , History, 19th Century , History, 20th Century , Skin Diseases/diagnosis , Skin Diseases/therapy , Dermatology , Skin , History, Ancient , History, Medieval , Egypt , Esthetics
11.
Enfermeria (Montev.) ; 10(1): 18-29, jun. 2021. graf
Article in Portuguese | LILACS-Express | LILACS, BDENF | ID: biblio-1278998

ABSTRACT

Resumo: Objetivo: Conhecer como a psoríase interfere na qualidade de vida dos pacientes na percepção de dermatologistas e identificar estratégias para melhoria e reorganização da assistência. Métodos: Pesquisa exploratória e descritiva, realizada em hospital público do interior de São Paulo, no período de dezembro de 2017 a março de 2018, com seis dermatologistas. As entrevistas foram transcritas e analisadas utilizando-se a estratégia metodológica do Discurso do Sujeito Coletivo. Resultados: Psoríase é uma doença que inflige prejuízo à qualidade de vida por estar associada a transtornos psicossociais, estigma, vergonha e perda da autoestima. Reduzir lesões e sintomas, melhorar a aparência, disponibilizar medicamento eficaz e oferecer atendimento humanizado são aspectos fundamentais para melhoria da qualidade de vida destes pacientes. Conclusão: Para os profissionais dermatologistas, a psoríase é uma doença crônica, que interfere na qualidade de vida dos pacientes, em virtude do preconceito sentido, dos transtornos psicossociais e sentimentos negativos que afloram, bem como das dificuldades sociais enfrentadas.


Resumen: Objetivos: conocer cómo la psoriasis afecta la calidad de vida de los pacientes en la percepción de los dermatólogos e identificar estrategias para mejorarla y reorganizar la atención. Métodos: Investigación descriptiva y exploratoria realizada en un hospital público del interior de São Paulo, de diciembre de 2017 a marzo de 2018, con seis dermatólogos. Las entrevistas fueron transcritas y analizadas utilizando la estrategia metodológica del Discurso Colectivo del Sujeto. Resultados: En opinión de los participantes, la psoriasis es una enfermedad que daña la calidad de vida por estar asociada a trastornos psicosociales, estigma, vergüenza y pérdida de la autoestima. Reducir lesiones y síntomas, mejorar la apariencia, disponer de una medicación eficaz vinculada a la atención humanizada son fundamentales para mejorar la calidad de vida de estos pacientes. Conclusión: Se observó que, para los dermatólogos, la psoriasis es una enfermedad crónica que interfiere con la calidad de vida, debido al prejuicio sentido, los trastornos psicosociales y sentimientos negativos que surgen, así como las dificultades sociales que enfrentan los pacientes.


Abstract: Objective: to know how psoriasis affects the quality of life of patients in the perception of dermatologists and identify strategies for improving it and reorganizing care. Methods: Descriptive, exploratory study research conducted in a public hospital in the countryside of São Paulo, from December 2017 to March 2018, with six dermatologists. The interviews were transcribed and analyzed using the methodological strategy of the Collective Subject Discourse. Results: Psoriasis is a disease, which affects the quality of life because it is associated with psychosocial disorders, shame, stigma and loss of self-esteem. Reducing injuries and symptoms, improving appearance, having an effective medication coupled with humanized care are fundamental for improving the quality of life of these patients. Conclusion: It was observed that for dermatologists, psoriasis is a chronic disease that interferes with the quality of life, due to the prejudice felt by patients, the psychosocial disorders and negative feelings that arise, as well as the social difficulties faced, by them.

12.
J. pediatr. (Rio J.) ; 97(2): 211-218, Mar.-Apr. 2021. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1287017

ABSTRACT

Abstract Objective: The aim of this study was to identify the pattern of pediatric dermatoses of patients evaluated at a dermatologic clinic of a reference center in Brazil and to compare these results to similar surveys conducted in other countries. Methods: A retrospective study was performed of patients up to 18 years old, evaluated at a dermatologic clinic between January 1, 2017 and December 31, 2017. Variables collected for analysis included age, gender, dermatological diagnosis, multidisciplinary follow-up, hospitalization, and complementary exams. Results: A total of 2330 patients were included for analysis, with a mean age of 9.7 years. 295 patients were diagnosed with more than one skin disease, leading to a total of 2668 diagnoses. Skin diseases were organized into categories and inflammatory dermatoses corresponded to the largest group (31.2%), mostly due to atopic dermatitis (18.3%). The other main categories were: genodermatoses (14.2%), infectious diseases (12.6%), adnexal disorders (12.5%), cysts and neoplasms (10.7%), and vascular disorders (7.0%). Fifty-six patients needed to be admitted to the dermatology ward; 25 of them (44.6%) for management of worsening of the skin disease, mainly atopic dermatitis, psoriasis, and drug reactions. There were 885 biopsies performed in 38.0% of the subjects and 751 patients (32.2%) required multidisciplinary care; most of them had some genodermatoses. Conclusions: Dermatologic disorders are very common in the pediatric age group and differ from those in adults, suffering influence from cultural, ethnic, socioeconomic, and environmental factors. Knowing the magnitude and distribution of these dermatoses is important to better plan healthcare policies.

13.
Medisan ; 25(2)mar.-abr. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1250347

ABSTRACT

Introducción: La gestión formativa y el perfeccionamiento de los programas académicos de posgrado son necesidades impostergables para la formación permanente de los profesionales en las universidades de ciencias médicas cubanas. Objetivo: Socializar las experiencias sistematizadas en los procesos de gestión de la calidad de los programas de posgrado en dos especialidades médicas. Métodos: Se efectuaron un diagnóstico y una evaluación externa de los programas académicos de posgrado de las especialidades en Dermatología y Medicina Interna de la Universidad de Ciencias Médicas de Santiago de Cuba, en los meses de mayo y septiembre del 2019, respectivamente, donde se ponderó la observación de las diferentes actividades de cada programa a través del desarrollo de las seis variables establecidas para ello, lo cual contribuyó a revelar las principales fortalezas y debilidades de dichos programas de estudio. Resultados: El análisis integral de los programas evidenció, durante el proceso de evaluación externa, el cumplimiento de los estándares establecidos en el modelo de calidad, por lo que se decidió por unanimidad, en el Acuerdo de la Sesión 49 de la Junta de Acreditación Nacional de octubre de 2019, otorgarles la categoría superior de acreditación de Programa de Excelencia. Conclusiones: Pudo demostrarse que en la gestión formativa de ambas especialidades, como figuras académicas de posgrado, se han revelado con asertividad los impactos pertinentes para el Sistema Nacional de Salud Pública.


Introduction: The training management and the improvement of the academic postdegree programs are urgency necessities for the permanent training of the professionals in the Cuban universities of medical sciences. Objective: To socialize the systematized experiences in the processes of quality management of the postdegree programs in two medical specialties. Methods: A diagnosis and an external evaluation of the post degree academic programs in the specialties of Internal Medicine and Dermatology were carried out in the Medical Sciences University in Santiago de Cuba, in the months of May and September, 2019 respectively, where the observation of the different activities of each program was considered through the development of the six established variables for it, which contributed to reveal the main strengths and weaknesses of these study programs. Results: The integral analysis of the programs evidenced, during the process of external evaluation, the fulfillment of the established standards in the quality pattern, reason why it was unanimously decided, in the 49 Session Agreement of the National Accreditation Meeting from October, 2019, to grant them the accreditation higher category of Excellency Program. Conclusions: It could be demonstrated that in the training management of both specialties, as academic figures of postdegree, have been revealed with assertiveness the pertinent impacts for the National System of Public Health.


Subject(s)
Program Evaluation , Dermatology , Internal Medicine , Programs of Study , Accreditation
14.
Medisur ; 19(2): 329-337,
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1279452

ABSTRACT

RESUMEN Fundamento: la incidencia de cáncer de piel se ha triplicado, por lo que el conocimiento sobre factores de riesgo y prevención es necesario para el médico general en formación. Objetivo diagnosticar la forma en que se aborda el tema prevención del cáncer cutáneo en la asignatura Dermatología. Métodos: investigación pedagógica desarrollada en la Universidad de Ciencias Médicas de Cienfuegos. Se analizaron las exigencias para el tratamiento del tema prevención del cáncer cutáneo en la asignatura Dermatología. Se aplicó entrevista a muestra intencional de profesores de Dermatología y encuestas a estudiantes. Se realizó el análisis de documentos rectores, programas, etc. Resultados los estudiantes reciben el tema durante su quinto año de la carrera. Todos los profesores coinciden en que dentro de los temas de prevención impartidos en la carrera no es abordado el relacionado con el cáncer cutáneo; el 82,8 % refiere que el tema es abordado en conferencia, fundamentalmente el diagnóstico de pacientes enfermos y los aspectos sobre prevención son utilizados con menos relevancia. Todos los estudiantes coinciden en que nunca se les habla del cáncer cutáneo como una localización importante y susceptible de realizar medidas de prevención; el 85,7 % refiere que es un tema muy largo y se hace más énfasis en diagnosticar las lesiones, clasificarlas, tratarlas y no en cómo prevenirla, además en la prácticas no son observados muchos pacientes para poder identificarlas. Conclusiones: la forma en que es abordado el tema sobre prevención del cáncer cutáneo en la asignatura Dermatología no es suficiente para lo que necesita el médico general.


ABSTRACT Background: the incidence of skin cancer has tripled, so knowledge about risk factors and prevention is necessary for the general practitioner in training. Objective: to diagnose the way in which the prevention of skin cancer is approached in the Dermatology subject. Methods: pedagogical research developed at the Cienfuegos University of Medical Sciences. The requirements for the treatment of the prevention of skin cancer in the Dermatology subject were analyzed. An interview was applied to an intentional sample of Dermatology professors and student surveys. The analysis of guiding documents, programs, etc. was carried out. Results: students receive the subject during their fifth year of the degree. All the professors agree that within the prevention topics taught in the career, the one related to skin cancer is not addressed; the 82.8% refer that the subject is addressed in a conference; basically the diagnosis of sick patients and the aspects of prevention are used with less relevance. All students agree that skin cancer is never mentioned as an important location that is susceptible to preventive measures; the 85.7% refer that it is a very long topic and more emphasis is placed on diagnosing injuries, classifying them, treating them and not on how to prevent them, in addition, many patients are not observed in practice in order to identify them. Conclusions: the way in which the topic of skin cancer prevention is approached in the Dermatology subject is not enough for what the general practitioner needs.

15.
Colomb. med ; 52(1): e7014577, Jan.-Mar. 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1249641

ABSTRACT

Abstract Case description: 32-month-old boy, IgG positive for SARS-CoV-2, presented to the emergency department with dermatologic lesions. Clinical findings: Four days before admission, he presented skin eruptions with redness and pruritus on hands and feet. Generalized papular erythema was evidenced, upper extremities with diffuse erythematosquamous plaques, palmoplantar keratoderma, so he was evaluated by a dermatologist who diagnosed pityriasis rubra pilaris. Treatment and outcome: rehydrating cream, cetirizine 0.5 mg/kg/day every two days, and prednisolone 2 mg/kg/day in the morning. He was discharged after 14 days, the patient presented clinical improvement, but the erythematous lesion persisted on the trunk and extremities. In the evaluation, after three months, the patient did not show the described lesions, evidencing an improvement and clinical resolution of the dermatological problems. Clinical relevance: We report a patient with pityriasis rubra piloris associated with a post-infection by SARS-CoV-2 that had not been described before.


Resumen Descripción del caso: Niño 32 meses de vida, con IgG positivo para SARS-CoV-2, acude al servicio de emergencia por presentar lesiones dermatológicas. Hallazgos clínicos: Cuatro días antes del ingreso presentó erupciones en la piel, con enrojecimiento y prurito en manos y pies. Se evidenció eritema papular generalizado, extremidades superiores con placas eritematoescamosas difusas, queratodermia palmo-plantar por lo que es evaluado por dermatólogo quien diagnostica pitiriasis rubra pilaris. Tratamiento y resultado: Crema rehidratantes, cetirizina 0.5 mg/kg/día cada 2 días y prednisolona 2 mg/kg/día por la mañana. Fue dado de alta a los 14 días, el paciente presenta mejora clínica, pero aún persiste la lesión eritematosa en tronco y extremidades. En la evaluación a los tres meses el paciente no mostró las lesiones descritas, evidenciando una mejoría y resolución clínica de los problemas dermatológicos. Relevancia clínica: Se reporta un paciente con afectación por pitiriasis rubra piloris asociado a una post-infección por SARS-CoV-2 que no se había descrito antes.

16.
An. bras. dermatol ; 96(2): 200-209, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248753

ABSTRACT

Abstract The technological advancement of the pharmaceutical industry, resulting from the techniques of molecular biology and expansion of the knowledge of immunopathogenesis, has modified the therapeutic arsenal used in dermatology. Scientific research and regulatory standards cause drug costs to rise, thus making their use impossible in most public policies. In order to make high-cost drugs viable in the public health network, the Specialized Pharmaceutical Assistance Component was created. However, despite the frequent incorporation of medications, the constant requirement of drugs through lawsuits leads to exorbitant costs to the state budget. The present work analyzed through a descriptive observational study, the current situation of the Specialized Component and the involvement of medicines used in dermatology, through legal reviews, financial analyses, and medical articles, aiming at future incorporations for the specialty. When assessing the legal demands for dermatological drugs in the state of São Paulo, the specialty still has a low participation and psoriasis is the main disease involved in requiring drugs through the judicial system in the state. New methods of access to raw materials must be created to reduce legal issues. Cost-effectiveness and public planning studies are mandatory for incorporating new dermatological therapies.


Subject(s)
Humans , Pharmaceutical Preparations , Dermatology , Socioeconomic Factors , Brazil , Drug Costs
17.
Rev. bras. cir. plást ; 36(1): 40-45, jan.-mar. 2021. tab
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1151550

ABSTRACT

Introdução: A crescente incidência de câncer de pele leva a um alto número de procedimentos cirúrgicos em todo o mundo. O principal objetivo do tratamento cirúrgico do câncer de pele é sua excisão completa, preservando a função e o melhor resultado estético. A ressecção inicial incompleta pode resultar em recorrências e danos graves. O objetivo é analisar os fatores de risco para margens positivas no seguimento de lesões cutâneas removidas cirurgicamente, por um ano, no departamento de cirurgia plástica do Hospital Royal Perth. Métodos: Foi analisado um levantamento de amostras histopatológicas de 947 pacientes operados. Todos os pacientes com excisão incompleta confirmada (EI) foram submetidos a uma segunda cirurgia ou até mesmo a uma terceira vez. Resultados: No total, 947 lesões foram encontradas, 6,6% das cirurgias tiveram margens comprometidas, com distribuição histopatológica de 75% de carcinoma basocelular (CBC), 21,4% de carcinoma de células escamosas (CCE) e 3,6% de outras lesões. A relação da presença de margens cirúrgicas comprometidas entre o CCE, quando comparada ao CBC, leva a um risco relativo de 2,8 e um valor p de 0,041, sugerindo que o primeiro é um fator de risco para a presença de margens cirúrgicas comprometidas. Para o estadiamento, a necessidade de uma segunda abordagem cirúrgica esteve presente em 61,29% dos pacientes, 20,9% estavam em observação, 3,2% estavam ausentes do serviço, 8% foram diretamente à quimioterapia ou radioterapia e 6,4% remarcaram a cirurgia. Conclusão: O conhecimento dos fatores de risco para margens positivas é necessário para que o cirurgião entenda o prognóstico e o acompanhamento de cada paciente.


Introduction: The increasing incidence of skin cancer leads to a high number of surgical procedures worldwide. The surgical treatment of skin cancer's main objective is its complete excision, preserving the function and the best aesthetic result. Incomplete initial resection can result in recurrences and major damage. The objective is to analyze the risk factors for positive margins in the follow-up of cutaneous lesions surgically removed, for one year, in the plastic surgery department of the Royal Perth Hospital. Methods: A survey of histopathological samples from 947 operated patients was analyzed. All patients with confirmed incomplete excision (IE) underwent a second surgery or even a third time. Results: In total, 947 lesions were found, 6.6% of surgeries had compromised margins, with a histopathological distribution of 75% of basal cell carcinoma, 21.4% of squamous cell carcinoma, and 3.6% of other lesions. The relation of the presence of compromised surgical margins between the SCC, compared to BCC, leads to a relative risk of 2.8 and a p-value of 0.041, which suggests that the SCC is a risk factor for the presence of compromised surgical margins. For staging, the need for a second surgical approach was present in 61.29% of the patients, 20.9% were under observation, 3.2% were absent from the service, 8% went directly to chemotherapy or radiotherapy, and 6.4% rescheduled the surgery. Conclusion: Knowledge of risk factors for positive margins is necessary for the surgeon to understand the prognosis and monitoring of each patient.

18.
Rev. bras. cir. plást ; 36(1): 100-107, jan.-mar. 2021. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1151662

ABSTRACT

A percepção da beleza é ainda algo pouco compreendida, apesar de francamente notável. Pessoas consideradas belas notadamente tem melhor autoestima e um melhor desempenho em suas relações interpessoais. A procura por tratamentos cosmiátricos está em franca ascensão e o crescimento entre os homens é ainda maior. A perfeita compreensão das diferenças entre os atributos masculinizantes e feminilizantes em uma face deve ser encorajado, a fim de obter melhores resultados estéticos e a prevenção de estigmas de tratamento. Nesta revisão, será abordada cada região facial, pormenorizando os padrões de beleza de cada gênero, norteando os detalhes do tratamento.


The beauty perception is still poorly understood, though downright remarkable. People considered beautiful notably have better self-esteem and perform better in their interpersonal relationships. Demand for cosmetic treatments is on the rise and growth among men is even higher. Perfect understanding of the differences between masculinizing and feminizing attributes on a face should be encouraged in order to achieve better aesthetic results and the prevention of treatment stigmas. This review will cover each facial region, detailing the beauty standards of each gender, guiding the details of treatment.

19.
Arq. bras. med. vet. zootec. (Online) ; 73(2): 395-405, Mar.-Apr. 2021. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1248927

ABSTRACT

The objective of this study was to investigate the effects of a gel formulation from the association of Plectranthus neochilus and Cnidoscolus quercifolius on tissue repair in cutaneous wounds in rats. A surgical wound was induced in 35 Wistar rats and treated according to group: G1 - commercial phytotherapeutic gel; G2 - Carbopol gel 1%; G3, 4, 5 - gel formulation from Boldo-gambá and Favela (FGBF) at 2.5%, 5%, and 10%, respectively. 1ml of the product was applied topically daily, for 14 days. Macroscopic evaluation of the wound showed inflammation, granulation, and epithelization in all groups. The FGBF 2.5% group showed greater angiogenic potential. There was a significant difference between the surgical area of the wounds treated with FGBF 2.5%, 5%, or 10% compared to the group with the commercial phytotherapeutic gel. On histomorphometry of the skin, there were reepithelization of the epidermis and superficial dermis, longitudinal collagen fibers, fibroblasts, and blood vessels, and in the deeper dermis, fibroblasts, transverse and longitudinal collagen fibers, blood vessels, and inflammatory cells. The 2.5% formulation had the greatest increase in fibroblast proliferation and most intense collagenization on day 14 of treatment.(AU)


Este trabalho objetivou investigar os efeitos de uma formulação em gel da associação da Plectranthus neochilus e da Cnidoscolus quercifolius no processo de reparação tecidual em feridas cutâneas de ratos. Foi induzida uma ferida cirúrgica em 35 ratos Wistar, sendo tratadas de acordo com os grupos: G1 - fitoterápico comercial; G2 - gel de carbopol 1%; G3, G4 e G5 - formulação gel boldo-gambá mais favela (FGBF) 2,5%, 5% e 10%, respectivamente. Aplicou-se 1mL do produto, via tópica, diariamente, durante 14 dias. Na avaliação macroscópica das feridas, verificou-se inflamação, granulação e epitelização em todos os grupos. O grupo FGBF 2,5% apresentou maior potencial angiogênico. Houve diferença significativa entre as áreas cirúrgicas das feridas tratadas com os FGBF 2,5%, 5% ou 10%, comparados ao grupo com o gel fitoterápico comercial. Na histomorfometria da pele, observou-se reepitelização da epiderme e da derme superficial, fibras colágenas longitudinais, fibroblastos e vasos sanguíneos e, na derme profunda, fibroblastos, fibras colágenas transversais e longitudinais, vasos sanguíneos e células inflamatórias. A formulação a 2,5% teve o maior aumento na proliferação de fibroblastos e mais intensa colagenização no dia 14 de tratamento.(AU)


Subject(s)
Animals , Rats , Wound Healing , Wounds and Injuries/therapy , Jatropha/chemistry , Plectranthus/chemistry , Plants, Medicinal , Wounds and Injuries/veterinary , Rats, Wistar/physiology , Phytotherapy/veterinary
20.
Rev. Assoc. Med. Bras. (1992) ; 67(2): 182-184, Feb. 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1287816

ABSTRACT

SUMMARY Cutaneous manifestations are considered an infrequent presentation of coronavirus disease 2019 (COVID-19) and are mostly described in outpatient settings. Its onset during the course of the severe COVID-19 disease has been poorly described in severe cases. Studies focused on dermatological manifestations mostly described maculopapular or pernio-like lesions and less frequently vesicular or varicella-like eruption. We described the occurrence of a vesiculopapular eruption in three laboratory-confirmed COVID-19 patients associated with severe lung injury in whom the skin findings preceded viral reactivation and recrudescence of hypoxemia. The potential mechanisms for COVID-19-related cutaneous manifestations include immune hypersensitivity, cytokine-release syndrome, deposition of microthrombi, and vasculitis.

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