RESUMO
RESUMEN Introducción: el daño actínico crónico es un grupo de alteraciones en la estructura, función y apariencia de la piel como resultado de la exposición no controlada a las radiaciones ultravioletas. Puede provocar el cáncer de piel. Objetivo: caracterizar a los pacientes con daño actínico crónico, atendidos en la consulta de Dermatología del Hospital Comunitario Valle Hermoso, en el departamento de Cochabamba, Bolivia. Materiales y métodos: se realizó un estudio clínico descriptivo, prospectivo, en un universo de 1 833 pacientes diagnosticados con daño actínico crónico, atendidos en la consulta de Dermatología del Hospital Comunitario Valle Hermoso, en Cochabamba, entre septiembre de 2017 y septiembre de 2018. Se evaluaron las variables edad, sexo, color y fototipo de piel, ocupación, uso de medios de protección solar, exposición a otro tipo de radiaciones, manifestaciones clínicas de fotodaño y altitud del lugar de residencia. Resultados: predominaron el grupo de edad de 25 a 59 años, el sexo femenino, el color de piel mestizo (77,08 %), el fototipo de piel IV (76,98 %) y la ocupación comerciante (72,56 %). La mayoría de los pacientes (82,7 %) no utilizaron medios de protección solar, y el 99,8 % no tuvieron exposición a otro tipo de radiaciones. Las lesiones por fotodaño que prevalecieron fueron melasma (83,03 %) y lentigos (12,22 %). El 99,29 % vivían en zonas de gran altitud. Conclusiones: se caracterizaron los pacientes con daño actínico crónico, obteniendo en algunas variables estudiadas resultados similares a los mencionados por otros investigadores (AU).
ABSTRACT Introduction: chronic actinic damage is a group of alterations in the structure, function, and appearance of the skin as a result of uncontrolled exposure to ultraviolet radiation. It can cause skin cancer. Objective: to characterize the patients with chronic actinic damage, treated at the Dermatology consultation of Valle Hermoso Community Hospital, in the department of Cochabamba, Bolivia. Materials and methods: a descriptive, prospective clinical study was conducted in a universe of 1,833 patients diagnosed with chronic actinic damage, treated at the Dermatology clinic of the Valle Hermoso Community Hospital, Cochabamba, between September 2017 and September 2018. The variables age, sex, skin color, skin phototype, occupation, use of sun protectors, exposure to other types of radiation, clinical manifestations of photodamage and altitude of the place of residence were evaluated. Results: the age group from 25 to 59 years, the female sex, mestizo skin color (77.08 %), the IV skin phototype (76.98 %) and merchant occupation (72.56 %) predominated. Most patients (82.7 %) did not use sun protection means, and 99.8 % had no other radiation exposure. The prevailing photodamage lesions were melasma (83.03 %) and lentigo (12.22 %). 99.29 % lived in high altitude areas. Conclusions: the patients with chronic actinic damage were characterized, obtaining in some variables studied results similar to those mentioned by other researchers (AU).
Assuntos
Humanos , Masculino , Feminino , Pacientes/classificação , Transtornos de Fotossensibilidade/epidemiologia , Transtornos de Fotossensibilidade/diagnóstico , Efeitos da Radiação , Diagnóstico Clínico , Lentigo/diagnóstico , Melanose/diagnósticoRESUMO
Introducción: El envejecimiento cutáneo es parte de un proceso de deterioro endógeno y exógeno en las células. Los cambios degenerativos y metabólicos que ocurren, hacen a esta población vulnerable a afecciones dermatológicas. Objetivo: Definir las enfermedades cutáneas frecuentes en pacientes geriátricos, atendidos en consulta de dermatología. Métodos: Se realizó una investigación observacional descriptiva transversal, en pacientes geriátricos atendidos en la consulta de Dermatología en la Policlínica de Combatientes de Ciego de Ávila, en el periodo comprendido de enero a diciembre del 2019. La serie de estudio se conformó con 144 adultos mayores. Las variables estudiadas fueron: edad, sexo, color de piel, fototipos cutáneos, afecciones dermatológicas, localización y morbilidades asociadas. Resultados: Predominaron los adultos mayores entre 70 y 79 años (53,5 por ciento), del sexo masculino (50,7 por ciento). El 63,9 por ciento de los pacientes tenía fototipo cutáneo III. Las dermatosis más frecuentes fueron la púrpura senil (34 por ciento) y queratosis seborreica (25 por ciento), fueron más afectados los adultos mayores de piel blanca (69,4 por ciento). Las dermatosis en la cara y extremidades fueron las más frecuentes (53,5 por ciento y 17,4 por ciento). El 46,6 por ciento de los pacientes padecían de afecciones del sistema osteomioarticular, seguido por la hipertensión arterial (18,5 por ciento) y diabetes mellitus (12,6 por ciento). Conclusiones: Predominaron los adultos mayores del sexo masculino de 70 a 79 años, con fototipo cutáneo III. La púrpura senil, la queratosis seborreica y la xerosis fueron afecciones frecuentes en ancianos de piel blanca. Se destacaron las lesiones limitadas a la cara(AU)
Introduction: Skin aging is part of an endogenous and exogenous deterioration process in cells. The degenerative and metabolic changes that occur make this population vulnerable to dermatological conditions. Objective: To define frequent skin diseases in geriatric patients, seen in a dermatology office. Methods: A cross-sectional descriptive observational investigation was carried out in geriatric patients treated in the Dermatology consultation at the Policlínica de los Combatientes, Ciego de Ávila, in the period from January to December 2019. The study series consisted of 144 older adults. The variables studied were: age, sex, skin color, skin phototypes, dermatological conditions, location and associated morbidities. Results: Older adults between 70 and 79 years old (53,5 percent), male (50,7 percent) predominated. 63,9 percent of the patients had skin phototype III. The most frequent dermatoses were senile purpura (34 percent) and seborrheic keratosis (25 percent), older adults with white skin were more affected (69,4 percent). Dermatoses on the face and extremities were the most frequent (53,5 percent and 17,4 percent). 46,6 percent of the patients suffered from disorders of the osteomyoarticular system, followed by arterial hypertension (18,5 percent) and diabetes mellitus (12,6 percent). Conclusions: Older male adults from 70 to 79 years old, with skin phototype III predominated. Senile purpura, seborrheic keratosis, and xerosis were common conditions in white-skinned elderly. Lesions limited to the face were highlighted(AU)
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Humanos , Masculino , Idoso , Dermatopatias , Envelhecimento da Pele , Ceratose Seborreica , Dermatologia , Epidemiologia Descritiva , Estudos Transversais , Populações VulneráveisRESUMO
BACKGROUND AND OBJECTIVE: The minimal erythema dose (MED), an essential measurement in studies of skin photosensitivity, requires establishing MED values for specific populations, given genetic variation. Different ways to assess erythema are also relevant. We aimed to determine MED values in a sample of Colombian patients and correlations between MED and Fitzpatrick skin type. We also studied concordance correlation between MEDs and two alternative ways to assess erythema. PATIENTS AND METHODS: Cross-sectional study of 113 individuals in Bogotá, Colombia. We used a solar simulator to measure UV-A radiation and combined UV-A and UV-B (UVA+UVB) radiation, o se podría suprimir este término porque UVA y UVB son términos conocidos for MED calculation. Narrowband UV-B (NBUVB) radiation was measured in a phototherapy cabin. Erythema was assessed visually and with a Mexameter MX 18 device. RESULTS: The median MEDs of UVA+UVB radiation were 22mJ/cm2 for Fitzpatrick skin typesI andII, and 33 and 43mJ/cm2, respectively, for typesIII andIV. The MEDs of UV-A radiation were 22, 42, 86, and 100J/cm2 for typesI, II, III, andIV, respectively. The MEDs of NBUVB light were 390, 550, 770, and 885mJ/cm2 for the 4 skin types. The correlation between MEDs and skin types ranged from 0.5 to 0.69. Lin's concordance correlation coefficients between visual and Mexameter assessments of erythema were greater than 0.8 in all cases. CONCLUSION: This study allowed us to understand MED values for UV-A, UVA+UVB, and NBUVB according to different skin types in the Colombian population. Concordance correlation coefficients between the different methods of erythema assessment were very good. Correlations between MEDs and skin types were moderate to good.
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Eritema , Pigmentação da Pele , Colômbia , Estudos Transversais , Humanos , Raios Ultravioleta/efeitos adversosRESUMO
BACKGROUND: The Fitzpatrick skin phototype scale (FSPTS) is a widely used instrument to assess skin type. METHODS: A cross-sectional survey collected responses from 254 subjects from Quito regarding self-reported FSPTS, gender, age, education, and tobacco and alcohol consumption. Univariate and multivariate logistic regression analyses were performed to determine if ethnicity, hair color, and eye color significantly predict FSPTS. In addition, we studied the correlation between FSPTS and the SCINEXA scale with Pearson's correlation coefficient. RESULTS: Ethnicity, eye color, and hair color are significant independent predictors of FSPTS (p < 0.0001). CONCLUSIONS: Patient self-reported race and pigmentary phenotypes are inaccurate predictors of sun sensitivity as defined by Fitzpatrick skin phototype. Our study does not fully represent the population of the country. There are limitations to using patient-reported race and appearance in predicting individual sunburn risk.
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Transtornos de Fotossensibilidade/classificação , Transtornos de Fotossensibilidade/epidemiologia , Pigmentação da Pele , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Equador/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Fotossensibilidade/diagnóstico , Transtornos de Fotossensibilidade/fisiopatologia , Grupos Raciais , Fatores de Risco , Autorrelato , Pigmentação da Pele/fisiologia , Queimadura Solar/diagnóstico , Queimadura Solar/epidemiologia , Queimadura Solar/etnologia , Queimadura Solar/fisiopatologia , Bronzeado/fisiologiaRESUMO
Objective: We sought to evaluate serum 25-hydroxycholecalciferol (vitamin D [25-OHD]) levels, skin phototype, and sun index in a sample of patients to determine the association between these factors and metabolic risk. Design: This was a cross-sectional study involving 729 adults (50.2% male). Mean age was 65.13±9.18 years, sun index 5.71±5.06, body mass index (BMI) 27.60±5.34 kg/m2, and waist circumference 97.29±12.08cm. Hypertension, metabolic syndrome, and Type 2 diabetes were reported in 77.8, 74.5, and 38.9 percent, respectively; Fitzpatrick Skin Types III and IV were reported in 60.6 percent. Results: Mean serum 25-OHD was 25.72±10.91ng/mL; 31 percent of subjects had serum 25-OHD below 20ng/mL, and 63.1 percent had serum 25-OHD below 30ng/mL. Although there were no significant differences between the vitamin D deficient and sufficient groups regarding age, BMI, waist circumference, or presence of diabetes, in the group with 25-OHD less than 20ng/mL (sun index of 4.5±4.08), higher serum triglycerides and lower high-density lipoprotein cholesterol (HDL-C) levels were measured: triglycerides 179.14±103.53 versus 161.63±90.23mg/dL (p=0.029) and HDL-C 43.48±12.38 versus 45.94±14.14mg/dL (p=0.018) compared to the group with 25-OHD levels of 20ng/mL or higher (sun index: 6.25±5.36). Considering less than 25th percentile (25-OHD: 18.7ng/mL) and 75th percentile or higher (25-OHD: 30.8 ng/mL), the differences in serum triglycerides remained significant: 176.63±103.79 versus 157.47±80.49 (p=0.039). Conclusion: We found a high prevalence of vitamin D deficiency in individuals with high sun exposure, regardless of age, BMI, and waist circumference. This deficiency was associated with increased serum triglycerides and decreased HDL-C levels.
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BACKGROUND: Cancer is the main complication of transplantation surgery. The literature concerning renal transplant recipients among the Afro-Caribbean population is scant. The aim of this study was to determine the incidence of cancer in these patients, with the secondary objective being to identify predisposing factors for cancer. PATIENTS AND METHODS: This was an epidemiological and retrospective study that included all Guadeloupians of phototype V-VI undergoing renal transplantation from 01/01/2004 to 31/12/2011. Skin cancer screening was performed before transplantation and during an annual dermatological consultation following transplantation. Screening for non-cutaneous cancers was guided by clinical symptoms or by the results of the screening examinations recommended in the current guidelines. At the study time-point (31/12/2011), all patients were examined by a dermatologist. RESULTS: One hundred and two patients were included : 42 women and 60 men (mean age: 52.1±11.6 years at transplantation). Eight cancers were diagnosed. The cumulative incidence of cancer was 7.8% at 3 years. Three factors were associated with more rapid onset of cancer: personal history or familial history of cancer, and genital lesion induced by HPV. CONCLUSION: Our results suggest a low incidence of cancer in Afro-Caribbean renal transplant patients. Personal or family history of cancer and HPV-induced genital lesions would appear to accelerate the onset of cancer in this population.
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Transplante de Rim , Neoplasias/etnologia , Complicações Pós-Operatórias/etnologia , Neoplasias Cutâneas/etnologia , Adulto , África/etnologia , Região do Caribe/etnologia , Feminino , Guadalupe/epidemiologia , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/etiologia , Neoplasias Induzidas por Radiação/etnologia , Síndromes Neoplásicas Hereditárias/etnologia , Infecções por Papillomavirus/etnologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Risco , Neoplasias Cutâneas/etiologia , Luz Solar/efeitos adversos , Infecções Tumorais por Vírus/etnologiaRESUMO
Vitamin D deficiency has been linked to bone fragility in children and adults, and to an increased risk of chronic diseases. The main sources of vitamin D are the diet and cutaneous synthesis, the latter being the most important one, since foods are relatively poor in vitamin D. The main factors influencing this endogenous production are the seasons, the time of day, latitude and skin phototype. Due to the contribution of sun exposure in maintaining vitamin D levels, it would be expected that this deficiency would be more prevalent in countries at a high latitude; it has been shown, however, that hypovitaminosis D is commonly found in tropical regions such as Brazil. In high latitude regions in which extreme skin phototypes have been compared, the prevalence of vitamin D deficiency is more common in people with originally darker skin who have a natural barrier to the already lower UV irradiation penetrating the skin. In Brazil, particularly in the areas where sun rays are more abundant, the difference in sunlight exposure between subjects showed no significant variation in serum 25-hydroxyvitamin D (25OHD). .
A deficiência de vitamina D tem sido associada à fragilidade óssea em crianças e adultos e ao aumento do risco de doenças crônicas. As principais fontes de vitamina D são a dieta e a síntese cutânea, sendo esta última a mais importante, uma vez que os alimentos são relativamente pobres em vitamina D. Os principais fatores que influenciam essa produção endógena são as estações do ano, a hora do dia, a latitude e o fototipo de pele. Devido à contribuição da exposição solar em manter os níveis de vitamina D, seria de esperar que essa deficiência fosse mais prevalente nos países com alta latitude; no entanto, a hipovitaminose D é comumente encontrada em regiões tropicais como o Brasil. Em regiões de alta latitude em que os extremos de fototipos de pele foram comparados à prevalência de deficiência de vitamina D, é mais comum em pessoas com pele originalmente mais escura que têm uma barreira natural à já baixa penetração da irradiação UV na pele. No Brasil, particularmente nas áreas mais ensolaradas, a diferença de exposição solar entre os indivíduos não mostrou variação significativa nos níveis séricos de 25-hidroxivitamina D (25OHD).