Requirements for Accessing New Dermatology Drugs in Spain: Results of the EQUIDAD Study. / Condicionantes de acceso a nuevos medicamentos dermatológicos en España: resultados del proyecto EQUIDAD.

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.

[Translated article] Requirements for Accessing New Dermatology Drugs in Spain: Results of the EQUIDAD Study.

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.

Necrosis grasa subcutánea múltiple: correlación ecográficohistopatológica. Multiple encapsulated fat necrosis: histopathological relation to ultrasound findings.

Encapsulated fat necrosis is a benign entity that has multiple possible conditions in the differential diagnosis. Because of this, the ultrasound and histological studies become highly relevant. We present a 14-year-old boy with this condition who exhibited numerous nodules that were detected after an intentional weight loss of 20kg. The ultrasound and histopathological examinations were necessary to confirm the diagnosis. Even though there is not a clear traumatic record in all cases, trauma constitutes the main hypothesis for its development, by decreasing the blood supply to the adipose tissue lobules and causing subsequent ischemic necrosis. Similar lesions have been described in the omentum and in the breast after surgical procedures or invasive diagnostic tests. In the ultrasound study, at least three presentation patterns have been described, which might match the three histological states, from early fat tissue degeneration to ultimate necrosis and even calcification. It is important to know the clinical characteristics, the ultrasound patterns, and the histological findings of this condition for an accurate diagnosis.

[Dermatological emergencies: a cross-sectional study of a hospital of intermediate complexity]. / Urgencias dermatológicas: estudio transversal de un hospital de complejidad intermedia.

OBJECTIVE: To determine if the introduction of some referral criteria in the dermatology emergency department has changed the number of patients referred from the emergency department, as well as the type of diseases, and the profile of the patient who uses this service. MATERIAL AND METHODS: A cross-sectional study was conducted on all consecutive patients attended in the emergency department of the Hospital Príncipe de Asturias during a 31-day period from March 2015 to May 2015 and in the same period in 2016. Variables collected were: gender, age, days from the onset, day of the week, complementary diagnostic tests, referral, reason for consultation, diagnosis and group, whether or not they met the criteria, destination, and whether or not they had a previous appointment. RESULTS: A total of 525 patients were seen in dermatology emergency department in 2015, and 371 in 2016 (P<.001). Of the 896 patients seen 55.7% were women and 44.3% men (14.45 patients per day). A total of 121 diagnoses were made, with the most common being: other dermatitis, drug reactions, and atopic dermatitis. Only 32 pathologies made up 70% of the diagnoses. More than half (51.6%) did not meet the referral criteria. CONCLUSIONS: The introduction of referral criteria has led to a reduction of 30% in the number of patients in 2016. The main diagnoses in both groups were other dermatitis and drug reactions. The profile of the patient is in accordance with the description in the literature.