Anestesia en dermatología / Anesthesia in dermatology

En la práctica dermatológica, se realizan diversos procedimientos quirúrgicos y estéticos que pueden causar dolor a los pacientes. Actualmente en el mercado se dispone, de un amplio arsenal de drogas que permiten lograr una anestesia segura y eficaz. Existen diferentes modalidades y técnicas de anestesia, según el tipo de intervención y el segmento corporal en el cual se va a realizar el procedimiento. Los efectos adversos de los diferentes anestésicos están bien definidos y se deben tomar ciertas precauciones en poblaciones especiales donde el riesgo de complicaciones es mayor. Es de fundamental importancia que el clínico posea un acabado conocimiento de los diversos fármacos utilizados en anestesia, para poder minimizar las complicaciones derivadas de su administración.

In dermatological practice, various surgical and cos-metic procedures are performed that can cause pain to patients. A large stock of drugs is now available on the market to provide safe and effective anesthesia. There are different modalities and techniques of anesthesia, depending on the type of intervention and the body segment in which the procedure will be performed. The adverse effects of different anesthe-tics are well defined and certain precautions should be taken in special populations where the risk of complications is greater. It is fundamental that the clinician has a thorough knowledge of the various drugs that can be used in anesthesia, in order to minimize complications arising from its administration

High frequency ultrasound with color Doppler in dermatology

Abstract: Ultrasonography is a method of imaging that classically is used in dermatology to study changes in the hypoderma, as nodules and infectious and inflammatory processes. The introduction of high frequency and resolution equipments enabled the observation of superficial structures, allowing differentiation between skin layers and providing details for the analysis of the skin and its appendages. This paper aims to review the basic principles of high frequency ultrasound and its applications in different areas of dermatology.

Caracterización de pacientes pediátricos usuarios de fototerapia en el Servicio de Dermatología, Hospital Clínico Universidad de Chile (2007-2015) / Characterization of pediatrics patients users of phototherapy in dermatology service, Hospital Clínico Universidad Chile (2007-2015)

Phototherapy is the use of specific wavelenghts of light that have shown effectiveness in the treatment of several cutaneous diseases. Current indications for phototherapy in Dermatology include multiple pathologies and it is considered to be costeffective. Literature about its use in children is rare, there are no studies on phototherapy in Chilean children. Patients and methods: Observational, descriptive, retrospective study. Clinical records of pediatric patients treated with phototherapy at University of Chile Clinical Hospital between 2007 and 2015, were studied. For each patient, the following parameters were analyzed: age of starting treatment, sex, skin phenotype, diagnosis, prescribed phototherapy and weekly frecuency. Results: 146 patients, 85 girls and 51 boys, average age 11.7 +/- 4.0 years. Predominant skin phenotype, was Fitzpatrick type III. Vitiligo was identified as the most common indication for phototherapy (52,2 percent), followed by psoriasis (22,6 percent). By a large margin, the most used type of phototherapy was nb UVB (96.6 percent). Most of the patients were treated twice per week (69.2 percent). Discussion: The obtained results in this group are similar to those results described in the international literature. Further studies are required for a better knowledge about efficacy and possible long-term effects of phototherapy on Chilean children.

Patient-assisted teledermatology practice: What is it: When, where, and how it is applied.

Recent teledermatology practice has been focused on different models made possible by robust advances in information technology leading to consistent interaction between the patient and health care professionals. Patient-assisted teledermatology practice also called patient-enabled teledermatology or home based teledermatology is one such novel model. There is a lack of scientifi c literature and substantive reviews on patient-assisted teledermatology practice. The present article reviews several studies and surveys on patientassisted teledermatology practice and outlines its advantages and barriers to clinical utility and analyses the potentiality of this concept. Incorporating patient-assisted teledermatology practice as a novel model in the revised classifi cation of teledermatology practice is proposed. In patient-assisted teledermatology, the patient can upload his/her clinical images as a fi rst contact with the dermatologist or an initial face-to-face examination can be followed by teledermatology consultations. The latter method is well suited to chronic diseases such as psoriasis, vitiligo, and leg ulcers, which may need frequent follow-up entailing signifi cant costs and time, particularly in the elderly. Teledermatology may also be used by the treating dermatologist to seek expert opinion for diffi cult cases. Studies have demonstrated the importance and usability of the concept of patient-assisted teledermatology practice. Various teledermatology care models are available and the appropriate model should be chosen depending on whether the clinical situation is that of easily diagnosed cases (“spotters”), chronic cases or doubtful cases and difficult-to-manage cases.

Importancia das doenças de transmissâo sexual na formaçâo dos dermatologistas / Importance of sexually transmitted diseases in dermatology training

A maioria destas doenças têm expressâo cutânea que permite o diagnóstico precoce e o tratamento oportuno.

DermaMan: scoring dermatology in your palm.

Personal Digital Assistants (PDAs) have become a part of everyday life. DermaMan is a freely available, Java-based, dermatology-specific calculator for handheld devices. It includes modules to compute PASI, MASI, SCORAD, and for calculations related to topical PUVA and Botox (R) administration.

Lasers in dermatology.

Laser technology, since its inception, has grown to find it's in varied fields, and medical science has been no exception. Dermatological surgery is in itself an emerging field in medical science, and the evolution of laser technology has further widened its scope, with various therapeutic well as diagnostic applications. Though the use of this technology is rapidly evolving, controlled studies to compare the efficacy of different types of lasers in specific skin conditions, or its effect on different skin types, is lacking. This study presents the observations of the response to the Carbon-di-oxide laser used to treat various skin conditions, in the Nepali skin phenotype. Lasers are being used to treat a wide variety of dermatological conditions, many of which did not have satisfactory treatment in the past. Further studies are required to study the effect of lasers in the Nepali skin phenotype, so as to standardize the wavelengths, doses and exposure times that would be suitable to treat specific skin conditions.

Aplicaciones del ultrasonido de alta resolución y alta frecuencia en dermatología / High resolution and high frequency ultrasound in dermatology

El ultrasonido en la práctica dermatológica se ha vuelto cada vez más frecuente. Este método requiere de una máquina de ultrasonido de alta resolución, con transductores de alta frecuencia que alcancen los 15 MHz o más. No menos importante es un operador entrenado en estrecho contacto con los clínicos. En este artículo revisaremos las indicaciones más frecuentes para el ultrasonido dermatológico, que en su mayoría es realizado con Doppler color, para determinar la vascularización de las lesiones. Describimos la anatomía normal de la piel y la uña y luego los gallazgos ultrasonográficos en las patologías benignas y malignas de la piel, incluyendo la uña.

Imaging techniques in dermatology

Since the discovery of X-rays, the use of imaging technology has continued to play an important role in medicine. Technological advancements have led to the development of various imaging modalities, most of which have been used to image organs deep within the human body. More recently, attention has focused on the application of imaging technology for evaluation of the skin. A variety of techniques are currently being used to examine the skin and these include specialized photography, surface microscopy, ultrasound, laser Doppler perfusion imaging, confocal microscopy, magnetic resonance imaging and optical coherence tomography. These modalities can provide information that can assist in the management of skin problems. Although many of these techniques are still undergoing research, they are showing promise as useful clinical tools in dermatology. In this review article we discuss about each of these technologies in brief