RESUMEN
BACKGROUND: Skin problems are among the most frequent reasons for seeking medical attention in primary care. In recent years, as a result of the process of adapting medical curricula to the requirements of the European Higher Education Area, the amount of time students spend learning the concepts of dermatology has been reduced in many universities. MATERIAL AND METHODS: In order to reach a consensus on core content for undergraduate education in dermatology, we sent a survey to the 57 members of the instructors' group of the Spanish Academy of Dermatology and Venereology (AEDV), asking their opinions on what objectives should be set for a dermatology course in Spain. A total of 131 previously selected objectives were listed. We then applied the Delphi method to achieve consensus on which ones the respondents considered important or very important (score≥4 on a Likert scale). RESULTS: Nineteen responses (33%) were received. On the second round of the Delphi process, 68 objectives achieved average scores of at least 4. The respondents emphasized that graduates should understand the structure and functions of the skin and know about bacterial, viral, and fungal skin infections, the most common sexually transmitted diseases (STDs), and the 4 main inflammatory dermatoses. Students should also learn about common complaints, such as itching and bald patches; the management of dermatologic emergencies; purpura and erythema nodosum as signs of internal disease; and the prevention of STDs and skin cancer. During clinical clerkships students should acquire the communication skills they will need to interview patients, write up a patient's medical history, and refer the patient to a specialist. CONCLUSIONS: The AEDV's group of instructors have defined their recommendations on the core content that medical faculties should adopt for the undergraduate subject of dermatology in Spain.
Asunto(s)
Curriculum , Dermatología/educación , Educación de Pregrado en Medicina , Venereología/educación , Humanos , EspañaRESUMEN
BACKGROUND: Human papilloma virus (HPV) is increasingly recognized as an important human carcinogen but its role in the aetiopathogenesis of basal cell carcinoma (BCC) in immunocompetent individuals is unclear. OBJECTIVE: A prospective case-control study was designed to compare the prevalence of HPV in BCC and normal skin samples from immunocompetent subjects and to assess the influence of different clinical features on the risk of cutaneous HPV. METHODS: A total of 142 samples from 70 BCC cases (superficial BCC 38 and nodular BCC 32) and 72 controls were analysed by a degenerated nested PCR technique. Clinical data were recorded and risk factors for HPV infection were assessed by multivariate analysis. RESULTS: There were 31 HPV DNA-positive samples. HPV was detected more frequently in cases (25.7%) than in controls (18.1%) and in nodular (31.3%) than in superficial (21.1%) BCC lesions but differences were not statistically significant. Older age (OR 1.5; 95% CI: 1.02-1.09) and actinic keratosis (OR 2.62; 95% CI 1.15-5.96) were the only significant factors associated to the presence of HPV. Risk of HPV positivity was also higher in blond-haired subjects, fair/pale skin colour, history of sunburn, solar lentigines and seborrheic keratosis but the differences were not significant. Both in cases and controls, ß -types were the most frequent. CONCLUSIONS: HPV does not seem to play a fundamental role in the aetiopathogenesis of either nodular or superficial BCC. The presence of HPV appears to be more related to actinic damage and possibly to an alteration of the barrier function associated with ageing.
Asunto(s)
Carcinoma Basocelular/virología , Inmunocompetencia , Papillomaviridae/aislamiento & purificación , Neoplasias Cutáneas/virología , Piel/virología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A randomized, double-blind, placebo-controlled trial was conducted to assess interferon-beta efficacy and safety in the treatment of anogenital condylomatous lesions. One hundred patients received a daily intramuscular injection of either interferon-beta (IFN-beta) (2 MIU/day) or placebo for 10 days. Of 94 evaluable patients, the complete response rate observed 8 weeks after treatment was significantly higher in the group receiving IFN-beta, as compared to the placebo-treated group (51% vs 28.9%, P < 0.05). After one year, 24 patients (100%) out of 24 complete responders to IFN-beta who attended for follow-up remained free of lesions. Twelve of 13 patients with complete response to placebo (92.3%) remained free of lesions after one year. Side effects were mild and no significant analytical changes were observed. In conclusion, interferon-beta is an effective and safe treatment for long-term eradication of anogenital condylomatous lesions.
Asunto(s)
Condiloma Acuminado/terapia , Interferón beta/uso terapéutico , Adulto , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intramusculares , Interferón beta/administración & dosificación , Interferón beta/efectos adversos , Masculino , Persona de Mediana Edad , EspañaRESUMEN
We describe two patients who developed multiple itching nodules following immunization with vaccines adsorbed on aluminium hydroxide. Both patients had been treated with vaccines for extrinsic asthma and rhinitis for 4 and 10 years respectively. The lesions were persistent and lasted for several years. Histopathological findings were those of a foreign body reaction. Aluminium was most probably involved in the pathogenesis of these lesions because its presence could be demonstrated in macrophages using energy-dispersive X-ray microanalysis. Although some symptomatic relief was achieved with topical corticosteroids and oral antihistamines, treatment was unsuccessful.
Asunto(s)
Alérgenos/efectos adversos , Hidróxido de Aluminio/efectos adversos , Asma/prevención & control , Desensibilización Inmunológica/efectos adversos , Erupciones por Medicamentos/etiología , Reacción a Cuerpo Extraño/inducido químicamente , Rinitis/prevención & control , Adulto , Brazo , Erupciones por Medicamentos/patología , Femenino , Reacción a Cuerpo Extraño/patología , Humanos , Inyecciones Subcutáneas , Pruebas del ParcheRESUMEN
We study here the case of a male patient aged 22 years with antecedents of Down syndrome and X-linked ichthyosis. The results obtained from the administration of 13-cis retinoic acid are commented upon. The association with other diseases and the treatment are also reviewed.
Asunto(s)
Enfermedades del Tejido Conjuntivo/complicaciones , Síndrome de Down/complicaciones , Tejido Elástico/patología , Ictiosis/complicaciones , Tretinoina/uso terapéutico , Adulto , Enfermedades del Tejido Conjuntivo/tratamiento farmacológico , Enfermedades del Tejido Conjuntivo/patología , Humanos , Ictiosis/genética , MasculinoRESUMEN
1,109 patients suffering from non-gonococcal urogenital infections have been studied. 63.4% of the patients had genital discharge. Microorganisms were found in 685 patients (61.8%), only one agent being isolated in 73.6% and two in 22.1% of the cases respectively. The rest of the patients had an association of three or more microorganisms. In women, the most frequently identified microorganism was Candida sp (29.9%), followed by U. urealyticum (20.5%) and G. vaginalis (19.7%). In men, U. realyticum (40.1%) was the most frequent followed by C. Trachomatis (21.4%) and M. hominis (16.6%).
Asunto(s)
Neoplasias de los Genitales Femeninos/etiología , Neoplasias de los Genitales Masculinos/etiología , Infecciones Urinarias/etiología , Adolescente , Adulto , Anciano , Infecciones Bacterianas/epidemiología , Candidiasis Vulvovaginal/epidemiología , Niño , Infecciones por Chlamydia/epidemiología , Femenino , Herpes Genital/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Infecciones por Mycoplasmatales/epidemiología , Enfermedades de Transmisión Sexual/etiología , Tricomoniasis/epidemiologíaRESUMEN
A retrospective study to investigate the relationship between the isolation of Chlamydia trachomatis and other factors occurring in 146 patients suffering of non-gonococcal urethritis, has been released 39 being positive for C. trachomatis. The relationship between the isolation of C. trachomatis and previous antibiotic treatment, age, sexual different contacts in the last month and year has been studied. The main feature affecting the isolation is the absence of antimicrobial therapy a previously to the specimen collection and being performed after four days post-contact.
Asunto(s)
Infecciones por Chlamydia/epidemiología , Uretritis/etiología , Adolescente , Adulto , Antibacterianos/farmacología , Infecciones Bacterianas/complicaciones , Chlamydia trachomatis/aislamiento & purificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Enfermedades de Transmisión Sexual/epidemiología , España , Uretritis/epidemiología , Uretritis/microbiologíaAsunto(s)
Eritema/patología , Lepra Lepromatosa/patología , Adulto , Eritema/complicaciones , Femenino , HumanosAsunto(s)
Mama , Queratosis/tratamiento farmacológico , Pezones , Tretinoina/uso terapéutico , Adulto , Mama/patología , Femenino , Humanos , Queratosis/patologíaAsunto(s)
Carcinoma de Células Escamosas , Dermatosis del Pie , Dermatosis de la Mano , Queratosis , Neoplasias Laríngeas , Síndromes Paraneoplásicos , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/diagnóstico , Humanos , Queratosis/patología , Neoplasias Laríngeas/complicaciones , Neoplasias Laríngeas/diagnóstico , Masculino , Persona de Mediana Edad , Síndromes Paraneoplásicos/patologíaAsunto(s)
Hipertensión Pulmonar/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Estenosis de la Válvula Mitral/complicaciones , Adolescente , Adulto , Femenino , Corazón/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Arteria Pulmonar/diagnóstico por imagen , Radiografía , Valores de ReferenciaRESUMEN
Neutrophilic dermatosis of the dorsal hands is a recently described disorder. It is still debatable if it constitutes a separate entity, a variant of Sweet syndrome or pyoderma gangrenosum or an overlap disorder of both. We report the clinical features, histopathological findings, and evolution of a 35-year-old patient with the diagnosis of neutrophilic dermatosis of the dorsal hands and distant lesions on the forehead.
Asunto(s)
Dermatosis de la Mano/etiología , Piodermia Gangrenosa/diagnóstico , Síndrome de Sweet/diagnóstico , Adulto , Antiinflamatorios/uso terapéutico , Dermis/patología , Diagnóstico Diferencial , Dermatosis Facial/tratamiento farmacológico , Dermatosis Facial/etiología , Femenino , Dermatosis de la Mano/tratamiento farmacológico , Dermatosis de la Mano/patología , Humanos , Neutrófilos/patología , Prednisona/uso terapéutico , Piodermia Gangrenosa/complicaciones , Piodermia Gangrenosa/tratamiento farmacológico , Síndrome de Sweet/complicaciones , Síndrome de Sweet/tratamiento farmacológico , Terminología como Asunto , Infecciones Urinarias/complicacionesRESUMEN
Eight cases of bowenoid papulosis are reported. The clinical diagnoses were confirmed by histology. In one case an immunoperoxidase method showed the presence of papillomavirus antigen in the nucleus of the most superficial epidermal cells. We consider bowenoid papulosis to be a condition with specific features that distinguish it clinically and histologically from carcinoma in situ and condylomata acuminata.
Asunto(s)
Enfermedad de Bowen/patología , Carcinoma de Células Escamosas/patología , Neoplasias del Pene/patología , Pene/patología , Neoplasias Cutáneas/patología , Adulto , Humanos , Masculino , Persona de Mediana Edad , Papillomaviridae/aislamiento & purificación , Pene/microbiologíaRESUMEN
Lipoatrophia semicircularis is an apparently rare condition, which presents as semicircular band-like atrophy of the subcutaneous fatty tissue and involving half the circumference of the anterolateral aspects of the thighs. Repeated external microtraumatism seems to be the most plausible explanation in several cases in the literature, though in some patients the underlying traumatic mechanism is difficult to establish. No relation to underlying clinical or biologic abnormalities appears to be. Seven patients with lipoatrophia semicircularis are described. A detailed clinical history revealed precipitating trauma in all cases. A review is made of earlier reports in the literature.
Asunto(s)
Lipodistrofia/etiología , Paniculitis/etiología , Piel/lesiones , Muslo/lesiones , Tejido Adiposo/patología , Adolescente , Adulto , Femenino , Humanos , Lipodistrofia/patología , Masculino , Persona de Mediana Edad , Paniculitis/patología , Piel/patologíaRESUMEN
Seven-three patients diagnosed with vascular dementia (VD) left to their natural evolution have been observed during a period of time of one year. The objective of this study is to find an index to quantify the degree of loss of cognitive capabilities in patients affected by VD, as well as to define the minimum loss of punctuation in this index, that can only be caused by an unfavourable evolution of the disease. This index, which we call Percentual Variation Index (PVI), is based on the evolution of the punctuations of the Cognoscitive Mini-Exam (CME) after a follow-up of one year. Our definition states that in order to consider patients as having cognitive impairment of vascular origin, they must lose more than 10% of their basal CME score in one year. This method could be useful in assessing the therapeutic efficacy of drugs used in treating such illnesses.
Asunto(s)
Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/etiología , Demencia Vascular/complicaciones , Pruebas Neuropsicológicas , Anciano , Femenino , Humanos , Masculino , Modelos PsicológicosRESUMEN
New inert materials such as polymerized silicones, Bioplastique, Artecoll, and Dermalive are now being used as injectable aesthetic microimplants. These substances are better than the old ones because they tend not to migrate and do not usually produce much of a host immune response. Adverse reactions after injection of these materials are rare, although there are a few reported cases as a result of bad technique or anomalous granulomatous reactions. We report on four patients with unsightly results after cosmetic microimplants, including one of Artecoll, one of Dermalive (to the best of our knowledge, the latter is the first such case reported), and two of silicone. This report describes the histopathologic features of cutaneous reactions to these injectable aesthetic materials.