Prevalencia de infección por VIH en pacientes con patología dermatológica en un centro de referencia nacional 2005-2006 / HIV infection prevalence in patients having cutaneous pathology in a national reference center (2005-2006)

Objetivo Estimar la prevalencia de infección por VIH en pacientes con patología cutánea en un centro de referencia nacional en Colombia. Métodos Se realizó un estudio de corte transversal, en pacientes dermópatas mayores de 18 años, sin diagnóstico previo de infección por VIH. Se calculó un tamaño muestral de 1 537 pacientes. Se definió como caso confirmado un paciente con pruebas positivas de Elisa y Western Blott. La prevalencia se calculó como el número de casos confirmados sobre el total de la población. Se evaluaron asociaciones mediante el estimador de razón de prevalencias. Resultados Ingresaron al estudio 1 649 pacientes. En total 20 sujetos fueron definidos como caso confirmado, para un prevalencia del 1,21 por ciento. Los moluscos contagiosos y la dermatitis seborreica fueron las enfermedades con la más alta prevalencia de infección por VIH no diagnosticada previamente (3,91 por ciento y 2,05 por ciento respectivamente). La razón de prevalencias de molusco contagioso e infección por VIH fue de 3,96 (p: 0,01562). Conclusiones Los pacientes mayores de 18 años con diagnóstico de moluscos contagioso tienen casi 4 veces el riesgo de los otros pacientes dermópatas de tener infección por VIH.

Objective Determining the prevalence of HIV infection in patients suffering from cutaneous disease in a national reference center in Colombia. Methods This was a cross-sectional study of patients aged 18 or older, having cutaneous pathology and no previous HIV diagnosis. The calculated sample size was 1,537 patients. A confirmed case was defined as being that of a patient having positive results in the ELISA and Western blot tests. Prevalence was the number of confirmed cases divided by the total population. The associations were measured by using prevalence ratio. Results 1,649 patients were enrolled in the study. Our center’s prevalence was 1.21 percent (20 cases). Molluscum contagiosum and seborrheic dermatitis were the diseases having the highest prevalence of HIV infection which had not been previously diagnosed (3.91 percent and 2.05 percent, respectively). Molluscum contagiosum and HIV infection prevalence ratio was 3.96 (p: 0.01562). Conclusions The risk of HIV infection in patients aged 18 or older suffering from Molluscum contagiosum was nearly 4 times higher than the risk in patients having other cutaneous pathologies.

[HIV infection prevalence in patients having cutaneous pathology in a National Reference Center (2005-2006)]. / Prevalencia de Infección por VIH en Pacientes con Patología Dermatológica en un Centro de Referencia Nacional 2005-2006.

OBJECTIVE: Determining the prevalence of HIV infection in patients suffering from cutaneous disease in a national reference center in Colombia. METHODS: This was a cross-sectional study of patients aged 18 or older, having cutaneous pathology and no previous HIV diagnosis. The calculated sample size was 1,537 patients. A confirmed case was defined as being that of a patient having positive results in the ELISA and Western blot tests. Prevalence was the number of confirmed cases divided by the total population. The associations were measured by using prevalence ratio. RESULTS: 1,649 patients were enrolled in the study. Our center's prevalence was 1.21 % (20 cases). Molluscum contagiosum and seborrheic dermatitis were the diseases having the highest prevalence of HIV infection which had not been previously diagnosed (3.91 % and 2.05 %, respectively). Molluscum contagiosum and HIV infection prevalence ratio was 3.96 (p: 0.01562). CONCLUSIONS: The risk of HIV infection in patients aged 18 or older suffering from Molluscum contagiosum was nearly 4 times higher than the risk in patients having other cutaneous pathologies.

Cáncer de Piel: Perfil Epidemiológico de un Centro de Referencia en Colombia 2003-2005 / Skin cancer: a Colombian reference centre's epidemiological profile 2003-2005

Con el objetivo de conocer el perfil epidemiológico y estimar la incidencia por tipo tumoral de cáncer de piel, entre los años 2003-2005, en el Centro Dermatológico Federico Lleras Acosta, Bogotá Colombia, se identificaron los casos nuevos de patología tumoral maligna diagnosticados en este período. Se registraron 168 659 diagnósticos confirmados nuevos, de los cuales 2 184 correspondieron a tumores malignos de piel. El carcinoma basocelular presentó un aumento de 4 por 1 000 en el 2003, a 11 por 1 000 en el 2005. Los pacientes con carcinoma escamocelular pasaron de 1 caso por 1 000 en el 2003, a 3 casos por 1 000 en el 2005. Los casos de melanoma pasaron de 2,7 por 10 000 en el 2003, a 13 por 10 000 en el 2005.

Skin cancer cases were identified from 2003-2005 to ascertain the epidemiological profile and incidence of skin cancer at the Centro Dermatológico Federico Lleras Acosta-Colombia. 168 659 confirmed diagnoses were registered between 2003 and 2005, 2 184 corresponding to skin cancer. Basal cell carcinoma increased from 4 per 1 000 in 2003 to 11 per 1 000 in 2005. Patients suffering from squamous cell carcinoma increased from 1 per 1 000 in 2003 to 3 per 1 000 in 2005. Cases of melanoma increased from 2,7 per 10 000 in 2003 to 13 per 10 000 in 2005.

Polymerase chain reaction with two molecular targets in mucosal leishmaniasis' diagnosis: a validation study.

We validated the polymerase chain reaction (PCR) with a composite reference standard in 61 patients clinically suspected of having mucosal leishmaniasis, 36 of which were cases and 25 were non-cases according to this reference standard. Patient classification and test application were carried out independently by two blind observers. One pair of primers was used to amplify a fragment of 120 bp in the conserved region of kDNA and another pair was used to amplify the internal transcript spacers (ITS) rDNA. PCR showed 68.6% (95% CI 59.2-72.6) sensitivity and 92% (95% CI 78.9-97.7) specificity; positive likelihood ratio: 8.6 (95% CI 2.8-31.3) and negative likelihood ratio: 0.3 (95% CI 0.3-0.5), when kDNA molecular target was amplified. The test performed better on sensitivity using this target compared to the ITS rDNA molecular target which showed 40% (95% CI 31.5-42.3) sensitivity and 96% (95% CI 84.1-99.3) specificity; positive likelihood ratio: 10 (95% CI 2.0-58.8) and negative likelihood ratio: 0.6 (95% CI 0.6-0.8). The inter-observer agreement was excellent for both tests. Based upon results obtained and due to low performance of conventional methods for diagnosing mucosal leishmaniasis, we consider PCR with kDNA as molecular target is a useful diagnostic test and the ITS rDNA molecular target is useful when the aim is to identify species.

Polymerase chain reaction with two molecular targets in mucosal leishmaniasis' diagnosis: a validation study

We validated the polymerase chain reaction (PCR) with a composite reference standard in 61 patients clinically suspected of having mucosal leishmaniasis, 36 of which were cases and 25 were non-cases according to this reference standard. Patient classification and test application were carried out independently by two blind observers. One pair of primers was used to amplify a fragment of 120 bp in the conserved region of kDNA and another pair was used to amplify the internal transcript spacers (ITS) rDNA. PCR showed 68.6 percent (95 percent CI 59.2-72.6) sensitivity and 92 percent (95 percent CI 78.9-97.7) specificity; positive likelihood ratio: 8.6 (95 percent CI 2.8-31.3) and negative likelihood ratio: 0.3 (95 percent CI 0.3-0.5), when kDNA molecular target was amplified. The test performed better on sensitivity using this target compared to the ITS rDNA molecular target which showed 40 percent (95 percent CI 31.5-42.3) sensitivity and 96 percent (95 percent CI 84.1-99.3) specificity; positive likelihood ratio: 10 (95 percent CI 2.0-58.8) and negative likelihood ratio: 0.6 (95 percent CI 0.6-0.8). The inter-observer agreement was excellent for both tests. Based upon results obtained and due to low performance of conventional methods for diagnosing mucosal leishmaniasis, we consider PCR with kDNA as molecular target is a useful diagnostic test and the ITS rDNA molecular target is useful when the aim is to identify species.

[Skin cancer: a Colombian reference centre's epidemiological profile 2003-2005]. / Cáncer de Piel: Perfil Epidemiológico de un Centro de Referencia en Colombia 2003-2005.

Skin cancer cases were identified from 2003-2005 to ascertain the epidemiological profile and incidence of skin cancer at the Centro Dermatológico Federico Lleras Acosta-Colombia. 168,659 confirmed diagnoses were registered between 2003 and 2005, 2,184 corresponding to skin cancer. Basal cell carcinoma increased from 4 per 1,000 in 2003 to 11 per 1,000 in 2005. Patients suffering from squamous cell carcinoma increased from 1 per 1,000 in 2003 to 3 per 1,000 in 2005. Cases of melanoma increased from 2.7 per 10,000 in 2003 to 13 per 10,000 in 2005.

Causal agents of photoallergic contact dermatitis diagnosed in the national institute of dermatology of Colombia.

OBJECTIVE: To describe and identify the photoallergens causing photoallergic contact dermatitis in the population attending the outpatient clinic of the Centro Dermatologico Federico Lleras Acosta (CDFLLA), the National Institute of Dermatology of Colombia. MATERIALS AND METHODS: Eighty-two patients with clinical diagnosis of photoallergic contact dermatitis enter the study. These patients attended the CDFLLA between August 2001 and May 2003. Photopatch tests were performed using the standard series of sunscreens (Chemotechnique Diagnostics) and 6-methylcoumarin. Cetyl alcohol, phenoxyethanol, methylparabene, propylene glycol, triethanolamine, propylparabene, trichlorocarbanilide and dichromate were also included. The allergens were applied in duplicate on the healthy skin of the back and covered with opaque tape withdrawn 24 h later, the panel on the right was irradiated with an ultraviolet A dose of 5 J/cm(2). The tests were read 24 h after the application of the allergens, 24 and 72 h post-irradiation. The readings were assessed according to the visual scoring system recommended by the International Contact Dermatitis Research Group. RESULTS: Twenty-six patients (31.7%) showed positive photopatch test responses to one or several allergens. Four of them showed positive results to three components of the series and four patients to two components. Thirty-eight photoallergic and 18 allergic reactions were observed. Ultraviolet filters were the substances which more frequently produced positive photopatch test responses (30.5%). The most common ultraviolet filter photoallergen was benzophenone-3 with 22/82 positive results (26.8%), followed by octyl methoxycinnamate (8/82), benzophenone-4 and mexenone (2/82), phenylbenzimidazole sulphonic acid, methylbenziliden camphor and octyl dimethyl PABA (1/82). One patient showed a photoallergic response to 6-methylcoumarin. There was a concordance between the allergen which elicited the positive response and the use of different substances which contained that molecule among its compounds in 17 patients (65.3%). 19.5% of the patients (16/82) showed positive results to one or several allergens in the irradiated panel as well as in the unirradiated control site. These cases were diagnosed as contact allergy, probably caused by aeroallergens, presenting a natural history and a clinical picture similar to photocontact allergy. The most common allergen was dichromate with 10 positive results. CONCLUSIONS: The results of this study confirm that sunscreens are the more frequently involved substances in photoallergic contact dermatitis in our population. Identification of the photoallergen is the key element for adequate disease control and patient education.