ABSTRACT
Este trabalho apresenta uma infra-estrutura de teledermatologia construída para prover suporte integral a protocolos e condutas clínicas, além do telediagnóstico e triagem de pacientes, apoiando tanto o profissional da atenção primária quanto o especialista no processo de atendimento ao paciente. A infra-estrutura é descrita em termos da tecnologia utilizada para sua construção e dos resultados e experiências obtidos durante sua implantação e operação, mostrando que a mesma contribui não só para resolutividade, mas também para a melhora progressiva da qualidade técnica dos exames dermatológicos executados na atenção primária.
This work presents a teledermatology infrastructure built to provide integral support to examination and clinical management protocols, including tele-diagnostic and patient triage, supporting both the primary care physician and the specialist during the patient care process. The infrastructure is described in terms of the adopted technology and in terms of results obtained during its deployment and operation, showing that it contributes not only to the case-resolving capacity, but also to the progressive improvement of the technical quality of dermatological examinations in the primary healthcare.
Subject(s)
Humans , Medical Informatics , Clinical Protocols , Telemedicine , Dermatology , Congresses as TopicABSTRACT
BACKGROUND: Basal cell carcinoma (BCC) is the most common malignant neoplasm in humans. BCC is asymptomatic, and its growth is slow, which may explain why patients often delay seeking treatment. OBJECTIVE: To determine the clinical, historical, and demographic variables associated with the high Dermatology Life Quality Index (DLQI) scores of patients with BCC. METHODS: We performed a cross-sectional study of 78 consecutive patients with primary BCCs who underwent tumor excision with margin control. Age, sex, habits, number of BCCs, BCC location, pathologic types, and DLQI were analyzed. RESULTS: Most patients had skin phototypes I and II (89.8%) and nodular BCC (66.0%). DLQI analysis showed that 89.7% of patients had scores less than 5 (no or small effects on patient's life). Wearing sunscreen for more than 5 years, tumor ulceration, having a tumor larger than 2 cm in diameter, and having a tumor located not on the head were associated with higher DLQI scores in patients (p < .05). CONCLUSION: Age, sex, outdoor activities, habitual sun exposure, or quantity of tumors did not influence quality of life. Patients who had used sunscreen for more than 5 years, had ulcerated tumors, had tumors larger than 2 cm and had tumors located outside of the head had higher DLQI scores.
Subject(s)
Carcinoma, Basal Cell/surgery , Quality of Life , Skin Neoplasms/surgery , Brazil , Carcinoma, Basal Cell/pathology , Female , Humans , Life Style , Male , Middle Aged , Skin Neoplasms/pathology , Socioeconomic FactorsABSTRACT
Pênfigo Vegetante foi primeiramente descrito como uma variante do pênfigo vulgar, em 1876, por Neumann. Em 1889, Hallopeau descreveu um paciente com pústulas e placas vegetantes, e sugeriu ser uma variante do Pênfigo Vegetante de Neumann. Ambos os tipos de pênfigo vegetante são caracterizados pelo desenvolvimento de placas vegetantes, especialmente, em dobras (axila, inguinal, perianal). Os autores apresentam e discutem um caso de Pênfigo Vegetante com uma clínica incomum, com ausência de acometimento de mucosas e áreas de flexão, em paciente idosa, associado ao uso de enalapril como possível desencadeador. Diagnóstico clínico e histológico sugestivos de Pênfigo Vegetante tipo Hallopeau.
Pemphigus Vegetans was first described as a variant of Pemphigus Vulgaris in 1876 by Neumann. In 1889, Hallopeau described a patient with pustules and vegetating plaques, suggesting that it would be a variant of Pemphigus Vegetans of Neumann. Both types of Pemphigus Vegetans are characterized by the development of vegetating plaques especially on skin folds (axillae, groin, perianal region). The authors present and discuss a case of Pemphigus Vegetans with an unusual clinical presentation lacking involvement of mucous membrane and flexor surfaces in an elderly female patient, associated with the use of enalapril as possible trigger factor. Clinical and histological diagnosis were suggestive of Pemphigus Vegetans of the Hallopeau type.
Subject(s)
Aged , Female , Humans , Antihypertensive Agents/adverse effects , Enalapril/adverse effects , Pemphigus/chemically induced , Anti-Inflammatory Agents/therapeutic use , Diagnosis, Differential , Pemphigus/pathology , Prednisone/therapeutic useABSTRACT
Pemphigus Vegetans was first described as a variant of Pemphigus Vulgaris in 1876 by Neumann. In 1889, Hallopeau described a patient with pustules and vegetating plaques, suggesting that it would be a variant of Pemphigus Vegetans of Neumann. Both types of Pemphigus Vegetans are characterized by the development of vegetating plaques especially on skin folds (axillae, groin, perianal region). The authors present and discuss a case of Pemphigus Vegetans with an unusual clinical presentation lacking involvement of mucous membrane and flexor surfaces in an elderly female patient, associated with the use of enalapril as possible trigger factor. Clinical and histological diagnosis were suggestive of Pemphigus Vegetans of the Hallopeau type.
