RESUMO
BACKGROUND: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. MATERIAL AND METHODS: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. RESULTS: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected at the local level (i.e., differences between hospitals within the same autonomous community). CONCLUSIONS: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain.
Assuntos
Dermatologia , Humanos , Espanha , Estudos TransversaisRESUMO
BACKGROUND: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. MATERIAL AND METHODS: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. RESULTS: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected at the local level (i.e., differences between hospitals within the same autonomous community). CONCLUSIONS: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain.
Assuntos
Dermatologia , Humanos , Espanha , Estudos TransversaisAssuntos
Anti-Infecciosos Locais , Dermatite Alérgica de Contato , Criança , Humanos , Clorexidina , Testes do Emplastro , AlérgenosAssuntos
Doença de Bowen/tratamento farmacológico , Papillomavirus Humano 16/efeitos dos fármacos , Fotoquimioterapia/métodos , Neoplasias Cutâneas/tratamento farmacológico , Doença de Bowen/complicações , Doença de Bowen/radioterapia , Doença de Bowen/virologia , Feminino , Seguimentos , Papillomavirus Humano 16/genética , Humanos , Lasers de Gás/uso terapêutico , Masculino , Estudos Retrospectivos , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/virologia , Resultado do TratamentoRESUMO
Scombroid poisoning is a common cause of food poisoning worldwide. It is caused by ingestion of oily fish contaminated with bacteria that trigger the formation of high concentrations of histamine. Scombroid poisoning manifests mainly as a skin complaint (flushing that spreads downward and/or an erythematous urticarial rash affecting the face and upper trunk). Although the clinical course is usually self-limiting and benign, vascular compromise, bronchospasm, and arrhythmias have been described. It is important to establish a differential diagnosis that includes conditions such as fish allergy. Oral antihistamines are the mainstay of treatment. Scombroid poisoning is best prevented by refrigerating fish properly. The practical review of scombroid poisoning provided here is intended for dermatologists.
Assuntos
Peixes/microbiologia , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/etiologia , Algoritmos , Animais , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/tratamento farmacológico , Doenças Transmitidas por Alimentos/metabolismo , Histamina/biossíntese , Antagonistas dos Receptores Histamínicos/uso terapêutico , HumanosAssuntos
Encéfalo/patologia , Transtornos da Memória/etiologia , Micose Fungoide/complicações , Nistagmo Patológico/etiologia , Neoplasias Cutâneas/complicações , Corticosteroides/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bexaroteno , Carmustina/administração & dosagem , Terapia Combinada , Citarabina/administração & dosagem , Progressão da Doença , Evolução Fatal , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/complicações , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Micose Fungoide/tratamento farmacológico , Micose Fungoide/patologia , Micose Fungoide/radioterapia , Terapia PUVA , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/radioterapia , Tetra-Hidronaftalenos/uso terapêuticoAssuntos
Neoplasias Faciais/diagnóstico , Linfoma Folicular/diagnóstico , Neoplasias Cutâneas/diagnóstico , Anticorpos Monoclonais Murinos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Combinada , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Neoplasias Faciais/tratamento farmacológico , Feminino , Humanos , Linfoma Folicular/tratamento farmacológico , Linfoma Folicular/cirurgia , Quimioterapia de Manutenção , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Prognóstico , Recidiva , Indução de Remissão , Rituximab , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/cirurgia , Esplenectomia , Vincristina/administração & dosagemRESUMO
Hand eczema is a very frequent pathology in Dermatology. We report the case of a 65-year-old woman who developed a photoallergic eczema on her hands due to benzydamine present in her gynecological washing solution. It is probably an under-diagnosed cause of hand dermatitis. It also draws attention to the importance of a good anamnesis in dermatology.