RESUMO
Purpose: The COVID-19 pandemic affected medical practice worldwide due to interventions to prevent spreading. Its effect on ophthalmology practices in Latin America has not yet been explored. We aimed to assess the perceptions about the pandemic from countries' ophthalmological national and subspecialty retina societies affiliated to the Pan-American Association of Ophthalmology (PAAO). Patients and Methods: A survey-based study of leaders of national ophthalmological and retinal societies was conducted. The survey was sent by email to 30 societies, from which 20 responded (12 countries, 66.6% response rate). It included closed- and open-ended questions about (1) operational capacity and precautions, (2) telemedicine and virtual care, (3) procedures, and (4) post-pandemic considerations. Results: There was a marked decline in ophthalmology patient visits (80-95%) and elective surgeries (90%) during 2020 compared to before the pandemic. Precautions like temperature checks, mask usage, and social distancing were widely implemented while personal protective equipment (PPE) availability varied. Telemedicine use was limited due to lack of experience with it. Reopening plans focused on maintaining precautions and gradually resuming activities. Economic and security concerns were raised, and adherence to guidelines was emphasized. Respondents acknowledged the need to adapt to a "new normal". Long duration drugs, fewer imaging studies, and shorter wait times were preferred; however, availability of long duration drugs was limited. Conclusion: The pandemic impacted ophthalmology in Latin America, with reduced patient visits, procedures, and surgeries. Delayed treatment and complications were likely the result of the pandemic.
Assuntos
Antirreumáticos , Artrite Reumatoide , Pérnio , Lúpus Eritematoso Cutâneo , Adalimumab/efeitos adversos , Antirreumáticos/efeitos adversos , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Pérnio/induzido quimicamente , Pérnio/diagnóstico , Humanos , Lúpus Eritematoso Cutâneo/induzido quimicamente , Lúpus Eritematoso Cutâneo/diagnóstico , Lúpus Eritematoso Cutâneo/tratamento farmacológicoAssuntos
Dermatomiosite , Ectrópio , Síndromes Paraneoplásicas , Autoanticorpos , Capecitabina/efeitos adversos , Dermatomiosite/induzido quimicamente , Dermatomiosite/complicações , Dermatomiosite/diagnóstico , Ectrópio/induzido quimicamente , Ectrópio/diagnóstico , Humanos , Síndromes Paraneoplásicas/induzido quimicamente , Síndromes Paraneoplásicas/diagnóstico , Síndromes Paraneoplásicas/tratamento farmacológicoAssuntos
Hepatite C/complicações , Isquemia/etiologia , Vasculite/diagnóstico , Terapia Combinada , Feminino , Dedos/irrigação sanguínea , Heparina/uso terapêutico , Hepatite C/tratamento farmacológico , Humanos , Isquemia/tratamento farmacológico , Pessoa de Meia-Idade , Plasmaferese , Prostaglandinas/uso terapêutico , Rituximab/uso terapêutico , Esteroides/uso terapêutico , Vasculite/tratamento farmacológico , Vasculite/etiologiaAssuntos
Anemia Hemolítica Autoimune/tratamento farmacológico , Imunossupressores/administração & dosagem , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Rituximab/administração & dosagem , Anemia Hemolítica Autoimune/sangue , Anemia Hemolítica Autoimune/imunologia , Azatioprina/uso terapêutico , Relação Dose-Resposta a Droga , Feminino , Glucocorticoides/administração & dosagem , Glucocorticoides/uso terapêutico , Hemoglobinas/análise , Humanos , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/imunologia , Pessoa de Meia-Idade , Pulsoterapia , Retratamento/métodos , Resultado do TratamentoAssuntos
Dermatopatias/patologia , Adulto , Atrofia/patologia , Epiderme/patologia , Humanos , MasculinoAssuntos
Fármacos Dermatológicos/efeitos adversos , Histiocitoma Fibroso Benigno/induzido quimicamente , Psoríase/tratamento farmacológico , Neoplasias Cutâneas/induzido quimicamente , Ustekinumab/efeitos adversos , Histiocitoma Fibroso Benigno/patologia , Humanos , Masculino , Neoplasias Cutâneas/patologia , Adulto JovemRESUMO
Siliconomas are subcutaneous nodules that usuallyappear as a consequence of the migration of freesilicon implanted in other locations. They are morefrequent in women with abnormal breast implants,such as poly implant prostheses (PIP), but they may alsoappear after illegal injection of free silicone. We reporta 57-year-old woman who attended our Dermatologyclinic complaining of relapsing facial panniculitis ofunknown origin. After a thorough work-up, thesenodules were determined to be the consequence ofdermal filler made with fluid silicone, which had beeninjected 20 years prior. High frequency skin ultrasoundof one of the nodules showed a hyperechoic image,also known as "snowstorm," which was located in thesubcutaneous tissue. The disposition of silicone in thisplane obscures the view of any sonographic structurein the underlying plane. Cutaneous sonographyhas become one of the most useful non-invasivetechniques in diagnosis of filler complications andother inflammatory diseases. Combined treatmentwith prednisone and allopurinol was successful, withno recurrence after 1 year of follow-up.
Assuntos
Preenchedores Dérmicos/efeitos adversos , Dermatoses Faciais/diagnóstico por imagem , Reação a Corpo Estranho/diagnóstico por imagem , Paniculite/diagnóstico por imagem , Silicones/efeitos adversos , Tela Subcutânea/diagnóstico por imagem , Alopurinol/uso terapêutico , Dermatoses Faciais/tratamento farmacológico , Dermatoses Faciais/patologia , Feminino , Reação a Corpo Estranho/tratamento farmacológico , Reação a Corpo Estranho/patologia , Sequestradores de Radicais Livres/uso terapêutico , Glucocorticoides/uso terapêutico , Humanos , Pessoa de Meia-Idade , Paniculite/tratamento farmacológico , Paniculite/patologia , Prednisona/uso terapêutico , Tela Subcutânea/patologia , UltrassonografiaRESUMO
A 17-year-old adolescent girl attended our clinic for a scheduled review of her nevus lesions. She complained about a lesion on the posterior region of her neck, which she had noticed approximately 2 years before. Even though it had not caused any symptoms, its appearance had changed according to her parents. The patient's medical history, as well as that of her family's, was unremarkable.
Assuntos
Melanoma/patologia , Nevo Pigmentado/patologia , Neoplasias Cutâneas/patologia , Adolescente , Diagnóstico Diferencial , Feminino , HumanosRESUMO
Mycobacteria cause a range of diseases in both immunocompetent and immunosuppressed individuals. An increase in non-tuberculous mycobacterial (NTM) infections targeting skin has been described. Many hypotheses have been developed in order to explain it: the increasing burden of immunocompromised individuals, immigration from endemic countries, improved laboratory identification techniques, and changes inhuman behavior that expose individuals to this NTM. Mycobacterium mucogenicum group comprises M. mucogenicum, Mycobacterium aubagnense, and Mycobacterium phocaicum. This group of organisms was first named Mycobacterium chelonae-like organism in 1982. Most clinically significant cases of those organisms involved catheter-related infections. Nevertheless, we report an interesting patient with a cutaneous infection produced by M. mucogenicum mimicking a squamous cell carcinoma; an excellent response to combined therapy with rifampicin and clarythromicin was observed.
Assuntos
Carcinoma de Células Escamosas/diagnóstico , Dermatoses da Mão/diagnóstico , Infecções por Mycobacterium/diagnóstico , Mycobacterium , Neoplasias Cutâneas/diagnóstico , Diagnóstico Diferencial , Mãos , Dermatoses da Mão/patologia , Humanos , Imunocompetência , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium/patologiaRESUMO
Centrofollicular B Cell lymphomas constitute 25% of non-Hodgkin lymphomas that originate in the skin. They are the second in frequency of those lymphomas with extranodal location after gastrointestinal B lymphomas. The primary cutaneous centrofollicular lymphoma is characterized by the neoplastic proliferation of centrocytes and centroblasts confined to the skin. The prognosis is considered excellent with low probability of extracutaneous dissemination. We present a patient recently diagnosed in our unit with a good response to radiotherapy and complete resolution of the tumor with mild atrophy of the site.
Assuntos
Bochecha , Neoplasias Faciais/diagnóstico , Linfoma Folicular/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adulto , Doenças Assintomáticas , Neoplasias Faciais/patologia , Neoplasias Faciais/radioterapia , Feminino , Humanos , Linfoma Folicular/patologia , Linfoma Folicular/radioterapia , Radioterapia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/radioterapiaRESUMO
La psoriasis es una enfermedad crónica, inflamatoria, mediada inmunológicamente, con una considerable repercusión en la calidad de vida de los pacientes. Su importancia, además, está dada, entre otros factores, por su elevada prevalencia en la población. Los avances en el conocimiento de la inmunopatología de esta enfermedad y de la biología molecular han permitido el desarrollo de nuevos fármacos que representan una nueva forma de abordar la situación de estos pacientes, y que se encuadran en la denominada terapia biológica. El etanercept se empleó por primera vez en estudios clínicos con seres humanos en 1992 y ya son varios cientos de miles los enfermos tratados en todo el mundo por diferentes afecciones. Actualmente, la Agencia Europea de Evaluación de Medicamentos tiene aprobada la indicación de etanercept en las siguientes enfermedades: 1. Psoriasis en placa en adultos (adultos con psoriasis en placa, de moderada a grave, que no han respondido o que tienen contraindicada, o no toleran, otra terapia sistémica incluyendo ciclosporina, metotrexato o PUVA); 2. Psoriasis pediátrica grave en placa. 3. Artritis psoriásica; 4. Artritis reumatoidea; 5. Artritis idiopática juvenil poliarticular; 6. Espondilitis anquilosante. Su utilización en la psoriasis, ya bien conocida, ha hecho que poco a poco empiecen a surgir cuestiones sobre su manejo en situaciones especiales que requieren tener en cuenta las particularidades de su aplicación (lactancia, vacunaciones, infecciones) que abordaremos en este trabajo...