RESUMEN

The management of hair and scalp conditions is difficult in any patient, especially given the emotional and psychological implications of hair loss. This undertaking becomes even more challenging in the ethnic patient. Differences in hair care practices, hair shaft morphology, and follicular architecture add complexity to the task. It is imperative that the physician be knowledgeable about these practices and the phenotypic differences seen in ethnic hair in order to appropriately diagnose and treat these patients. In this chapter, we will discuss cultural practices and morphologic differences and explain how these relate to the specific disorders seen in ethnic populations. We will also review the most prominent of the ethnic hair conditions including acquired trichorrhexis nodosa, traction alopecia, central centrifugal cicatricial alopecia, pseudofolliculitis barbae, dissecting cellulitis, and acne keloidalis nuchae.

Asunto(s)

RESUMEN

Skin popping refers to the act of subcutaneous injection of intravenous drugs, a practice that often results in the development of cellulitis and the formation of soft tissue abscesses. Although the foot and ankle represent common injection sites, few data have described the presentation and natural history of this pathologic entity. The objective of the present study was to retrospectively assess the descriptive demographic data of a patient cohort admitted for lower extremity skin and soft tissue infection caused by intravenous drug abuse. Fifty skin popping lesions in 49 patients were identified during a 733-day data collection period (August 1, 2010 to August 31, 2012) that had been treated by the in-patient podiatric surgical service for lower extremity infection caused by intravenous drug abuse at an urban, level-one trauma center. With respect to patient race, our hospital has a typical in-patient census of 55% black patients and 25% white patients. The present patient cohort consisted of 12% black patients and 65% white patients. The mean length of stay was 5.71 ± 3.56 days, and 42 patients (85.71%) underwent some form of surgical debridement, with 31 (63.27%) having undergone a formal procedure in the operating room. Six patients (12.24%) left the hospital against medical advice or refused intervention at some definitive point of care, and 36 (73.47%) did not return for scheduled outpatient follow-up visits. Three cases (6%) resulted in minor amputation. The microbiologic culture data and common antibiotic prescriptions used in the diagnosis and treatment, respectively, of these patients have been summarized. We hope these original descriptive data can be used by other physicians treating patients at similar urban practices to improve the care of these sometimes difficult-to-treat patients and better serve this population as a whole.

Asunto(s)

Asunto(s)

RESUMEN

BACKGROUND: Acute lower limb cellulitis is a common yet potentially serious condition. Previous studies have identified risk factors in the non-U.K. population. Ethnicity has been postulated as a possible risk factor but has not previously been investigated. OBJECTIVES: To identify risk factors for acute lower limb cellulitis in the U.K. population. METHODS: One hundred and fifty consecutive patients with cellulitis requiring hospital admission and 300 controls were recruited to this prospective case-control study. Controls were matched for age and sex. RESULTS: Strongly predictive risk factors for acute lower limb cellulitis in the U.K. include being of white ethnicity and preceding episodes of injury to the affected leg. No systemic illnesses were identified as increasing an individual's risk of presenting with cellulitis. CONCLUSIONS: This study has identified that patients of white ethnicity are at higher risk of developing acute lower limb cellulitis compared with other ethnic groups. The importance of local risk factors has also been shown in the U.K. population.

Asunto(s)

RESUMEN

Se realizó un estudio retrospectivo en el Hospital de La Misericordia durante cinco años, recolectando 201 casos de pacientes con diagnóstico de celulitis periorbitaria con el fin de investigar su frecuencia en nuestro medio y conocer sus principales manifestaciones clínicas, focos de origen, comportamiento y complicaciones según los diferentes grupos etarios. El objetivo fundamental estuvo dirigido a realizar un diagnóstico más precoz de la celulitis preseptal (periorbitaria) o postseptal (celulitis orbitaria, absceso subperióstico, absceso orbitario, trombosis del seno cavernoso) con el fin de iniciar un manejo más oportuno, adecuado y racional de acuerdo a las diferentes variables que inciden en dicha patología. Los movimientos oculares fueron un predictor muy fidedigno para sospechar celulitis postseptal. Los principales focos de origen fueron: dentario, traumatismos, sinusitis y patología ocular y éstos a su vez estuvieron muy correlacionados con el motivo de consulta en los diferentes grupos de edad. Las radiografías de senos paranasales y la valoración odontológica fueron los principales medios para encontrar el foco de origen. Se observaron complicaciones en un 6.5 por ciento (13 pacientes) tales como: celulitis orbitaria, absceso subperióstico y recaídas, jugando un papel muy importante la TAC de órbita en el diagnóstico de estas entidades.

Asunto(s)