ABSTRACT
OBJECTIVES: a description of the epidemiology of tuberculosis in the province of Prato (Tuscany Region, Central Italy) during the period 2007-2014 and verify the latency time between the onset of symptoms and the start of therapy. DESIGN: descriptive, observational study. SETTING AND PARTICIPANTS: tuberculosis cases were identified for the period 2007-2014 through an analysis of the notification files available at the Hygiene and Public Health Service of the Local Health Unit of Prato and through the Information System on Infectious Diseases database. RESULTS: in the years 2007-2014, 619 cases of tuberculosis were reported in the province of Prato, of which 465 (75.12%) were cases of pulmonary TB. The annual rate ranges from 35.2 cases per 100.00 inhabitants in 2010 to 18.5 cases per 100.000 inhabitants in 2012. The median age of foreign-born patients was significantly lower than the one of Italian-born subjects (34 years; interquartile range - IQR: 28-41 vs. 63 years; IQR: 45-77; <0.0001). The rate of cases in patients above 64 years and below 64 years was significantly different between Italian and foreign subjects (<0.01); this dissimilarity remained significant even after stratification by gender. Males were the most affected, in line with regional and national data. The average delay between the date of onset of symptoms and the initiation of therapy was 59 days (IQR: 28-104). CONCLUSIONS: tuberculosis is a complex disease both from an epidemiological and a clinical point of view. This complexity is more relevant in areas where different ethnic groups live together. The data presented in this paper show the necessity of an intervention to improve access to healthcare facilities through a deep collaboration among who works in public health, in general medicine, and in the multidisciplinary integrated care of the considered area.
Subject(s)
Tuberculosis/epidemiology , Adolescent , Adult , Age Distribution , Aged , Child , Disease Notification/statistics & numerical data , Emigrants and Immigrants/statistics & numerical data , Ethnicity/statistics & numerical data , Female , Humans , Incidence , Italy/epidemiology , Male , Middle Aged , Retrospective Studies , Sex Distribution , Time-to-Treatment , Tuberculosis/ethnology , Young AdultABSTRACT
Antecedentes: el liquen plano es una enfermedad con probabilidad de transformación maligna. La afectación oral se presenta en el 60 al 70% y el riesgo de cáncer oral es de 0-12,5%. La distinción entre liquen y reacción liquenoide oral es dificultosa. Se han descripto numerosos criterios para distinguirlas y se han asociado a riesgo de transformación maligna, pero aún así hay varias inconsistencias. Objetivo: determinar las características epidemiológicas y anatomopatológicas de los pacientes con liquen y reacción liquenoide oral. Establecer la frecuencia de progresión a cáncer considerando si hay diferencia entre los grupos. Diseño: estudio descriptivo, retrospectivo, observacional y longitudinal. Métodos: se recopilaron datos de pacientes evaluados en el Hospital Lagomaggiore de Mendoza, desde enero de 2003 a diciembre de 2014. Se incluyeron pacientes mayores de 18 años con confirmación histopatológica de liquen o reacción liquenoide oral. El análisis se realizó con Graph Pad Instat y se utilizaron medidas de tendencia central, de dispersión, test de normalidad y test exacto de Fisher. Resultados: se incluyeron 110 pacientes con confirmación histopatológica. Cuatro pacientes desarrollaron cáncer oral, 4,23% de los líquenes y 2,56% de las reacciones liquenoides. No hubo diferencia significativa entre grupos. En todos los casos, el cáncer oral ocurrió sobre la zona afectada previamente. Conclusiones: se registraron cuatro pacientes con progresión a cáncer oral. Estos hallazgos justifican el tratamiento y seguimiento. Se requieren más estudios para determinar si el liquen oral y las reacciones liquenoides son entidades separadas (AU)
Background: lichen planus is a disease with probability to become malignant. Oral affection occurs between 60% and 70% and the risk of oral cancer is from 0% to 12.5%. The difference between lichen and lichenoid oral reaction is troublesome. The literature has described numerous criteria to differentiate them and they have been associated to the risk of a malignant transformation, but there are still many inconsistencies. Objetive: to determine epidemiological and anatomopathological characteristics in patients with lichen and lichenoid oral reactions. To settle the frequency of progression to cancer, putting under consideration if there are differences between each group. Study design: Descriptive, retrospective, observational and longitudinal study. Methods: data have been taken from evaluated patients at Lagomaggiore Hospital in Mendoza, from January 2003 until December 2014. Patients over 18 years old with histopathological diagnosis of lichen or lichenoid oral reactions were included. The analysis was done with Graph Pad Instat and there were used central trends, dispersal, normal test and exact Fisher's test measures. Results: we include 110 patients with histopathological diagnosis confirmed. Four patients developed oral cancer; 4.23% of patients with lichen and 2.56% of patients with lichenoid reactions. We did not find a significant difference between groups. In all cases oral cancer occurs in the previously affected zone. Conclusions: there were registered four patients with cancer progression. These findings justify the follow up and treatment. More studies are needed to establish if oral lichen and oral lichenoid lesions are different entities (AU)
Subject(s)
Humans , Male , Female , Lichen Planus, Oral/diagnosis , Lichenoid Eruptions/diagnosis , Mouth NeoplasmsABSTRACT
Introducción.La vulva puede ser asiento de diversos tumores malignos, de los cuales el más frecuente es el espinocelular; sin embargo, los tumores vulvares no espinocelulares son de gran importancia debido su mal pronóstico.Objetivos. Determinar la forma de presentación clínica, sintomatología, variedad histopatológica y el estadio de los tumores vulvares no espinocelulares al momento de la consulta. Evaluar el rol del dermatólogo en el diagnóstico y seguimiento de estos pacientes. Métodos. Se realizó un estudio retrospectivo, observacional y analítico de pacientes que concurrieron por derivación al consultorio de Patología Vulvar desde agosto de 2002 a agosto de 2010. Se evaluaron las historias clínicas y los archivos anatomopatológicos e iconográficos delos tumores vulvares no espinocelulares. Resultados. De un total de 637 consultas por derivación en el consultorio de patología vulvar, el 9,1% (n=56) correspondió a tumores malignos. De éstos, el 76,78% (n=43) fueron carcinoma espinocelular (incluidos neoplasia intravulvar y carcinoma invasor) y el 23,22% (n=15), carcinoma no espinocelular. Del total de estos últimos, ocuparon en orden de frecuenta decreciente: tumores secundarios de otros órganos, enfermedad de Paget extramamaria, melanoma, adenocarcinoma de la glándula de Bartolino y sarcoma. El motivo de consulta más frecuente fue dolor, y la forma clínica de presentación fue lesión exofítica única. Conclusiones. Destacamos la alta incidencia de tumores vulvares no espinocelulares en nuestro medio: representa el 23,2% de las neoplasias vulvares, en comparación con la literatura, que es del 10%.
Background. The vulva may be the seat of many malignancies, of which the most common is squamous-cell carcinoma; nevertheless non squamous-cell vulvar neoplasms are significant because of their poor prognosis. Objectives. To determine the symptoms, clinical presentation and stage of the disease at thetime of consultation. To establish associations with various risk factors and evaluate prognosis. Toasess the role of the dermatologist in the appropriate diagnosis and monitoring of these patients.Methods. We performed a retrospective and observational study of patients seen at a vulvar-disease Clinic from August 2002 to August 2010. We reviewed the clinical records, biopsy specimens and iconographic files.Results.From a total of 680 consultations to a vulvar-disease Clinic 7% (n=48) corresponded to malignant tumors. Of these 73% (n=35) were squamous-cell carcinomas and 27% (n=13) were non-squamous-cell carcinomas, which in decreasing order of frequency, were: secondarytumors from other organs, extramamammary Pagets disease, melanoma, adenocarcinoma andsarcoma. The most frequent cause of consultation was pain, and the clinical presentation was a single exophytic lesion.
Subject(s)
Female , Vulvar Neoplasms/diagnosis , Vulvar Neoplasms/etiology , Vulvar Neoplasms/therapy , Bartholin's Glands , Bartholin's Glands/pathology , Melanoma , Paget Disease, Extramammary , Prognosis , RhabdomyosarcomaABSTRACT
Desde la publicación de Crovato, Desirello y Rebora, en 1983, comienza a considerarse a la enfermedad de Dowling-Degos, a la acropigmentación reticulada de Kitamura y a la acropigmentación de Dohi como variantes fenotípicas de un mismo trastorno cutáneo. Presentamos una paciente de sexo femenino que consultó durante 10 años por lesiones de enfermedad de Dowling-Degos, y que fue desarrollando lentamente máculas hiperpigmentadas acrales y depresiones palmares correspondientes a la acropigmentación reticulada de Kitamura.
