Asunto(s)
Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Lesiones Precancerosas/patología , Infecciones Tumorales por Virus/diagnóstico , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/epidemiología , Condiloma Acuminado/terapia , Femenino , Humanos , Incidencia , Masculino , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/terapia , Lesiones Precancerosas/epidemiología , Prevención Primaria/métodos , Pronóstico , Medición de Riesgo , Infecciones Tumorales por Virus/epidemiología , Infecciones Tumorales por Virus/terapiaAsunto(s)
Enfermedades del Sistema Nervioso Central/etiología , Neurofibromatosis 1/complicaciones , Enfermedades del Sistema Nervioso Central/diagnóstico por imagen , Enfermedades del Sistema Nervioso Central/patología , Humanos , Imagen por Resonancia Magnética , Neurofibromatosis 1/diagnóstico por imagen , Neurofibromatosis 1/patología , Enfermedades de la Piel/diagnóstico por imagen , Enfermedades de la Piel/etiología , Enfermedades de la Piel/patología , Tomografía Computarizada por Rayos XAsunto(s)
Histiocitosis de Células de Langerhans/diagnóstico por imagen , Cráneo/patología , Adolescente , Adulto , Edad de Inicio , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Niño , Preescolar , Diagnóstico Diferencial , Histiocitosis de Células de Langerhans/diagnóstico , Humanos , Lactante , Recién Nacido , Maxilares/diagnóstico por imagen , Maxilares/patología , Imagen por Resonancia Magnética , Enfermedades Mandibulares/diagnóstico por imagen , Enfermedades Mandibulares/etiología , Radiografía , Cráneo/diagnóstico por imagen , Pérdida de Diente/etiologíaAsunto(s)
Encéfalo/patología , Incontinencia Pigmentaria/diagnóstico por imagen , Enfermedades del Nervio Óptico/patología , Cuerpo Calloso/patología , Humanos , Incontinencia Pigmentaria/patología , Imagen por Resonancia Magnética , Enfermedades del Nervio Óptico/etiología , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Lobular capillary hemangiomas (pyogenic granulomas) occur on both mucosal and cutaneous surfaces. There are conflicting data regarding the increased prevalence of lobular capillary hemangiomas in female versus male subjects. Some studies have noted a female predominance of lobular capillary hemangiomas, but other studies do not reveal such a disparity. Because of an increased prevalence during pregnancy, oral tumors are also known as "granuloma gravidarum" or "pregnancy tumors." A hormonal influence for these mucosal lesions has been postulated. There are, however, no studies that address a possible relationship between hormones and cutaneous lesions. OBJECTIVE: This study presents the epidemiology of lobular capillary hemangiomas, with an emphasis on cutaneous lesions. METHODS: We reviewed 63,759 dermatopathology reports from a regional, private dermatopathology laboratory and found 325 cases of lobular capillary hemangiomas over a 1-year period. RESULTS: In our study of lobular capillary hemangiomas, cutaneous lesions accounted for 86%, with mucosal lesions representing only 12% of cases. Seven cases were excluded (one was intravascular, two were subcutaneous, and in 4 the location was not specified). Overall, male patients outnumbered female patients. The peak incidence for cutaneous lobular capillary hemangiomas was found in the second decade of life. The most common cutaneous sites were the trunk, upper extremities, and head. Mucosal lesions were primarily seen on the lips, gingiva, and tongue, and these affected females more than males by a ratio of 2:1, most commonly in the fourth decade of life. CONCLUSION: Cutaneous lobular capillary hemangiomas were equally prevalent in male and female patients. This would refute a female hormonal influence in the induction of cutaneous lobular capillary hemangiomas. Our data may suggest a hormonal influence on mucosal lesions because mucosal lobular capillary hemangiomas were twice as common in female patients. However, the small number of lesions in our study precludes us from making such a conclusion.
Asunto(s)
Granuloma Piogénico/epidemiología , Complicaciones del Embarazo/epidemiología , Enfermedades de la Piel/epidemiología , Piel/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Estudios Epidemiológicos , Femenino , Granuloma Piogénico/patología , Humanos , Incidencia , Lactante , Masculino , Persona de Mediana Edad , Membrana Mucosa/patología , Embarazo , Complicaciones del Embarazo/patología , Factores Sexuales , Enfermedades de la Piel/patologíaAsunto(s)
Dermatosis Facial/patología , Hiperplasia Gingival/patología , Granulomatosis con Poliangitis/diagnóstico , Adulto , Diagnóstico Diferencial , Dermatosis Facial/etiología , Hiperplasia Gingival/etiología , Granulomatosis con Poliangitis/complicaciones , Granulomatosis con Poliangitis/patología , Humanos , MasculinoRESUMEN
Proliferative verrucous leukoplakia (PVL) is a distinct variant of oral leukoplakia characterized by a high rate of malignant transformation. Histologic features are variable and range from epithelial dysplasia to verrucous squamous cell carcinoma. To our knowledge, there have been no previous reports of cutaneous PVL. We present an interesting case of PVL involving the skin.
Asunto(s)
Leucoplasia Bucal/complicaciones , Enfermedades de la Piel/etiología , Anciano , Biopsia , Enfermedad Crónica , Diagnóstico Diferencial , Femenino , Humanos , Leucoplasia Bucal/patología , Orofaringe/patología , Piel/patología , Enfermedades de la Piel/patologíaRESUMEN
Benign tumors of the vulva, although relatively uncommon, are often referred to dermatologists for evaluation and treatment. The clinical features of benign tumors may overlap with malignant neoplasms, and therefore, a biopsy is often necessary to make a definitive diagnosis. This article discusses benign tumors of the vulva that are not associated with infectious agents and presents their classification according to cell of origin.
Asunto(s)
Neoplasias de la Vulva/diagnóstico , Adenoma de las Glándulas Sudoríparas/diagnóstico , Biopsia , Dermatitis Seborreica/diagnóstico , Diagnóstico Diferencial , Endometriosis/diagnóstico , Femenino , Tumor de Células Granulares/diagnóstico , Hemangioma/diagnóstico , Histiocitoma Fibroso Benigno/diagnóstico , Humanos , Leiomioma/diagnóstico , Lipoma/diagnóstico , Linfangioma/diagnóstico , Neurofibroma/diagnóstico , Nevo/diagnóstico , Pólipos/diagnóstico , Neoplasias de la Vulva/clasificación , Neoplasias de la Vulva/patología , Neoplasias de la Vulva/cirugíaRESUMEN
OBJECTIVES: Mucocutaneous diseases are common in patients infected with human immunodeficiency virus (HIV). To identify cutaneous diseases for which HIV-infected people are at high risk, we sought those that are strongly associated with specific HIV-related oral lesions and with progression of HIV disease. DESIGN: A cross-sectional study of HIV-positive outpatients referred to a university stomatology clinic for diagnosis and treatment of oral diseases. Each subject underwent both complete oral and cutaneous examinations. RESULTS: Among 55 men, with a median age of 41 years and a median CD4 cell count of 125/microliter (range 0-950/microliter), 93% had active oral diseases or conditions, including candidiasis, hairy leukoplakia, ulcers, Kaposi's sarcoma (KS), and xerostomia, and 95% had skin conditions, including onychomycosis, dermatophytosis, seborrheic dermatitis, KS, folliculitis, xerosis, and molluscum contagiosum. Seborrheic dermatitis, xerosis, skin KS, and molluscum contagiosum were associated with oral HIV-sentinel lesions (oral candidiasis, hairy leukoplakia, and KS), with low CD4 cell counts, and with AIDS. CONCLUSION: Our results suggest that xerosis and seborrheic dermatitis may be early harbingers of HIV disease progression. Their roles as predictors warrant further study, based on their associations with low CD4 cell counts and AIDS and strong co-prevalence with one of the most common HIV-related oral lesions, oral candidiasis.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA , Infecciones por VIH/complicaciones , Enfermedades de la Boca/etiología , Enfermedades de la Piel/etiología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Adulto , Anciano , Recuento de Linfocito CD4 , Candidiasis Bucal/etiología , Estudios Transversales , Dermatitis Seborreica/etiología , Dermatomicosis/etiología , Progresión de la Enfermedad , Foliculitis/etiología , Humanos , Ictiosis/etiología , Huésped Inmunocomprometido , Leucoplasia Vellosa/etiología , Masculino , Persona de Mediana Edad , Molusco Contagioso/etiología , Oportunidad Relativa , Sarcoma de Kaposi/etiología , Estadísticas no ParamétricasRESUMEN
Many diseases present with both neurologic and dermatologic manifestations. Eight such clinical cases are presented, along with clinical photographs of the skin lesions, in the format of a self-evaluation. Each case is followed by a discussion and a brief review of the characteristic cutaneous and neurologic findings. The intent is to demonstrate classic dermatologic manifestations of diseases seen by neurologists.
Asunto(s)
Enfermedades del Sistema Nervioso/complicaciones , Enfermedades del Sistema Nervioso/diagnóstico , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/etiología , Adulto , Anticonvulsivantes/inmunología , Niño , Hipersensibilidad a las Drogas/diagnóstico , Femenino , Humanos , Enfermedad de Lyme/diagnóstico , Masculino , Meningitis Meningocócica/diagnóstico , Persona de Mediana Edad , Mieloma Múltiple/diagnóstico , Síndrome POEMS/diagnóstico , Fiebre Maculosa de las Montañas Rocosas/diagnóstico , Sífilis/diagnóstico , Esclerosis Tuberosa/diagnósticoRESUMEN
EPIDEMIOLOGY: Is the study of disease occurrence in human populations. As a science, epidemiology emphasizes descriptive and analytic observation, clinical trial, behavioral intervention, and the practical utility of diagnostic tests. "Epidemiology" is derived from the Greek epi (among), demos (people), and logos (doctrine). CLINICAL EPIDEMIOLOGY: Is the application of epidemiologic principles and methods to problems arising in clinical medicine, dermatology included. For dermatologists, understanding this discipline is as important as mastering other basic sciences, such as immunology, microbiology, and dermatopathology. The recognization of Lyme disease is a classic work of "infectious" disease epidemiology. In 1972, a disease characterized by erythema chronicum migrans and "endemic arthritis" clustered in Lyme, Connecticut. By 1975, an infectious agent was suspected to be the cause of the disease. In 1977, the tick was thought to be the vector; in 1980, the spirochete became the prime suspect and, in 1982, Borrelia burgdorferi was identified as the etiologic agent. The study of hexachlorobenzene exposure, resulting in porphyria turcica, is an example of classic "chronic" disease epidemiology. The illness began in 1955 when sporadic cases of porphyria occurred in eastern Turkey. In 1957, the first case with illness resembling congenital erythropoietic porphyria was described. In subsequent years, over 3000 patients developed "epidemic" porphyria. The cause was due to the ingestion of seed wheat which had been treated with fungicides containing 20% hexachlorobenzene. EPIDEMIOLOGIC METHODS: For research, published elsewhere as Dermatoepidemiology. I., include descriptive observational study, analytic observational study, epidemiologic experimental study and tests for sensitivity, specificity, and positive/negative predictive value. Epidemiologic principles, instead, stress the correct interpretation of data, minimization of bias, and the appreciation of natural variations in collected data.
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Enfermedades de la Piel/epidemiología , Sesgo , Métodos Epidemiológicos , Humanos , Incidencia , Neoplasias Cutáneas/epidemiologíaRESUMEN
During the past few years there has been significant interest in studying methods that document outcomes of medical care. Outcomes management should result in higher quality health care at lower cost. However, what does outcomes research mean and how does it apply to dermatology and specifically to the individual dermatologist? This article reviews the evolution of medical outcomes research and presents the status of the current instruments, indices, and methods.
Asunto(s)
Evaluación de Resultado en la Atención de Salud , Dermatología , Humanos , Evaluación de Resultado en la Atención de Salud/tendencias , Garantía de la Calidad de Atención de Salud , Calidad de Vida , Enfermedades de la Piel/clasificación , Enfermedades de la Piel/terapiaRESUMEN
The prevalence of infections in the immunocompromised host is increasing. The oral cavity is a primary or sole site in many cases. It is important for the practicing clinician to recognize the more common infections in this growing patient population. Oral examinations are an essential component of all physical examinations, especially when immunosuppression is known or suspected. We recommend that all patients starting immunosuppressive therapy receive a comprehensive oral examination before the institution of such therapy to eliminate potential sources of oral and odontogenic infections. The examination should include full mouth dental radiographs and a complete soft-tissue examination. Timely, accurate diagnoses may have important implications with regard to management, prognosis, cost, morbidity, and mortality.