RESUMEN
Atopic dermatitis is a multifactorial disease that can concomitantly occur with irritant or allergic contact dermatitis. The colloquial use of atopic dermatitis and eczema interchangeably has created confusion among patients and providers alike. Atopic skin is a complex entity that involves a defective barrier and biome, an aberrant immune response, and abnormal neural activation, while eczema is a generalized term denoting a particular appearance common to multiple diagnoses including atopic dermatitis and contact dermatitis. The conventional paradigm that simplifies atopic dermatitis and allergic contact dermatitis into distinct Th2 and Th1 processes, respectively, fails to acknowledge potential immunologic intersection points and contributes to impaired disease management. This article will review the complex interplay of atopic dermatitis and contact dermatitis and discuss treatment strategies for recalcitrant cases.
Asunto(s)
Dermatitis Alérgica por Contacto/patología , Dermatitis Atópica/patología , Dermatitis Irritante/patología , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/inmunología , Dermatitis Atópica/diagnóstico , Dermatitis Atópica/inmunología , Dermatitis Irritante/diagnóstico , Dermatitis Irritante/inmunología , Eccema/diagnóstico , Eccema/inmunología , Eccema/patología , Humanos , Células TH1/inmunología , Células Th2/inmunologíaRESUMEN
The improved survival of liver transplant recipients (LTRs) has been accompanied by a concomitant rise in long-term liver transplantation complications, including skin cancer. A recent study found that the prevalence of skin cancer among LTRs is 13.5%, a rate equivalent to that observed among kidney transplant recipients. Given the morbidity associated with skin cancer in LTRs, an individualized, multidisciplinary approach to skin cancer prevention that incorporates patient education, encourages consistent use of primary prevention methods, and ensures routine dermatologic screening should be universally adopted in this population. Chemopreventative measures should be considered in LTRs with a high skin cancer burden. Furthermore, additional studies should be performed in order to systematize these recommendations.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Inmunosupresores/efectos adversos , Trasplante de Riñón/efectos adversos , Trasplante de Hígado/efectos adversos , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/prevención & control , Receptores de Trasplantes/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de RiesgoRESUMEN
Use of dermoscopy and detection algorithms by primary care physicians can enhance assessment of clinically suspicious lesions compared with that of naked eye examinations.