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9.
Actas dermo-sifiliogr. (Ed. impr.) ; 102(8): 563-571, oct. 2011.
Artigo em Espanhol | IBECS | ID: ibc-92559

RESUMO

Los estudios epidemiológicos ponen de manifiesto que cada vez son más las personas que dicen poseer una piel sensible, presumiéndose una prevalencia del 50% en la población europea. Se trata de una condición cutánea de hiperreactividad cuya manifestación depende de gran variedad de factores y cuya patogénesis no es del todo conocida, aunque diferentes estudios señalan un origen biofísico para este desorden. El diagnóstico objetivo de piel sensible es difícil, ya que la mayoría de los síntomas que presentan los pacientes son subjetivos. Además, no existen pruebas diagnósticas realmente eficaces y con un fuerte componente predictivo, pues la sensibilidad de la piel varía mucho de unas personas a otras. Por otra parte existen numerosas variaciones entre los compuestos que desencadenan respuestas del tipo de piel sensible. Las repercusiones sobre la calidad de vida son importantes y frecuentemente se acompañan de sintomatología psiquiátrica, por lo que el médico dermatólogo debe explorar este campo en la anamnesis. En el tratamiento de esta condición se hace imprescindible la colaboración del paciente y altas dosis de tenacidad por parte del médico (AU)


Epidemiologic studies indicate that ever larger numbers of people report having sensitive skin, for which a European prevalence of 50% is estimated. Sensitive skin is characterized by hyperreactivity, with manifestations varying in relation to many factors. The pathogenesis of this disorder is poorly understood, although studies point to a biophysical mechanism. Objective diagnosis of sensitive skin is difficult, as information comes mainly from the patient's report of symptoms in the absence of effective, strongly predictive tests because of great interindividual variability in skin sensitivity. Substances that trigger a reaction in hypersensitive skin also vary greatly. The impact of this syndrome on quality of life is considerable and patients often present psychiatric symptoms; therefore, dermatologists should explore this possibility when taking a patient's history. Patient cooperation and physician persistence are both essential for treating sensitive skin (AU)


Assuntos
Humanos , Masculino , Feminino , Dermatite Irritante/etiologia , Dermatite Irritante/fisiopatologia , Dermatite Irritante/terapia , Irritantes/efeitos adversos , Prurido/induzido quimicamente , Dermatopatias , Hipersensibilidade , Hipersensibilidade/terapia , Dermatite Irritante/classificação , Testes de Irritação da Pele/classificação , Testes de Irritação da Pele/métodos , Cosméticos/efeitos adversos , Sabões/efeitos adversos , Higroscópicos/uso terapêutico , Dermatite Irritante/prevenção & controle , Salicilato de Sódio/uso terapêutico , Prurido Vulvar/induzido quimicamente , Dermatite Atópica/complicações
10.
Actas Dermosifiliogr ; 102(8): 563-71, 2011 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-21757181

RESUMO

Epidemiologic studies indicate that ever larger numbers of people report having sensitive skin, for which a European prevalence of 50% is estimated. Sensitive skin is characterized by hyperreactivity, with manifestations varying in relation to many factors. The pathogenesis of this disorder is poorly understood, although studies point to a biophysical mechanism. Objective diagnosis of sensitive skin is difficult, as information comes mainly from the patient's report of symptoms in the absence of effective, strongly predictive tests because of great interindividual variability in skin sensitivity. Substances that trigger a reaction in hypersensitive skin also vary greatly. The impact of this syndrome on quality of life is considerable and patients often present psychiatric symptoms; therefore, dermatologists should explore this possibility when taking a patient's history. Patient cooperation and physician persistence are both essential for treating sensitive skin.


Assuntos
Dermatite , Adolescente , Adulto , Antialérgicos/uso terapêutico , Comorbidade , Cosméticos/efeitos adversos , Dermatite/tratamento farmacológico , Dermatite/epidemiologia , Dermatite/etiologia , Dermatite/fisiopatologia , Dermatite/psicologia , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Dermatite Atópica/psicologia , Fármacos Dermatológicos/uso terapêutico , Suscetibilidade a Doenças , Toxidermias/tratamento farmacológico , Toxidermias/epidemiologia , Toxidermias/etiologia , Toxidermias/psicologia , Emolientes/uso terapêutico , Feminino , Humanos , Óleo de Semente do Linho/uso terapêutico , Masculino , Prevalência , Grupos Raciais , Envelhecimento da Pele , Dermatopatias/epidemiologia , Fenômenos Fisiológicos da Pele , Inquéritos e Questionários
11.
Actas Dermosifiliogr ; 101(7): 629-36, 2010 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-20858389

RESUMO

OBJECTIVE: To describe the clinical management of psoriatic arthritis for patients being treated by dermatologists and rheumatologists in Spain. METHODS: Multicenter, retrospective, naturalistic observational study in which demographic and clinical variables were recorded for patients diagnosed with psoriatic arthritis. Data referred to the previous 12 months and were collected during a single visit with the physician. RESULTS: A total of 266 patients were enrolled; 78.1% were being treated by rheumatologists and 21.9% by dermatologists. The data covered 1138 visits. The main reason for consulting a physician was to monitor psoriatic arthritis (82.7% of the visits). The most widely used examination was to determine the tender- and swollen-joint count (73.1%). The tests most frequently ordered were acute-phase reactants: erythrocyte sedimentation rate (79.8%) and C reactive protein level (74.5%). Affected body surface area and the Psoriasis Area and Severity Index were the main assessments used by dermatologists. Rheumatologists tended to examine the joints and record biochemical markers. A disease-modifying antirheumatic drug was prescribed for 71.1% of the patients; 51.8% were prescribed a biologic agent (61.5% in combination with another treatment). Treatment approach differed by specialty and was modified if response was nil or partial (the rationale for 45.1% of all changes). CONCLUSION: Differences in the management of psoriatic arthritis in dermatology and rheumatology were evident in both diagnostic and treatment approaches. These 2 specialties should cooperate to establish common practice guidelines for use in Spain.


Assuntos
Artrite Psoriásica/diagnóstico , Artrite Psoriásica/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Dermatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica , Estudos Retrospectivos , Reumatologia , Espanha , Adulto Jovem
12.
Actas dermo-sifiliogr. (Ed. impr.) ; 101(7): 629-636, sept. 2010. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-83101

RESUMO

Objetivo: Conocer el manejo clínico de los pacientes con artritis psoriásica atendidos en consultas de dermatología y reumatología en España. Método: Estudio observacional, multicéntrico, naturalístico, retrospectivo, en el que se recogieron parámetros demográficos y clínicos de pacientes diagnosticados de artritis psoriásica. Se realizó una única visita; los datos se refirieron a los 12 meses anteriores. Resultados: Participaron 266 pacientes, 78,1% procedentes de consultas de reumatología y 21,9% de dermatología. Se registró información de 1.138 visitas. El principal motivo de consulta fue el control de la artritis psoriásica (82,7% de las visitas). La exploración más utilizada fue el recuento de articulaciones dolorosas e inflamadas (73,1%) y las pruebas complementarias más frecuentes fueron la determinación de reactantes de fase aguda (velocidad sedimentación y proteína C reactiva) (79,8%; 74,5%). En dermatología destacó el uso del body surface area y el psoriasis area severity index como pruebas de evaluación habituales. En reumatología se utilizaron sobretodo criterios de evaluación articular y bioquímicos. El 71,1% de pacientes fueron tratados con algún fármaco modificador de la enfermedad, y el 51,8% con terapia biológica (61,5% con tratamiento combinado), observándose diferencias según la especialidad. La obtención de respuesta parcial o nula al tratamiento fue el principal motivo de modificación del mismo (45,1% de pacientes en los que hubo cambios). Conclusión: Se evidencian diferencias en el manejo de la artritis psoriásica según especialidad, tanto en el diagnóstico como el tratamiento de la enfermedad, considerándose imprescindible la colaboración entre dermatólogos y reumatólogos para establecer protocolos de actuación comunes en el ámbito asistencial español (AU)


Objective: To describe the clinical management of psoriatic arthritis for patients being treated by dermatologists and rheumatologists in Spain. Methods: Multicenter, retrospective, naturalistic observational study in which demographic and clinical variables were recorded for patients diagnosed with psoriatic arthritis. Data referred to the previous 12 months and were collected during a single visit with the physician. Results: A total of 266 patients were enrolled; 78.1% were being treated by rheumatologists and 21.9% by dermatologists. The data covered 1138 visits. The main reason for consulting a physician was to monitor psoriatic arthritis (82.7% of the visits). The most widely used examination was to determine the tender- and swollen-joint count (73.1%). The tests most frequently ordered were acute-phase reactants: erythrocyte sedimentation rate (79.8%) and C reactive protein level (74.5%). Affected body surface area and the Psoriasis Area and Severity Index were the main assessments used by dermatologists. Rheumatologists tended to examine the joints and record biochemical markers. A disease-modifying antirheumatic drug was prescribed for 71.1% of the patients; 51.8% were prescribed a biologic agent (61.5% in combination with another treatment). Treatment approach differed by specialty and was modified if response was nil or partial (the rationale for 45.1% of all changes). Conclusion: Differences in the management of psoriatic arthritis in dermatology and rheumatology were evident in both diagnostic and treatment approaches. These 2 specialties should cooperate to establish common practice guidelines for use in Spain (AU)


Assuntos
Humanos , Artrite Psoriásica/tratamento farmacológico , Equipe de Assistência ao Paciente/tendências , Padrões de Prática Médica , Psoríase/complicações , Estudos Retrospectivos , Estudos Observacionais como Assunto , Proteína C-Reativa/análise , Proteínas de Fase Aguda/análise , Índice de Gravidade de Doença , Antirreumáticos/uso terapêutico , Terapia Biológica
13.
Actas Dermosifiliogr ; 101(7): 629-636, 2010 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28709545

RESUMO

OBJECTIVE: To describe the clinical management of psoriatic arthritis for patients being treated by dermatologists and rheumatologists in Spain. METHODS: Multicenter, retrospective, naturalistic observational study in which demographic and clinical variables were recorded for patients diagnosed with psoriatic arthritis. Data referred to the previous 12 months and were collected during a single visit with the physician. RESULTS: A total of 266 patients were enrolled; 78.1% were being treated by rheumatologists and 21.9% by dermatologists. The data covered 1138 visits. The main reason for consulting a physician was to monitor psoriatic arthritis (82.7% of the visits). The most widely used examination was to determine the tender- and swollen-joint count (73.1%). The tests most frequently ordered were acute-phase reactants: erythrocyte sedimentation rate (79.8%) and C reactive protein level (74.5%). Affected body surface area and the Psoriasis Area and Severity Index were the main assessments used by dermatologists. Rheumatologists tended to examine the joints and record biochemical markers. A disease-modifying antirheumatic drug was prescribed for 71.1% of the patients; 51.8% were prescribed a biologic agent (61.5% in combination with another treatment). Treatment approach differed by specialty and was modified if response was nil or partial (the rationale for 45.1% of all changes). CONCLUSION: Differences in the management of psoriatic arthritis in dermatology and rheumatology were evident in both diagnostic and treatment approaches. These 2 specialties should cooperate to establish common practice guidelines for use in Spain.

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