Sistema de procedimientos para la formación interdisciplinar de la habilidad diagnosticar en residentes de dermatología / A System of Procedures for the Interdisciplinary Training of the Dill To Diagnose in Dermatology Residents

Introducción: En las prácticas de laboratorio se adquiere la habilidad que permite corroborar el diagnóstico de las enfermedades de la piel y anejos después de un diagnóstico presuntivo, con la utilización del método clínico. Esto se respalda en las exigencias establecidas en los documentos normativos de ese proceso formativo. Objetivo: Proponer un sistema de procedimientos para la formación interdisciplinar de la habilidad "diagnosticar enfermedades dermatológicas en los residentes de dermatología, a partir de insuficiencias detectadas en el programa de la especialidad. Métodos: La investigación fue cualitativa, con un estudio descriptivo en el Hospital Provincial General Docente Dr. Antonio Luaces Iraola, de Ciego de Ávila, desde 2018 hasta 2022. Se trabajó con toda la población conformada por 16 residentes de primer año en dermatología. Se utilizaron métodos de nivel teórico, empírico y estadístico. Resultados: En el sistema de procedimientos propuesto, se concretan fortalezas y debilidades, objetivo general, orientaciones metodológicas, precisión de los objetivos específicos y sistema de acciones para cada procedimiento, y sistema de control y evaluación de la efectividad de las acciones realizadas. La demostración de la formación de la habilidad diagnosticar, a través de un caso clínico real, reveló como esencial la consecutividad lógica de las acciones del residente desde la atención médica del caso y la formulación del diagnóstico presuntivo hasta el establecimiento del diagnóstico corroborativo en los laboratorios de anatomía patológica, microbiología y parasitología médica. Conclusiones: Se aporta un sistema de procedimientos que posibilita la formación de la habilidad "diagnosticar enfermedades dermatológicas en los residentes, con carácter secuencial, interdisciplinar e investigativo(AU)

Introduction: Laboratory practices provide the ability that allows corroborating the diagnosis of skin and adnexal diseases after a presumptive diagnosis, with the use of the clinical method. This is supported by the requirements established in the standardization documents of this training process. Objective: To propose a system of procedures for the interdisciplinary training of the skill to diagnose dermatological diseases in Dermatology residents, based on insufficiencies detected in the specialty program. Methods: The research was qualitative and consisted in a descriptive study carried out in Hospital General Docente Dr. Antonio Luaces Iraola, of Ciego de Avila, from 2018 to 2022. The work was done with the entire population made up of 16 first-year residents in Dermatology. Theoretical, empirical and statistical methods were used. Results: In the proposed system of procedures, strengths and weaknesses are specified, together with general objective, methodological guidelines, precision of specific objectives and system of actions for each procedure, as well as system of control and evaluation of the effectiveness of the actions. Demonstrating the received formation for the diagnostic skill, through a real clinical case, revealed as essential the logical consecutivity of the resident's actions from the medical attention of the case and the formulation of the presumptive diagnosis to the establishment of the corroborative diagnosis in the laboratories of pathological anatomy, microbiology and medical parasitology. Conclusions: A system of procedures is provided that makes possible the formation of the skill to diagnose dermatological diseases in residents, with sequential, interdisciplinary and investigative character(AU)

Participation of Latino Authors in TOP Dermatology Journals During 2021: a Brief Bibliometric Analysis / Participación de autores latinos en revistas TOP de dermatología durante el 2021: un corto análisis bibliométrico / Participação de autores latinos nas revistas TOP de dermatologia durante 2021: uma breve análise bibliométrica / Participation of Latino Authors in TOP Dermatology Journals During 2021: a Brief Bibliometric Analysis

A key global health objective is to promote the advancement of scientific production in disciplines with low publication volume, as opposed to specialties addressing pathologies that represent the greatest global disease burden (1). Dermatology is one such discipline, which has experienced substantial growth in research on immunopathogenic, pathophysiological, diagnostic, and therapeutic aspects (2-4). The extent to which Latin American authors and institutions have been involved in publishing scientific articles in the dermatology journals with highest impact worldwide remains unknown.

Un objetivo clave de salud mundial es promover el avance de la producción científica en disciplinas con bajo volumen de publicación, a diferencia de especialidades que abordan las patologías que representan la mayor carga de enfermedad a nivel mundial (1). La Dermatología es una de esas disciplinas que ha experimentado un crecimiento sustancial en investigación en aspectos inmunopatogénicos, fisiopatológicos, diagnósticos y terapéuticos (2-4). El alcance en el cual los autores e instituciones latinoamericanas han participado en la publicación de artículos científicos en revistas de dermatología con mayor impacto mundial permanece incierto.

Um objetivo fundamental da saúde global é promover o avanço da produção científica em disciplinas com baixo volume de publicações, em oposição às especialidades que abordam patologias que representam a maior carga de doenças em todo o mundo (1). A Dermatologia é uma das disciplinas que tem experimentado um crescimento substancial nas pesquisas em aspectos imunopatogênicos, fisiopatológicos, diagnósticos e terapêuticos (2-4). A extensão da participação de autores e instituições latino-americanas na publicação de artigos científicos em revistas de dermatologia de maior impacto global permanece incerta.

Concepción didáctica del proceso formativo interdisciplinar de la habilidad diagnosticar enfermedades para residentes de Dermatología / Didactic Concept of the Interdisciplinary Formation Process of the Diagnostic Ability of Dermatology Residents

Fundamento: El estudio teórico, el diagnóstico realizado y la experiencia de los investigadores, posibilitan formular como problema de la presente investigación: limitaciones en el desarrollo de la habilidad diagnosticar enfermedades dermatológicas en los residentes de la especialidad de Dermatología del Hospital General Provincial Docente "Dr. Antonio Luaces Iraola" de Ciego de Ávila. Objetivo: Elaborar una concepción didáctica del proceso de formación interdisciplinar de la habilidad diagnosticar enfermedades dermatológicas en los residentes de la especialidad de Dermatología, a partir de la caracterización del estado actual de esta habilidad. Metodología: Se realizó una investigación educativa con un componente descriptivo en el Hospital General Provincial Docente "Dr. Antonio Luaces Iraola" de Ciego de Ávila, en los cursos escolares desde 2016 al 2020. La población de estudio fueron los 16 residentes de 1.er año que matricularon la especialidad de Dermatología en el período de estudio. Se emplearon métodos del nivel teórico y empírico. Resultados: La caracterización realizada reveló limitaciones en el desarrollo de la habilidad diagnosticar enfermedades dermatológicas en los laboratorios de Anatomía Patológica, Microbiología y Parasitología Médica, por los residentes (100 %). La concepción didáctica del proceso de formación interdisciplinar de la habilidad diagnosticar orienta el proceso desde las actividades docentes-atencionales y prácticas de laboratorio en una consecutividad lógica y sistematización desde las diferentes formas de enseñanza y tipologías de clase. Integra la interdisciplinariedad y la utilización del método investigativo establecido en las ideas rectoras. Conclusiones: La concepción didáctica como aporte de la investigación resuelve la contradicción dialéctica entre la aplicación del método clínico y los procedimientos en la práctica de laboratorio que se da en ese proceso formativo y constituye un soporte didáctico que respalda las actividades prácticas en los laboratorios para cumplir con los objetivos del Plan de estudio de la especialidad.

Background: The theoretical study, the diagnosis conducted and the experience of the researchers make possible to formulate the problem of the present research: limitations in the development of the ability to diagnose dermatological diseases in residents of the Specialty of Dermatology of the General Provincial Teaching Hospital "Dr. Antonio Luaces Iraola" of Ciego de Avila. Objective: To elaborate a didactic conception of the interdisciplinary training process of the ability to diagnose dermatological diseases in residents of the specialty of Dermatology, based on the characterization of the current state of that ability. Methodology: An educational research with a descriptive component was conducted at the Provincial General Teaching Hospital "Dr. Antonio Luaces Iraola" of Ciego de Avila, in the 2016-2020 school years. The study population consisted of the 16 first-year dermatology residents who enrolled in the specialty during the study period. Results: The characterization conducted showed limitations in the development of the ability to diagnose dermatological diseases in anatomic pathology laboratories, Microbiology and Medical Parasitology, by residents (100%). The didactic conception of the interdisciplinary training process of diagnostic ability focuses on teaching and learning activities and laboratory practices in a logical consecutiveness and systematization from the different forms of teaching and class typologies. It integrates the interdisciplinary and the use of the research method that is established in the guiding ideas. Conclusions: The didactic conception, as a research contribution, resolves the dialectic contradiction between the application of the clinical method and the procedures in laboratory practice that occurs in this formative process which is a didactic support that backs up the practical activities in the laboratories in order to achieve the objectives of the study plan of the specialty.

Lesiones cutáneas benignas y malignas en pacientes atendidos en un hospital general de Trujillo, Perú / Benign and malignant skin lesions in patients attended in a public hospital in Trujillo, Peru

Objetivo: Determinar las características clínicas y demográficas de los pacientes con lesiones de piel atendidos en un hospital general de Trujillo, Perú. Material y métodos: Estudio transversal, descriptivo, observacional y retrospectivo. Se hizo la revisión microscópica de 385 biopsias de piel de los archivos de Patología y de las historias clínicas de pacientes atendidos en el Hospital del Belén de Trujillo, durante el periodo comprendido entre enero del 2018 y diciembre del 2019. Resultados: La lesión más frecuente fue el carcinoma basocelular, localizado en alguna parte del rostro y de presentación mayor a edades de 60 años o más. En segundo lugar, carcinoma epidermoide. Las lesiones malignas afectaron al 66,7% de pacientes entre 55 y 79 años, con edad promedio de 67 años. En su mayoría (65,8%) fueron varones desocupados. De las lesiones benignas, la más frecuente fue el quiste de inclusión epidérmica y se ubicó en el tronco de varones entre 20 y 24 años. En segundo lugar, el pilomatrixoma se ubicó en los miembros superiores de menores de 10 años. Afectaron al 59,6%, entre los 30 y 54 años, con edad promedio de 44,1 años. En su mayoría (63,7%), se reportaron como ama de casa. Procedieron en su mayor parte de los distritos de Trujillo. No fue posible establecer el agente injuriante. Conclusiones: En personas de piel trigueña o cobriza, las lesiones tanto benignas como malignas tuvieron un patrón de presentación similar a la de otros estudios, tanto en localización, grupo etario y sexo. La procedencia y la ocupación no fueron contributorias.

SUMMARY Objective : To determine the clinical and socio demographic features of patients attended at a public hospital in Trujillo, Peru. Methods : A cross-sectional study that included 385 skin biopsies obtained from the archives of the Pathology Department and from the clinical charts of these patients at Hospital Belen in Trujillo from January 2018 to December 2019 was carried-out. Results : The most common entity was basocellular carcinoma located on the face in patients above 60 years of age. The second most common entity was epidermoid carcinoma. Malignant lesions affected 66.7% of patients between 55 and 79 years of age with a mean of 67 years. Most of the patients were unemployed males (65.8%). The most common benign lesion was the epidemic inclusion cyst mostly in the trunk among males from 20 to 24 years of age. The second most common benign lesion was the pilomatrixoma mostly located in the upper limbs of patients below 10 years of age. Benign lesions affected the 59.6% of the sample between 30 to 54 years of age with a mean of 44 years, mostly among housewives. Most of the patients came from districts of Trujillo. The causal agent was not identified. Conclusions : In mestizo patients both benign and malignant lesions had a clinical presentation similar as reported in the literature regarding location, age and gender distribution. Occupation and precedence were not contributory..

Competências do enfermeiro especialista em dermatologia: revisão de escopo / Skills of specialist nurses in dermatology: a scoping review

OBJETIVO: Mapear as competências do enfermeiro especialista em Dermatologia. MÉTODO: Trata-se de uma scoping review, desenvolvida conforme as recomendações do Joanna Briggs Institute (JBI). Para elaboração da questão de pesquisa utilizou-se a estratégia Population, Concept e Context. A busca por publicações, sem limitar idioma e recorte temporal, foi realizada nas fontes: The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), National Library of Medicine (MEDLINE) via PubMed, Scopus, Embase e Cochrane Library, além de sites das associações de especialistas e no Google Acadêmico. RESULTADOS: Foram selecionadas 17 publicações, originando as categorias: avaliação integral do paciente dermatológico, prescrição de medicamentos, detecção precoce e prevenção do câncer de pele, tratamento de feridas e estética. CONCLUSÃO: Diante da vasta possibilidade de atuação do enfermeiro nesta área, constata-se a necessidade de ampliação da discussão e de pesquisas sobre o tema.

OBJECTIVE: To map the competencies of specialist nurses in Dermatology. METHOD: A scoping review was conducted according to the recommendations of the Joanna Briggs Institute (JBI). The Population, Concept, and Context framework established the research question. The search for publications was carried out in different sources, including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin America and the Caribbean Literature on Health Sciences (LILACS), National Library of Medicine (MEDLINE) via PubMed, Scopus, Embase, and the Cochrane Library. Additionally, expert association websites and Google Scholar were searched. No language or time restrictions were applied. RESULTS: Seventeen publications were selected, originating the categories: integral evaluation of the dermatological patient, drug prescription, early detection and prevention of skin cancer, wound care, and aesthetics. CONCLUSION: Faced with the vast possibilities for nurses to work in Dermatology, there is a need to expand the discussion and research on the subject.

Teledermatología sincrónica en tiempos de Covid-19. Percepción del dermatólogo / Synchronous teledermatology in times of Covid-19. Dermatologist perception

Teledermatology (TD) is a remote medical care tool that experienced a great boom during the COVID19 pandemic, resulting in an increase in both, the number of remote consultations and the number of dermatologists who practice it. Several studies have reported a high degree of satisfaction among patients attended by this method. However, few studies have done so in dermatologists. We set out to investigate the experience of Chilean dermatologists with the tool by means of an online survey. Results. A total of 156 surveys were completed. The number of dermatologists using TD increased from 19.9% to 80.8% during the pandemic. They cited the absence of the physical examination-dermatoscopy as the main limitation to developing TD and reported feeling more comfortable with some pathologies. Dermatologists feel moderately comfortable and confident with the tool, however, they experienced varying degrees of stress and frustration. Only 40.8% plan to continue using TD in the future. Conclusion. Synchronous TD has clear limitations, however, these should emerge as an opportunity to consider in its development and its platforms, in order to generate a more comfortable tool for more dermatologists and thus extend its use, as an important tool for equal access to health care in Chile. (AU)

Uso de técnicas de aprendizado de máquina para classificação de fatores que influenciam a ocorrência de dermatites ocupacionais / Using machine learning techniques to classify factors that influence the occurrence of occupational dermatitis

Resumo Introdução: realizar a predição de doenças relacionadas ao trabalho é um desafio às organizações e ao poder público. Com as técnicas de aprendizado de máquina (AM), é possível identificar fatores determinantes para a ocorrência de uma doença ocupacional, visando direcionar ações mais efetivas à proteção dos trabalhadores. Objetivo: predizer, a partir da comparação de técnicas de AM, os fatores com maior influência para a ocorrência de dermatite ocupacional. Métodos: desenvolveu-se um código em linguagem R e uma análise descritiva dos dados e identificaram-se os fatores de influência de acordo com a técnica de AM que demonstrou melhor desempenho. O banco de dados foi disponibilizado pelo Serviço de Dermatologia Ocupacional da Fundação Oswaldo Cruz e contém informações de trabalhadores que apresentaram alterações cutâneas sugestivas de dermatite ocupacional no período de 2000-2014. Resultados: as técnicas com melhor desempenho foram: neural network, random forest, support vector machine e naive Bayes. As variáveis sexo, escolaridade e profissão foram as mais adequadas para os modelos de previsão de dermatite ocupacional. Conclusão: as técnicas de AM possibilitam predizer os fatores que influenciam a segurança e a saúde dos trabalhadores, os parâmetros que subsidiam a implantação de procedimentos e as políticas mais efetivas para prevenir a dermatite ocupacional.

Abstract Introduction: to predict work related diseases is a challenge for organizations and the governmental authorities. By means of machine learning (ML) techniques it is possible to identify factors that determine the occurrence of an occupational disease, aiming at taking more effective actions to protect workers. Objective: to predict, by comparing ML techniques, the factors which highly influence the occurrence of occupational dermatitis. Methods: we developed a code in R language and a descriptive analysis of the data and identified the influence factors according to the ML technique that presented the best performance. The database was made available by the Occupational Dermatology Service of Oswaldo Cruz Foundation and assembles information of the workers who experienced cutaneous alterations suggestive of occupational dermatitis between 2000-2014. Results: the techniques which presented the best performance were: neural network, random forest, support vector machine, and naive Bayes. Sex, schooling, and profession were the most adequate variables for the occupational dermatitis prediction models. Conclusion: ML techniques allowed to predict the factors that influence the workers' safety and health, as well as the parameters that subsidize the procedures implementation, and the most effective policies to prevent occupational dermatitis.

Dermatologia e pesquisa científica: análise das publicações em hospital de ensino no sul do Brasil / Dermatology and scientific research: analysis of publications in a teaching hospital in southern Brazil

Introdução: a Dermatologia destaca-se entre as especialidades médicas por seu pioneirismo na descoberta e ca-racterização de afecções da pele, tornando-se proeminente a compreensão da conjuntura da produção científica na especialidade. Objetivo: analisar o perfil das publicações científicas do Serviço de Dermatologia da Santa Casa de Porto Alegre/Universidade Federal de Ciências da Saúde de Porto Alegre. Método: estudo transversal e descritivo realizado a partir da análise das publicações do Serviço de Dermatologia, no período de janeiro de 2019 a dezembro de 2020. Resultados: a partir do levantamento de dados,foram identificadas 54 publicações no período, constituídas 81,5% (n = 44) por artigos e 18,5% (n = 10) por capítulos de livro. A maioria dos artigos foi 'relato de casos' (56,8%; n = 25). Cerca de 46,3% das publicações contaram com a participação de residentes e/ou especializandos, principal-mente no 3º ano dos programas. Conclusão: a análise das publicações científicas revelou predomínio de artigos em periódicos, principalmente em veículos nacionais, com expressiva participação de especializandos. O desenvolvimento científico da Dermatologia pressupõe a valorização das atividades de pesquisa no âmbito dos programas de especiali-zação e residência, com potencial de contribuição para a melhoria dos serviços de saúde e produtividade acadêmica. (AU)

Background: Dermatology stands out among the medical specialties for its pioneering role in the discovery and characterization of skin conditions, making the understanding of the conjuncture of scientific production in the spe-cialty prominent. Objective: the study aimed to analyze the profile of scientific publications of the Dermatology Service of Santa Casa of Porto Alegre / Federal University of Health Sciences of Porto Alegre. Method: this cross-sectional and descriptive study was conducted from the analysis of publications of the Dermatology Service from January 2019 to December 2020. Results: from the data collection, 54 publications were identified in the analyzed period, consisting of 81.5% (n = 44) of articles and 18.5% (n = 10) of book chapters. Most articles were 'case reports' (56.8%; n = 25). About 46.3% of the publications had the participation of residents and/or trainees, mainly in the 3rd year of the programs. Conclusion: the analysis of scientific publications revealed a predominance of articles in journals, mainly in national vehicles, with a significant participation of students. The scientific development of Dermatology presupposes the valorization of research activities within the scope of specialization and residency programs, with the potential to contribute to the improvement of health services and academic productivity. (AU)

Análise do perfil clínico e epidemiológico dos pacientes atendidos em um serviço terciário de dermatologia / Analysis of the clinico-epidemiological profile of patients attended in a tertiary dermatology service / Análisis del perfil clínico y epidemiológico de los pacientes atendidos en un servicio terciario de dermatología

OBJETIVO: Este artigo analisou o perfil epidemiológico e clínico dos pacientes atendidos em um serviço terciário de Dermatologia no município de Ponta Grossa-PR no período de 2016 a 2018. MÉTODOS: Trata-se de um estudo descritivo, exploratório, transversal e de abordagem quantitativa com dados coletados do prontuário médico. RESULTADOS: A maioria dos pacientes atendidos (I) era do sexo feminino; (II) com mais de 50 anos; (III) realizaram somente uma consulta, (IV) não foram submetidos a exames adicionais; e (V) apresentavam comorbidades, sobretudo, dermatológicas; o segmento corporal com maior número de lesões dermatológicas foi a cabeça; o grupo diagnóstico mais comum foi a afecção dos anexos cutâneos e o diagnóstico mais frequente foi a ceratose actínica. CONCLUSÃO: O estudo é fundamental para demonstrar quais são os pacientes e as doenças dermatológicas comumente encaminhadas para o serviço especializado, o que pode direcionar ações de prevenção primária, secundária e terciária.

OBJECTIVE: This article analyzed the epidemiological and clinical profile of patients treated at the outpatient Dermatology clinic, during 2016-2018, located in the municipality of Ponta Grossa-PR. METHODS: This is a descriptive exploratory, cross-sectional study with a quantitative approach, with data collected from the medical records. RESULTS: Most of the patients examinated: (I) were female; (II) over 50 years old; (III) attended to a single consultation; (IV) were not submitted to additional exams; and (V) had comorbidities, especially dermatological; the head was the most affected body segment; the most common diagnostic group was cutaneous annexes affections and the most frequent diagnosis was actinic keratosis. CONCLUSION: The study is fundamental to demonstrate who are the patients and which are the dermatological diseases commonly referred to the specialized service, which can guide primary, secondary and tertiary prevention actions.

OBJETIVO: Este artículo analizó el perfil epidemiológico y clínico de los pacientes atendidos en un servicio terciario de Dermatología en el municipio de Ponta Grossa-PR en el período de 2016 a 2018. MÉTODOS: Se trata de un estudio descriptivo, exploratorio y transversal con un enfoque cuantitativo con datos recogidos de las historias clínicas. RESULTADOS: La mayoría de los pacientes atendidos (I) eran mujeres; (II) tenían más de 50 años; (III) tenían una sola consulta, (IV) no se sometieron a exámenes adicionales; y (V) presentaban comorbilidades, principalmente, dermatológicas; el segmento corporal con mayor número de lesiones dermatológicas fue la cabeza; el grupo diagnóstico más común fue la afección de apéndices cutáneos y el diagnóstico más frecuente fue la queratosis actínica. CONCLUSIÓN: El estudio es fundamental para demostrar cuáles son los pacientes y las enfermedades dermatológicas que se derivan habitualmente al servicio especializado, lo que puede dirigir las acciones de prevención primaria, secundaria y terciaria.

Manifestaciones mucocutáneas y su relación con el recuento de linfocitos T CD4 en pacientes infectados con el virus de inmunodeficiencia humana hospitalizados en Medellín, Colombia / Mucocutaneous manifestations and their relationship with CD4 T-lymphocyte count in hospitalized patients infected with the human immunodeficiency virus (HIV) in Medellín, Colombia

Introducción. Entre el 80 y el 95 % de los pacientes infectados por el virus de inmunodeficiencia humana (HIV) desarrollan manifestaciones en la piel que sirven como marcadores de su estado inmunológico. Objetivos. Describir las manifestaciones dermatológicas y los factores clínicos y sociodemográficos de los pacientes hospitalizados con diagnóstico de HIV y su correlación con el recuento de linfocitos T CD4. Materiales y métodos. Se hizo un estudio observacional de corte transversal y retrospectivo a partir del registro de las historias clínicas de 227 pacientes mayores de edad con diagnóstico de HIV, evaluados por dermatología en un hospital de Medellín, Colombia. Resultados. Los 227 registros daban cuenta de 433 manifestaciones dermatológicas, el 64,4 % de ellas infecciosas. Las tres manifestaciones más frecuentes fueron candidiasis oral, condilomas acuminados y reacciones a medicamentos. Se encontró una relación estadísticamente significativa entre el virus del herpes zóster (HZ) diseminado y la sífilis secundaria, con un recuento de CD4 entre 200 y 499 células/mm3 (p=0,04 y 0,028, respectivamente), y entre la candidiasis oral y un recuento de CD4 menor de 100 células/ mm3 (p=0,008). Conclusiones. La relación entre el herpes zóster diseminado y un recuento de CD4 entre 200 y 499 células/mm3 sugiere que, a pesar de los recuentos altos, se pueden presentar formas graves de la enfermedad debido a una posible disfunción de las células T y el agotamiento del sistema inmunológico. La relación entre la candidiasis oral y un recuento de CD4 menor de 100 células/mm3 plantea la posibilidad de considerar esta infección micótica como un marcador importante de debilitamiento inmunológico de los pacientes con HIV.

Introduction. About 80-95% of patients infected with the human immunodeficiency virus (HIV) develop skin manifestations, which are markers of the patients' immune status. Objective. To describe the dermatologic manifestations and the clinical and sociodemographic factors of hospitalized patients diagnosed with HIV and their correlation with CD4 T-lymphocyte count. Materials and methods. We conducted an observational, cross-sectional, and retrospective study of the medical records of 227 adult patients with HIV diagnosis evaluated by dermatology in a hospital in Medellín, Colombia. Results. We included 227 patient records with 433 dermatologic manifestations, 64.4% of them infectious. The most frequent manifestations were oral candidiasis, condylomata acuminata, and drug reactions. Moreover, a statistically significant relationship was found between disseminated herpes zoster virus and secondary syphilis with a CD4 count between 200-499 cells/mm3 (p=0.04 and 0.028, respectively). There was also a statistically significant relationship between oral candidiasis and a CD4 count of less than 100 cells/ mm3 (p=0.008). Conclusions. The relationship between disseminated herpes zoster with CD4 between 200-499 cells/mm3 suggests that, despite having high CD4 counts, severe forms of the disease may occur due to possible T-cell dysfunction and depletion of the immune system. Additionally, the relationship between oral candidiasis and CD4 less than 100 cells/mm3 indicates the potential role of oral candidiasis as an essential marker of weakened immune status in HIV patients.

Caracterización de pacientes con cáncer de piel y otras afecciones causadas por fotodaño / Characterization of patients with skin cancer and other affections caused by photodamage

Introducción: El fotodaño es la agresión producida por la radiación solar en la piel. A su vez, la radiación ultravioleta es uno de los primeros agentes considerados como generadores de cáncer. Objetivo: Caracterizar a los pacientes con neoplasias cutáneas y otras afecciones causadas por fotodaño, según variables clínicas seleccionadas. Métodos: Se realizó un estudio transversal, observacional, clínico, descriptivo y retrospectivo de 64 pacientes diagnosticados con alguna afección causada por fotodaño, pertenecientes al área de salud del consultorio médico No. 11 del Policlínico Aquiles Espinosa Salgado de Las Tunas, desde enero del 2020 hasta igual periodo del 2022. Se analizaron variables, tales como edad, sexo, color de la piel, fototipo de piel, ocupación, uso regular de medios de protección solar antes de los 18 años de edad y actualmente, así como enfermedad dermatológica causada por fotodaño. Resultados: Predominaron el grupo etario de 60 años y más (43,7%), el sexo femenino (54,7 %), el color de la piel blanco (98,5 %), el fototipo de piel III (59,4 %) y los trabajadores estatales (53,1%).Se halló, que 90,6 % de los pacientes no tenían antecedentes de exposición a radiaciones no ultravioletas; 25,0 % refirió usar regularmente algún medio de protección antes de los 18 años de edad y 51,5 % lo emplean actualmente. La enfermedad dermatológica causada por fotodaño que primó fue el cáncer de piel (37,5 %). Conclusiones: Este estudio denotó la pertinencia y necesidad de identificación de las características clínicas de los pacientes con afecciones causadas por fotodaño en el consultorio médico referido.

Introduction: Photodamage is the aggression caused by solar radiation in the skin. In turn, the ultraviolet radiation is one of the first agents considered as cancer generators. Objective: Characterize the patients with cutaneous neoplasms and other affections caused by photodamage, according to selected clinical variables. Methods: A cross-sectional, observational, clinical, descriptive and retrospective study of 64 patients diagnosed with some affection caused by photodamage was carried out, belonging to the health area of the doctor office No. 11 of Achiles Espinosa Salgado Polyclinic in Las Tunas, from January, 2020 to the same period in 2022. Some variables were analyzed, such as age, sex, color of the skin, skin photo type, occupation, regular use of solar protection means before the 18 years and now, as well as dermatologic disease caused by photodamage. Results: There was a prevalence of the 60 years and over age group (43.7 %), female sex (54.7 %), color of the skin white (98.5 %), skin photo type III (59.4 %) and the state workers (53.1 %). It was found that 90.6 % of the patients didn't have history of exhibition to non ultraviolet radiations; 25.0 % referred to use some means of protection regularly before the 18 years and 51.5 % use it at the moment. The dermatologic disease caused by photodamage that prevailed was the skin cancer (37.5 %). Conclusions: This study denoted the relevance and necessity to identify the clinical characteristics of the patients with affections caused by photodamage in the doctor office abovementioned.

Teledermatology at a tertiary government hospital in Davao City during the COVID-19 pandemic: A retrospective descriptive study

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> Telemedicine is the practice of remote consultations that utilize computer-mediated communication. Given the visual nature of dermatology, it is most well-suited to adopt telecommunication practices. This enables remote medical care during public health emergencies like the current COVID-19 pandemic; limiting the risk of exposure for both patients and doctors alike.</p><p style="text-align: justify;"><strong>OBJECTIVES:</strong> This study aimed to describe the demographic and clinical profile of teledermatology patients from April to August 2020. Data were also compared with face-to-face consultations during the same period in 2019 in order to establish whether telemedicine can be a viable and reliable substitute to face-to-face consultations during a pandemic.</p><p style="text-align: justify;"><strong>METHODS:</strong> We retrospectively analyzed chart data during a 5-month period in 2020; wherein the number of online consultations were observed to be the highest. We noted demographic and clinical features and compared some of these data to those obtained in the same period in 2019.</p><p style="text-align: justify;"><strong>RESULTS:</strong> A total of 1,632 patients were seen via teledermatology in 2020 versus 7,219 face-to-face patients in 2019. Mean age for both groups were 26.59 and 36.89 respectively. Most patients in both years were from Davao. However, there was an increase in consults from other regions in 2020. Overall, the majority of cases for both periods were non-urgent inflammatory conditions.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> This study showed that providing remote dermatologic care is now possible with the advent of technology even during a pandemic. Teledermatology may serve as an effective adjunct to traditional consultations.</p><p style="text-align: justify;"><strong>KEYWORDS:</strong> telemedicine, dermatology, COVID-19, pandemic</p>

Historia de la lepra vinculada a la enseñanza de la Dermatología / History of leprosy linked to the teaching of Dermatology

RESUMEN Fundamento: la lepra es una enfermedad crónica trasmisible, poco contagiosa, producida por el mycobacterium leprae, es probablemente la más antigua de todas las enfermedades y es la segunda que más discapacidades causa después de la poliomielitis. Objetivo: profundizar acerca de los factores que contribuyeron en la evolución del conocimiento científico de la lepra y su vínculo con el desarrollo histórico del proceso de formación de los estudiantes de Medicina en la asignatura Dermatología en Cuba. Métodos: para la recogida de la información se emplearon artículos de Scielo, Google Scholar, MEDISAN y Elsevier, publicados e impresos para un total de 77; de ellos fueron seleccionados 23 que cumplían con el criterio de idioma español o traducidos al español y que abordaran la lepra, su historia y cómo se inserta en el proceso de formación en la carrera de Medicina. Desarrollo: los factores que contribuyeron en la evolución histórica de la lepra son las migraciones desde el viejo continente hasta las Américas, el desarrollo del conocimiento científico a partir del siglo XIX y en Cuba, el factor fundamental que determinó el desarrollo científico y formativo de la Dermatología vinculada a la enfermedad fue el triunfo de la Revolución en 1959. Conclusiones: se determinaron las diferentes etapas de evolución histórica de la enfermedad en el mundo y en Cuba, así como su vínculo con los procesos formativos de la carrera de Medicina y la asignatura Dermatología en Cuba.

ABSTRACT Background: leprosy is a chronic transmissible disease, not very contagious, caused by mycobacterium leprae, it is probably the oldest of all diseases and is the second causing more disabilities after poliomyelitis. Objective: to deepen into the factors that contributed to the evolution of scientific knowledge of leprosy and its link with the historical development of the training process of medical students in the Dermatology subject in Cuba. Methods: for data collection , articles from Scielo, Google Scholar, MEDISAN and Elsevier were used, published and printed for a total of 77; Of them, 24 were selected that met the criteria of Spanish language or translated into Spanish and that addressed leprosy, its history and how it is inserted in the training process in the Medicine degree. Development: the factors that contributed to the historical evolution of leprosy are the migrations from the old continent to the Americas, the development of scientific knowledge from the 19th century and in Cuba, the fundamental factor that determined the scientific and educational development of Dermatology linked to leprosy was the triumph of the Revolution in 1959. Conclusions: the different stages of historical evolution of the disease in the world and in Cuba were determined, as well as its link with the training processes of the Medicine degree and the Dermatology subject in Cuba.

Análisis curricular del programa de la asignatura Dermatología en la carrera de Medicina / Curriculum analysis of the program of the Dermatology subject in the Medicine Degree

RESUMEN Fundamento: la planeación curricular exige cambios para formar un profesional capaz de laborar en correspondencia con las competencias y desempeños del mercado vigente. Un análisis crítico de los planes y programas de estudios contribuye a sistematizar el ejercicio docente y permite identificar las reservas de mejora de los currículos. Objetivo: analizar críticamente el programa de la asignatura Dermatología para determinar sus fortalezas e insuficiencias, a fin de contribuir a su perfeccionamiento. Métodos: se realizó una revisión bibliográfica sistemática y documental para desarrollar un análisis crítico reflexivo del contenido de documentos, que incluyó varias fuentes, entre ellas: resoluciones, programas de asignatura Dermatología, artículos originales y de revisión. Se seleccionaron 13 fuentes teniendo en cuenta su pertinencia y actualización según objetivo del trabajo. La búsqueda digital se realizó en las bases de datos SciELO, Google Académico e Infomed de los últimos cinco años. Resultados: se realizó un análisis del programa actual de Dermatología, el cual logra una coherencia sistémica de los temas básicos de la asignatura que requiere un médico general; se le consideraron como limitaciones: la disminución de horas clase a pesar de que se le incorpora un nuevo tema Nevus, tumores y dermatosis precancerosas, no aparecen contenidos sobre Bioseguridad ni sobre foto-protección, y la presencia de las formas organizativas de la enseñanza también generó insatisfacciones. Conclusiones: el programa de la asignatura Dermatología se ajusta en sus objetivos, contenidos y evaluación de acuerdo con el modelo del profesional que se aspira a formar, sin embargo; es susceptible de ser perfeccionado.

ABSTRACT Background: curricular planning requires changes to train a professional capable of working in correspondence with the skills and performance of the current market. A critical analysis of the study plans and programs contributes to systematizing the teaching exercise and allows identifying the reserves for improvement of the curricula. Objective: to critically analyze the program of the Dermatology subject to determine its strengths and weaknesses, in order to contribute to its improvement. Methods: a systematic and documentary bibliographic review was carried out to develop a reflexive critical analysis of the content of documents, which included several sources, among them: resolutions, Dermatology subject programs, original and review articles. 13 sources were selected taking into account their relevance and updating according to the objective of the work. The digital search was carried out in the SciELO, Google Scholar and Infomed databases for the last five years. Results: an analysis of the current Dermatology program was carried out, which achieves a systemic coherence of the basic topics of the subject that a general practitioner requires; It was considered as limitations: the decrease in class hours despite the incorporation of a new topic Nevus, tumors and precancerous dermatoses, no content on Biosafety or photo-protection appears, and the presence of organizational forms of teaching also caused dissatisfaction. Conclusions: the program of the Dermatology subject is adjusted in its objectives, contents and evaluation according to the model of the professional who aspires to train, however; is capable of being perfected.

Assessment of the effect of treatment on the quality of life of adult Keloid

Background: Documentations of the effect of treatment on the quality of life of keloid patients are few. This study assessedimprovement in quality-of-lifefollowing keloid treatment. In addition, to assess which of the offered four modalities of treatment improved quality of life more.Methods:Thisquasi-experimentalstudy was conducted on 32 adults who had treatment for keloid disease in the clinic from February 2019 to January 2020. This was part of a comparative study of four different modalities of keloid treatment. The quality of life was assessed before and after treatment using the Dermatology Life Quality Index questionnaire (DLQI). Data was analyzed using SPSS version 23.0Results:Quality of life significantly improved after treatment with the mean ± SD DLQI score improving from 7.75 ± 6.15 to 4.16 ± 4.93, p=0.001. Quality of life before treatment was impaired in 93.7% and improved to 65.6%. Before treatment, 2 patients had no QOLimpairment but this improved to 11 patients after treatment. Prior to treatment, severely impaired QOLwas in recorded 28.1% of thepatient's and in 9.4% after treatment. Quality of life improved more in patients who had the combined intralesional triamcinolone acetonide and 5-flourouracil treatment. Significant improvement in the DLQI items of symptomatology, embarrassment, social activity and choice of clothing was noted.Conclusion:Treatment of keloid improves quality of life and this is dependent on the modality of treatment. The items of quality of life improved include; embarrassment, choice of clothing, interference with socialactivities, symptoms of pain and pruritus.

Maladies auto-immunes systémiques dans les Services de Médecine Interne et de Dermatologie du Centre Hospitalier Universitaire de Bouaké: profil de 50 patients / Systemic autoimmune diseases in the Internal Medicine and Dermatology Departments of the University Hospital of Bouake: profile of 50 patients

Introduction Les maladies auto-immunes systémiques (MAIS) sont peu connues malgré les progrès diagnostiques et thérapeutiques réalisés ces dernières années. L'objectif de ce travail était de décrire le profil épidémiologique, diagnostique et thérapeutique des MAIS dans les services de Médecine Interne et de Dermatologie du Centre Hospitalier Universitaire de Bouaké (CHU). Méthodes Il s'agissait d'une étude transversale descriptive réalisée dans les services de Médecine Interne et de Dermatologie du CHU de Bouaké, sur une période de 10ans (janvier 2009- décembre 2018). Résultats : Sur 30906 patients, 50 présentaient une MAIS soit une prévalence hospitalière de 0,16%. Les MAIS les plus fréquentes étaient le lupus érythémateux systémique (50%) et la sclérodermie systémique (42%). L'âge moyen était de 39,5ans ±15ans et le sex-ratio de 0,19. Le délai moyen de consultation était de 26,2 mois. Le tableau clinique était dominé par les signes généraux (98%), les manifestations cutanéomuqueuses (96%) et les manifestations articulaires (90%). Chez 37 patients ayant réalisé l'hémogramme, l'anémie représentait 51,3% des cas. Le syndrome inflammatoire était objectivé chez 67% des 12 patients possédant un bilan inflammatoire. Les auto-anticorps réalisés chez 05 patients étaient contributifs chez 03 patients. Les corticoïdes par voie générale étaient prescrits dans 56% des cas et les perdus de vue étaient observés dans 90% des cas. Conclusion : Les MAIS étaient rares dans notre étude, dominées par le lupus érythémateux systémique et la sclérodermie systémique. L'amélioration du plateau technique et l'accessibilité du bilan immunologique et la sensibilisation paraissent indispensables afin d'améliorer la prise en charge des patients.

Introduction: Systemic autoimmune diseases (SAID) are little known despite the diagnostic and therapeutic progress made in recent years. The objective of this work was to describe the epidemiological, diagnostic and therapeutic profile of SAID in Internal Medicine and Dermatology departments of the university hospital of Bouake. Methods: This was a cross-sectional study carried out in the Internal Medicine and Dermatology departments of the university hospital of Bouake, over a period of 10 years (January 2009-December 2018). Results: Of 30,906 patients, 50 presented SAID with a hospital prevalence of 0.16%. The most common SAID were systemic lupus erythematosus (50%) and systemic sclerosis (42%). The mean age was 39.5 ± 15 years, and the sex ratio was 0.19. The average consultation time was 26.2 months. The clinical picture was dominated by general signs (98%), mucocutaneous manifestations (96%) and articular manifestations (90%). In 25 patients who performed the blood count, anemia represented 76% of cases. The inflammatory syndrome was objectified in 67% of the 12 patients with an inflammatory profile. The auto-antibodies made in 05 patients were contributory in 03 patients. Systemic corticosteroids were prescribed in 56% of cases and patients were lost to follow-up in 90% of cases. Conclusion: SAID were rare in our study, dominated by systemic lupus erythematosus and systemic scleroderma. Improvement of the technical platform and accessibility of the immunological assessment appears essential in order to improve patient's care.

Prise en charge des patients COVID-19 à l'hôpital de dermatologie de Bamako / Care of COVID-19 patients at the dermatology hospital of Bamako

Aim: To assess the COVID-19 patients' treatment duration according to the place of treatment at the Dermatology Hospital of Bamako (DHB). Methods: This was a cross-sectional study comparing the management of COVID-19 PCR-positive patients in the hospital to that of those managed at home from March 2020 to April 2021 until two consecutive negative PCR 48 hours apart. Results: Among the 1109 patients, 369 were hospitalized, 497 followed at home. As of April 31, 2021, 81.2% (900/1109) of the patients recovered, 1.3% (14/1109) were transferred to another health structure, and 2.5% (28/1109) died. No statisticallysignificant difference was observed between the meanduration of the treatment for patients treated at home (10 days) in (95% CI, 9.69-10.3) and those managedathospital (10 days95% CI, 9.76-10.23) (Mantel-Cox test, p= 0.060). Conclusion: These results suggest that the place of treatment do not influence the time to recovery. This is particularly important given the current burden of COVID-19 management on the health workforce

Objectif: Evaluer la durée du traitement des patients COVID-19 selon le lieu de pris en charge à l'Hôpital de Dermatologie de Bamako (HDB). Méthodologie : Il s'agissait d'une étude transversale comparant la prise en charge des patients COVID-19 PCR-positifs à l'hôpital à celle à domicile de mars 2020 à avril 2021 jusqu'à l'obtention de deux tests PCR négatifs consécutifs à 48 heures d'intervalle. Résultats : Parmi les 1109 patients, 369 ont été hospitalisés, 497 suivis à domicile. Au 31 avril 2021, 81,2% (900/1109) des patients se sont rétablis, 1,3% (14/1109) ont été transférés dans une autre structure de santé et 2,5% (28/1109) sont décédés. Aucune différence statistiquement significative n'a été observée entre la durée moyenne du traitement pour les patients traités à domicile (10 jours) en (IC 95 %, 9,69-10,3) et ceux pris en charge à l'hôpital (10 jours IC 95 %, 9,76-10,23) (test de Mantel Cox, p= 0,060). Conclusion: Ces résultats suggèrent que le lieu de traitement n'influence pas le temps de récupération. Ceci est particulièrement important étant donné la charge actuelle de la gestion des COVID-19 sur le personnel de santé

A cross-sectional study of the prevalence and factors associated with self-medication among patients at the out-patient clinic of the department of dermatology in Rizal Medical Center

Introduction@#The trend of self-medication practices is increasing worldwide especially in developing countries like the Philippines. If inappro- priately practiced, this can lead to deleterious eff ects. Despite this, literature available in this area are limited.@*Objectives@#The primary objective of this study was to determine the prevalence and factors that contribute to self-medication practices among dermatology patients in the out-patient clinic of a tertiary government hospital.@*Methods@#An analytical cross-sectional study was conducted from December 2020 to April 2021 in an out-patient dermatology clinic of Rizal Med- ical Center using a self-administered questionnaire. Descriptive statistics were used to summarize participant characteristics while univariate binary logistic regression analysis was used to determine possible factors associated with self-medication.@*Results@#The practice of self-medication was prevalent in 88.70% of the participants. The most common facilitators for self-medication were recommendation by family or friends (49%) and having a previous prescription (39%). The most common medicines utilized were topical steroids (18%), combination topical medication (16%), and anti-acne preparations (10%). On univariate analysis, the likelihood of self-medication was almost four-fold among those with a monthly income of less than PHP 9,000 compared to those who had a higher monthly income.@*Conclusion@#There is a high prevalence of self-medication among patients with dermatologic conditions. Patients with low monthly income were almost four times more likely to self-medicate.