[Bowenoid papulosis. Review of 4 cases in a health center]. / Papulosis bowenoide. Revisión de cuatro casos en un centro de salud.

OBJECTIVE: To check the clinical, histological, evolutionary and therapeutic characteristics of Bowen's Disease. DESIGN: A descriptive study of a crossover type. SETTING: Primary Care and a Dermatology clinic at a Health Centre. PATIENTS: There were 4 adult males, aged between 25 and 31, with pigmented papulosis lesions on their external genitals. Two of them were HIV-positive. MEASUREMENTS AND MAIN RESULTS: Clinical records were used. The diagnosis was confirmed through histological analysis. In all cases the lesions were papulosis, multiple and affecting the external genitals. The patients were clinically controlled until the lesions disappeared. The patients' sexual partners were referred to Gynaecology clinics for examination, but no pathology was found in any of them. CONCLUSIONS: Basic knowledge of Bowen's Disease in Primary Care is important given that it is essential to reach a diagnosis as early as possible, in order to monitor the patient and his partner and so avoid any future complications arising from the pathology's presence, such as tumour processes affecting the uterine cervix. The performance of histological analyses when faced with any suspicious genital lesion must be encouraged, given that this technique is non-aggressive.

[An analysis of the referrals to specialist consultations made in a health center]. / Análisis de las derivaciones a las consultas de especialistas realizadas en un centro de salud.

The study of referrals from primary care areas permits the evaluation of health care in this level and reveals the educational requirements of the specialists in family medicine. Between January and April 1988 a prospective study was carried out to evaluate the referrals to the second level of care in the health center V Centenario. In 27,657 visits 1,906 referrals to the different specialties were ordered, which represents a rate of 6.89%. The most commonly consulted specialties were gynecology (18.94% of the overall referrals), ophthalmology (18.04%) and traumatology (16.10%). Psychiatry (1.41%), neurology (1.31%) and endocrinology (1.41%) were the specialties with the lowest referral rates. We compared our results with those from other authors and we have calculated what influence would be exerted on the second level of care if all primary care physicians had similar referral rates to those obtained in our center.