RESUMEN
Cutaneous malignant melanoma accounts for 3 to 5 percent of all skin cancers and is responsible for approximately 75 percent of all deaths from skin cancer. Persons with an increased number of moles, dysplastic (also called atypical) nevi, or a family history of the disease are at increased risk compared with the general population. An important tool to assist in the evaluation of potential melanomas for patients and health care professionals is the ABCDE mnemonic, which takes into account asymmetry, border irregularities, color variation, diameter, and evolution. Any suspicious pigmented lesion should be biopsied. Appropriate methods of biopsy can vary, and include deep shave, punch, and excisional biopsy. Regardless of the procedure selected, it is essential that the size of the specimen be adequate to determine the histologic depth of lesion penetration, which is known as the Breslow depth. The Breslow depth is the most important prognostic parameter in evaluating the primary tumor. Because early detection and treatment can lead to identification of thinner lesions, which may increase survival, it is critical that physicians be comfortable with evaluating suspicious pigmented lesions and providing treatment or referral as necessary.
Asunto(s)
Melanoma , Neoplasias Cutáneas , Biopsia , Dermoscopía , Humanos , Incidencia , Melanoma/diagnóstico , Melanoma/epidemiología , Melanoma/patología , Melanoma/cirugía , Estadificación de Neoplasias , Nevo/patología , Guías de Práctica Clínica como Asunto , Atención Primaria de Salud , Piel/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Estados Unidos/epidemiologíaAsunto(s)
Bursitis/etiología , Dermatitis por Contacto/etiología , Articulación del Codo , Exposición Profesional/efectos adversos , Olécranon , Neumonía/etiología , Sepsis/etiología , Adulto , Antibacterianos/uso terapéutico , Biopsia , Bursitis/diagnóstico , Bursitis/terapia , Dermatitis por Contacto/diagnóstico , Dermatitis por Contacto/terapia , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Masculino , Enfermedades Profesionales , Neumonía/diagnóstico , Neumonía/terapia , Sepsis/diagnóstico , Sepsis/terapiaAsunto(s)
Eritema Nudoso/microbiología , Dermatosis de la Mano/microbiología , Infecciones por Mycobacterium no Tuberculosas/diagnóstico , Mycobacterium marinum , Antiinfecciosos/uso terapéutico , Diagnóstico Diferencial , Eritema Nudoso/tratamiento farmacológico , Femenino , Antebrazo , Dermatosis de la Mano/tratamiento farmacológico , Humanos , Persona de Mediana Edad , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológicoRESUMEN
Psoriasis, a T-cell-mediated disorder, affects 1% to 3% of the world's population. The characteristic lesions occur in many different forms, can cause significant discomfort and social distress, and in some instances, lead to dehydration and metabolic derangement. A chronic, unpredictable course and the necessity of periodically switching drugs or classes of drugs make psoriasis frustrating to treat. However, topical and systemic drug therapies and phototherapy can help minimize the exacerbations and prolong remissions. In this article, Dr Shenenberger outlines treatment approaches and discusses research into the use of immunomodulatory agents.
Asunto(s)
Antiinflamatorios/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Factores Inmunológicos/uso terapéutico , Inmunosupresores/uso terapéutico , Terapia PUVA , Psoriasis/terapia , Frustación , Humanos , Terapia PUVA/métodos , Psoriasis/tratamiento farmacológico , Psoriasis/psicología , Calidad de VidaAsunto(s)
Eritema Nudoso/diagnóstico , Pierna/patología , Piel/patología , Adulto , Antiinflamatorios no Esteroideos/uso terapéutico , Diagnóstico Diferencial , Edema/etiología , Eritema Nudoso/complicaciones , Eritema Nudoso/tratamiento farmacológico , Femenino , Humanos , Ibuprofeno/uso terapéutico , Dolor/etiologíaRESUMEN
Unwanted facial hair is a common problem that is seldom discussed in the primary care setting. Although men occasionally request removal of unwanted facial hair, women most often seek help with this condition. Physicians generally neglect to address the problem if the patient does not first request help. The condition may be caused by androgen overproduction, increased sensitivity to circulating androgens, or other metabolic and endocrine disorders, and should be properly evaluated. Options for hair removal vary in efficacy, degree of discomfort, and cost. Clinical studies on the efficacy of many therapies are lacking. Short of surgical removal of the hair follicle, the only permanent treatment is electrolysis. However, the practice of electrolysis lacks standardization, and regulation of the procedure varies from state to state. Shaving, epilation, and depilation are the most commonly attempted initial options for facial hair removal. Although these methods are less expensive, they are only temporary. Laser hair removal, although better studied than most methods and more strictly regulated, has yet to be proved permanent in all patients. Eflornithine, a topical treatment, is simple to apply and has minimal side effects. By the time most patients consult a physician, they have tried several methods of hair removal. Family physicians can properly educate patients and recommend treatment for this common condition if they are armed with basic knowledge about the treatment options.