RESUMEN
Actinic keratosis is a precancerous lesion that is commonly seen in the elderly patient and requires treatment. It shows a predilection for areas of the skin that are exposed to the sun, and usually manifests as multiple skin-colored or discrete reddish scaly verrucous plaques. The diagnosis is usually based on the clinical appearance of the lesion. Therapeutic options include physical, immunological and chemical measures. The choice of treatment is determined by numerous factors, and can be adapted to the individual situation presenting.
Asunto(s)
Carcinoma de Células Escamosas/etiología , Queratosis , Lesiones Precancerosas , Neoplasias Cutáneas/etiología , Rayos Ultravioleta/efectos adversos , Adyuvantes Inmunológicos/administración & dosificación , Adyuvantes Inmunológicos/uso terapéutico , Factores de Edad , Anciano , Aminoquinolinas/administración & dosificación , Aminoquinolinas/uso terapéutico , Antimetabolitos Antineoplásicos/administración & dosificación , Antimetabolitos Antineoplásicos/uso terapéutico , Antineoplásicos/administración & dosificación , Antineoplásicos/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/cirugía , Crioterapia , Diagnóstico Diferencial , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/uso terapéutico , Humanos , Imiquimod , Inductores de Interferón/administración & dosificación , Inductores de Interferón/uso terapéutico , Queratosis/diagnóstico , Queratosis/tratamiento farmacológico , Queratosis/cirugía , Queratosis/terapia , Terapia por Láser , Masculino , Pomadas , Fotoquimioterapia , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/tratamiento farmacológico , Lesiones Precancerosas/cirugía , Lesiones Precancerosas/terapia , Factores de Riesgo , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/cirugía , Factores de TiempoRESUMEN
The treatment of the aging face has evolved to increasingly incorporate minimally office-based procedures. The importance of recognizing and treating facial rhytids has always been recognized as important, but an increasing number of modalities have been developed for this purpose. Similarly, there has been an increase of emphasis in the recognition of dyschromias, solar keratoses, and other skin abnormalities. In this article, an overview of many of the minimally invasive office-based procedures that we favor in our practice will be briefly reviewed.
Asunto(s)
Rejuvenecimiento , Ritidoplastia/métodos , Envejecimiento de la Piel/patología , Toxinas Botulínicas Tipo A/uso terapéutico , Quimioexfoliación/métodos , Colágeno/uso terapéutico , Dermabrasión/métodos , Femenino , Remoción del Cabello/métodos , Humanos , Queratolíticos/uso terapéutico , Queratosis/cirugía , Terapia por Láser , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Fármacos Neuromusculares/uso terapéutico , Planificación de Atención al Paciente , Fototerapia/métodos , Trastornos de la Pigmentación/cirugía , Enfermedades Cutáneas Vasculares/cirugíaRESUMEN
The skin is the organ most commonly affected by malignancies. Various cancers of the skin show a dramatic increase in incidence over the last decades. Epithelial skin tumors are most frequently, e.g., basal cell carcinoma and the squamous cell carcinoma with its precursors, the actinic keratoses. Melanoma, which is extremely difficult to treat in advanced tumor stages, is dreaded. Besides that, there are other epithelial malignant diseases, e.g. Morbus Bowen and adnexal tumors originating from the skin appendices. Mesenchymal malignant neoplasias such as Morbus Kaposi, angiosarcomas and other dermal sarcomas, are rare. Since the majority of malignant neoplasms is removable and curable by a simple surgical intervention, the knowledge of the different skin tumors is essential for non-dermatologist.
Asunto(s)
Carcinoma Basocelular , Carcinoma de Células Escamosas , Melanoma , Neoplasias Cutáneas , Adyuvantes Inmunológicos/administración & dosificación , Adyuvantes Inmunológicos/uso terapéutico , Aminoquinolinas/administración & dosificación , Aminoquinolinas/uso terapéutico , Antimetabolitos Antineoplásicos/administración & dosificación , Antimetabolitos Antineoplásicos/uso terapéutico , Antineoplásicos/administración & dosificación , Antineoplásicos/uso terapéutico , Biopsia , Enfermedad de Bowen/diagnóstico , Enfermedad de Bowen/tratamiento farmacológico , Enfermedad de Bowen/radioterapia , Enfermedad de Bowen/cirugía , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/tratamiento farmacológico , Carcinoma Basocelular/radioterapia , Carcinoma Basocelular/cirugía , Carcinoma de Células de Merkel/diagnóstico , Carcinoma de Células de Merkel/tratamiento farmacológico , Carcinoma de Células de Merkel/cirugía , Carcinoma de Células de Merkel/terapia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirugía , Ensayos Clínicos como Asunto , Terapia Combinada , Crioterapia , Diagnóstico Diferencial , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/uso terapéutico , Infecciones por VIH/complicaciones , Hemangiosarcoma/diagnóstico , Humanos , Imiquimod , Inmunoterapia , Queratosis/diagnóstico , Queratosis/tratamiento farmacológico , Queratosis/cirugía , Escisión del Ganglio Linfático , Metástasis Linfática , Linfoma/clasificación , Linfoma/diagnóstico , Linfoma/tratamiento farmacológico , Linfoma/radioterapia , Linfoma/cirugía , Masculino , Melanoma/diagnóstico , Melanoma/tratamiento farmacológicoRESUMEN
Actinic keratoses (AKs) are the most common epithelial premalignant lesions seen by dermatologists today. The vast therapeutic armamentarium for treating AKs can be roughly divided into 2 categories: topical and surgical/physical modalities. It is important for clinicians to be familiarized with the various therapeutic options for treating AKs and to deliver individualized treatments. This article will review the surgical and physical modalities available for the treatment of AKs.
Asunto(s)
Queratosis/terapia , Criocirugía , Dermabrasión , Electrocirugia , Humanos , Queratolíticos , Queratosis/cirugía , Terapia por Láser , Fototerapia , Lesiones Precancerosas/cirugía , Lesiones Precancerosas/terapia , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/terapiaRESUMEN
Potential patients in the developed world are increasingly turning to treatment with herbs. One of the most popular herbs taken for depression is St John's Wort, which contains the potential photosensitizer hypericin. 'Hypericism' is a term used to describe a state of skin sensitivity to visible light in animals following ingestion of hypericin-containing plants and feed. A patient who developed a severe phototoxic reaction to laser light at 532 nm and also an exaggerated and unexpectedly severe response to pulsed dye laser light at 585 nm is described. It subsequently transpired that the patient was taking St John's Wort at the time of laser treatment.
Asunto(s)
Antidepresivos/efectos adversos , Dermatitis Fototóxica/etiología , Hypericum/efectos adversos , Queratosis/cirugía , Terapia por Láser/efectos adversos , Perileno/análogos & derivados , Perileno/efectos adversos , Fitoterapia/efectos adversos , Preparaciones de Plantas/efectos adversos , Complicaciones Posoperatorias , Fármacos Sensibilizantes a Radiaciones/efectos adversos , Antracenos , Cara , Femenino , Humanos , Pierna , Persona de Mediana Edad , Procedimientos de Cirugía PlásticaRESUMEN
A previously unreported method to relieve excessive plantargrade pressure which may create an intractable plantar keratoma associated with metatarsal head pain is presented. This method is referred to as an intramedullary metatarsal decompression with condylectomy and is performed through a dorsal minimum incision. The rotary action of the bur is demonstrated. This method has proved less traumatic than previous procedures, permitting immediate ambulation with little postoperative pain or edema. In a series of cases, I have compared this method with control studies on the same patient in which intramedullary metatarsal decompression was performed on one foot and a neck osteotomy on the opposite foot. Results with intramedullary metatarsal decompression have been comparable but have fewer postoperative sequelae. Exuberant bone callus formation dorsally and at the osteotomy site, lateral displacement of bone segments, frequency of transfer lesions, delayed healing or nonunion of the osteotomy site, and the possibility of synostosis when two adjacent bones were osteotomized are all decreased. A short review of the rationale, selection of cases, and criteria for orthotics is presented. The concept and simplified method of treatment applied in a series of cases is described.