RESUMEN
Bariatric surgery aims at weight reduction of severely obese patients. The Roux-en-Y technique is one of the most common bariatric procedures and is occasionally accompanied by nutrient insufficiencies and metabolic changes. According to the literature, skin architecture and immunity change after bariatric surgery and may lead to inflammation and increased susceptibility to pathogens. Additionally, vitamin and mineral deficiencies frequently develop in these patients and affect the skin's defense mechanisms, possibly contributing to dermatological complications. Knowledge and recognition of skin changes after bariatric surgery make an important asset for the dermatologist and help in the proper treatment of these patients. We report 2 cases of infectious skin lesions where vitamin and trace element deficiencies have possibly contributed to their persistence and resistance to traditional treatments.
Asunto(s)
Absceso/microbiología , Infecciones por Acinetobacter/complicaciones , Derivación Gástrica/efectos adversos , Úlcera de la Pierna/etiología , Obesidad Mórbida/cirugía , Infecciones por Pseudomonas/complicaciones , Enfermedades Cutáneas Bacterianas/microbiología , Infecciones por Acinetobacter/tratamiento farmacológico , Acinetobacter baumannii , Antibacterianos/uso terapéutico , Calcio/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Infecciones por Pseudomonas/tratamiento farmacológico , Pseudomonas aeruginosa , Recurrencia , Vitamina B 12/uso terapéutico , Deficiencia de Vitamina B 12/tratamiento farmacológico , Deficiencia de Vitamina B 12/etiología , Vitamina D/uso terapéutico , Deficiencia de Vitamina D/tratamiento farmacológico , Deficiencia de Vitamina D/etiología , Zinc/deficiencia , Zinc/uso terapéuticoAsunto(s)
Carcinoma de Células Escamosas/patología , Opacidad de la Córnea/patología , Enfermedad de Darier/patología , Neoplasias Cutáneas/patología , Rayos Ultravioleta/efectos adversos , Adulto , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/terapia , Cicatriz , Opacidad de la Córnea/complicaciones , Opacidad de la Córnea/terapia , Enfermedad de Darier/complicaciones , Enfermedad de Darier/terapia , Humanos , Masculino , Neoplasias Cutáneas/terapiaRESUMEN
Obesity is one of the most frequently encountered medical problems of our time. Among the complications of this pathologic entity, renal disease is an important issue and its pathophysiologic mechanisms are a challenge for the physician, since a variety of etiologic factors are implicated in its genesis. For example, hypertension, hyperlipidemia and insulin resistance affect renal function, each one in a different way. Obesity seems to be a state in which kidneys demonstrate morphological and functional alterations, while hormonal and growth factors play a significant role. Among them, leptin, a recently discovered cytokine, has undergone extended investigation and has proven to be a factor that contributes to renal disease, mainly through mechanisms that involve activation of the TGF-beta system resulting in glomerulopathy and related clinical symptoms. Experiments in animals have revealed interesting aspects as far as the role of leptin in kidney function. Understanding the underlying mechanisms of obesity-related glomerulopathy may become a valuable aid in handling an obese patient with renal disease and associated problems.