[Dermoscopy for beginners (i): General information]. / Dermatoscopia para principiantes (i): características generales.

The incidence of skin cancer has been gradually increasing worldwide since the 1960s. It is currently a health and economic problem for the different health systems. Dermoscopy is a non-invasive in vivo diagnostic technique, developed to study skin lesions. It improves the diagnostic accuracy of hyperpigmented lesions, as well as an early diagnosis of potentially malignant lesions, especially melanoma. The time spent on physical examination is not significantly increased. New applications have currently been discovered for this technique. Dermoscopy requires a learning process. Due to the complexity of the topic, the text has been divided into 2 parts to try to simplify its presentation. This first part will focus on the more technical aspects and the characteristics of the device called dermoscope. In the second part, 2 diagnostical methods will be presented along with their easy interpretation and usefulness in Primary Care.

[Dermoscopy for beginners (ii): Dermoscopic structures and diagnostic methods]. / Dermatoscopia para principiantes (ii): estructuras dermatoscópicas y métodos diagnósticos.

Dermoscopy (DS) is an in vivo non-invasive diagnostic technique developed to study skin lesions. It improves the diagnostic accuracy of hyperpigmented lesions and early diagnosis of potentially malignant lesions, especially melanoma. It uses a device called a dermoscope to display deeper skin structures not visible to the naked eye, called dermoscopic structures. Only some of them have histological significance, basing them on DS. Many, more or less complex, dermoscopic methods have been developed to aid in the differential diagnosis of skin cancer. The most widespread is 2-step algorithm dermoscopy. But there are some more simple methods, designed to be operated by non-medical experts in DS. Two of them are useful in primary care: the 3-point checklist of DS, and the BLINCK algorithm. This paper focuses on describing the dermoscopic parameters needed to implement these algorithms, as well as their interpretation.

[Chikungunya, an emerging viral disease. Proposal of an algorithm for its clinical management]. / Chikungunya, una enfermedad vírica emergente. Propuesta de un algoritmo de manejo clínico.

Chikungunya fever (CHIK) is an emerging viral disease. It is caused by the Chikungunya virus, an alphavirus from the Togaviridae family. It is transmitted to humans by the bite of infected mosquitoes, mainly Aedes aegypti and Aedes albopictus. They are also involved in the transmission of dengue, malaria, etc. CHIK is now endemic in any region of Africa and Southeast-Asia. Cases of CHIK have been reported in America, the Caribbean, and Europe (France, Italy and Spain). There are reservoirs of these mosquitoes in some regions of Spain (Catalonia, Alicante, Murcia and Balearic islands). CHIK is characterized by a sudden high and debilitating fever, and severe or disabling symmetrical arthralgia. It tends to improve in days or weeks. There are severe and chronic forms of CHIK. There is no specific treatment or prophylaxis for CHIK. An algorithm is proposed for the clinical management of CHIK based in the latest guidelines.

[Klippel-Feil syndrome, a rare cervicalgia]. / Síndrome de Klippel-Feil, una cervicalgia poco frecuente.

Cervicalgia is defined as the presence of pain in the neck region, and can radiate to the shoulders, upper limbs or back. It is a source of frequent visits to Primary Care, and more than half of the general population will suffer neck pain at some point in their life. Klippel-Feil syndrome is an exceptional cause of cervicalgia. It belongs to the group of so-called malformations of the hold-down skull-cervical congenital disease. Klippel-Feil syndrome is a complex disease entity characterized by the fusion of two or more vertebrae, and may also be associated with other bone and visceral disorders. The characteristic clinical triad consists of short-neck, implantation below the hair in the occipital region, and limitation of cervical mobility. However, this clinical picture is present in less than 50% of these patients.

Esofagitis candidiásica en una paciente inmunocompetente. A propósito de un caso / Candida esophagitis in an immunocompetent woman. A case report

La esofagitis candidiásica (EC) es una de las formas invasivas de candidiasis. Su prevalencia diagnosticada mediante endoscopia digestiva alta oscila entre 0,77-2,4%. Su principal causa es la Candida albicans (CA). La EC afecta con mayor frecuencia a sujetos inmunodeprimidos, aunque también puede aparecer en sujetos sanos. Precisa tratamiento antifúngico sistémico. Presentamos el caso de una EC en una paciente sana con buena respuesta al tratamiento pautado, potencialmente relacionado con la toma de omeprazol por parte de la paciente (AU)

Candida esophagitis (CE) is one of the invasive infections caused by Candida albicans (CA). Its prevalence diagnosed by upper endoscopy ranges between 0.77-2.4%. Its main cause is CA. CE more often affects immunocompromised people, however it may affect healthy people too. CE requires systemic antifungal therapy. We report a case of a CE in a healthy woman who presented good response to prescribed treatment. Omeprazole might be involved in the development of her CE (AU)

Síndrome de Klippel-Feil, una cervicalgia poco frecuente / Klippel-Feil syndrome, a rare cervicalgia

La cervicalgia se define por la presencia de dolor en la región del cuello, pudiendo irradiarse o no a hombros, miembros superiores y/o espalda. Representa un motivo de consulta frecuente en atención primaria: más de la mitad de la población general presentará en algún momento de su vida dolor cervical. El síndrome de Klippel-Feil es una causa excepcional de cervicalgia. Es una enfermedad congénita del grupo de las denominadas malformaciones de la charnela craneocervical. Es una entidad nosológica compleja caracterizada por la fusión de 2 o más vértebras, pudiendo asociar también otras malformaciones y alteraciones óseas y viscerales. La tríada clínica característica consiste en cuello corto, implantación baja del cabello en la región occipital y limitación de la movilidad cervical. No obstante, dicha clínica está presente en menos del 50% de los pacientes (AU)

We present the case of a patient with chronic low back pain with an unfavourable progression despite the prescribed pharmacological treatment. The patient had symptoms associated with compression of the sciatic nerve in an atypical area. As it passed through the piriformis muscle, it was diagnosed as piriformis muscle syndrome. This diagnosis was based on the clinical signs and symptoms and the determination of the tests performed, with the imaging tests being absolutely normal. Treatment is basically with non-steroidal anti-inflammatory drugs, muscle relaxants and stretching exercises of this muscle (AU)

[Candida esophagitis in an immunocompetent women. A case report]. / Esofagitis candidiásica en una paciente inmunocompetente. A propósito de un caso.

Candida esophagitis (CE) is one of the invasive infections caused by Candida albicans (CA). Its prevalence diagnosed by upper endoscopy ranges between 0.77-2.4%. Its main cause is CA. CE more often affects immunocompromised people, however it may affect healthy people too. CE requires systemic antifungal therapy. We report a case of a CE in a healthy woman who presented good response to prescribed treatment. Omeprazole might be involved in the development of her CE.