Dermatología » Artículos

Sun protection for preventing basal cell and squamous cell skin cancers

dermatologia — Fri, 05 May 2017 13:25:29 +0000

‘Keratinocyte cancer’ is now the preferred term for the most commonly identified skin cancers basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), which were previously commonly categorised as non-melanoma skin cancers (NMSC). Keratinocyte cancer (KC) represents about 95% of malignant skin tumours. Lifestyle changes have led to increased exposure to the sun, which has, in turn, led to a significant increase of new cases of KC, with a worldwide annual incidence of between 3% and 8%. The successful use of preventive measures could mean a significant reduction in the resources used by health systems, compared with the high cost of the treatment of these conditions. At present, there is no information about the quality of the evidence for the use of these sun protection strategies with an assessment of their benefits and risks.

Revisión sobre infecciones dermatológicas

Tania Izquierdo — Fri, 24 Mar 2017 15:54:52 +0000

Las infecciones de la piel y de los tejidos blandos son el resultado de la invasión microbiana de la piel y de sus estructuras de soporte. El manejo está determinado por la severidad y localización de la infección y por las comorbilidades del paciente. Las infecciones pueden clasificarse como simples (sin complicaciones) o complicadas (o no necrotizantes necrotizantes), o como supurativas o no supurativas. La mayoría de las infecciones adquiridas en la comunidad son causadas por Staphylococcus aureus resistente a la meticilina y por estreptococo beta-hemolítico.

Las infecciones simples suelen ser monomicrobianas localizadas y presentan hallazgos clínicos. En contraste, las infecciones complicadas pueden ser mono- o polimicrobianas y pueden presentarse con síndrome de respuesta inflamatoria sistémica. El diagnóstico se basa en la evaluación clínica. Las pruebas de laboratorio pueden ser necesarias para confirmar un diagnóstico incierto, evaluar infecciones profundas o sepsis, determinar la necesidad de atención hospitalaria, y evaluar y tratar las comorbilidades. La elección antimicrobiana empírica inicial es, y en infecciones simples debería cubrir especies de Staphylococcus y Streptococcus. Pacientes con infecciones complicadas, incluyendo fascitis necrotizante y gangrena, requieren cobertura antibiótica empírica, tratamiento hospitalario y consulta quirúrgica para el desbridamiento. Los abscesos superficiales y pequeños responden bien al drenaje y rara vez requieren antibióticos. Los pacientes inmunocomprometidos requieren tratamiento temprano y cobertura antimicrobiana para posibles organismos atípicos.

Este artículo amplia información clínica sobre estas entidades.

Vea el texto completo.

Ramakrishnan K, Salinas RC, Agudelo Higuita NI. Skin and Soft Tissue Infections. Am Fam Physician. 2015 Sep 15;92(6):474-83.

The Atopic March: Progression from Atopic Dermatitis to Allergic Rhinitis and Asthma

dermatologia — Tue, 07 Mar 2017 17:50:46 +0000

Atopic dermatitis (AD) is an inflammatory disease characterized by pruritic skin lesions. The pathogenesis of AD may include disrupted epidermal barrier function, immunodysregulation, and IgE-mediated sensitization to food and environmental allergens. AD is also part of a process called the atopic march, a progression from AD to allergic rhinitis and asthma. This has been supported by multiple cross-sectional and longitudinal studies and experimental data.

Vea el artículo completo.

Zheng T, Yu J, Oh MH, Zhu Z. The Atopic March: Progression from Atopic Dermatitis to Allergic Rhinitis and Asthma. Allergy, Asthma & Immunology Research. 2011;3(2):67-73. doi:10.4168/aair.2011.3.2.67.

Permethrin and Ivermectin Both Effective Against Scabies

dermatologia — Wed, 21 Mar 2012 17:17:40 +0000

March 8, 2012 — Permethrin may be slightly more effective than ivermectin in the treatment of scabies. In a study involving 272 patients, a single dose of ivermectin provided a cure rate of 85.9% at 2 weeks compared with a 92.5% cure rate at 2 weeks from 2 applications (at a 1-week interval) of permethrin. The difference was not statistically significant (P = .42) in this noninferiority trial.

Mohamad Goldust, MD, from Tabriz University of Medical Sciences, Iran, and colleagues report the results of their study comparing the efficacy of oral ivermectin with topical application of permethrin in the treatment of scabies in an article published online March 5 in the Journal of Dermatology. The authors found not only a slightly higher cure rate with permethrin but also that permethrin-treated patients recovered earlier.

The cure rate from ivermectin increased to 100% after patients were treated with permethrin after a 4-week interval, according to the authors. Treatment with ivermectin after permethrin increased the cure rate to only 94.2%.

The authors suggest that a single dose of ivermectin may not be effective because it fails to act against the organism at all stages of its life cycle. Although permethrin attacks both the adult organism and its eggs, ivermectin attacks only the adult organism.

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