Pigmented purpura and cutaneous vascular occlusion syndromes

Purpura is defined as a visible hemorrhage in the skin or mucosa, which is not evanescent upon pressure. Proper classification allows a better patient approach due to its multiple diagnoses. Purpuras can be categorized by size, morphology, and other characteristics. The course varies according to the etiology, as do the diagnostic approach and treatment. This review discusses pigmented purpuras and some cutaneous vascular occlusion syndromes

Dermoscopic features of acral melanocytic nevi in a case series from Mexico

Background: Pigmented lesions on acral sites are common; clinical differentiation of nevi and early melanoma can be challenging. In these cases, dermoscopy can provide a more accurate diagnosis. Most dermoscopic patterns on acral skin have been described in Asian and European populations, while there are few studies in Latin American populations. Objectives: To determine the frequency of pigmented lesions in volar skin and their dermoscopic patterns in a Mexican population. Methods: An observational, descriptive, cross-sectional study was performed in Hispanic patients with the presence of at least one pigmented lesion on acral skin. Clinical and dermoscopic images were obtained. These were subsequently evaluated independently by two dermatologists trained and experienced in dermoscopy. Results: A total of 582 pigmented lesions on volar skin were diagnosed in 321 patients. Overall, prevalence of acral pigmented lesions on volar skin was 6.8%. For both observers, parallel furrows were the most frequent pattern described, but for observer 2, a lattice-like pattern was prevalent on the toes and a homogeneous pattern on the sides of the feet. There was lower inter-observer agreement, with a kappa index of 0.144. Study limitations: The lesions were not biopsied, so clinical-histological correlation could not be performed. The study did not correlate dermoscopic patterns with age. Conclusions.: As previously reported by other authors, parallel furrows were the most frequently found dermoscopic pattern on palmoplantar skin

Proporcionalidade dos subsídios federais e matrículas em universidades públicas estaduais no México

Las Universidades Públicas en México (UPE´s), son instituciones que atienden el nivel superior cuya su función es desarrollar la academia mediante la docencia, investigación, extensión y difusión de la cultura; cada año firman un convenio con la Secretaría de Educación Pública (SEP) y su respectivo gobierno estatal para el cumplimiento de las funciones sustantivas. La presente investigación tiene como objetivo analizar si las UPE´s reciben los subsidios de manera proporcional a la matrícula atendida, y así, estar en igualdad de condiciones para el cumplimiento de sus objetivos. Para ello, se utilizó un estudio no experimental de tipo cuantitativo y descriptivo mediante datos agrupados, considerando como muestra el 100% de la población; el análisis contempla los años 2019, 2020, 2021 y 2022 referentes al subsidio federal recibido y la matrícula que atendieron en los periodos señalados, teniendo como principal resultado que el promedio de subsidio federal entregado por estudiante es de 58,000 pesos a 68,000 pesos y una desviación de 16,000 pesos; se determina que no existen criterios o reglas claras para la designación, demostrando que los incrementos son sujetos a factores políticos; siendo el indicador de matrícula un excelente referente para la asignación equitativa del subsidio federal.The Public Universities in Mexico (UPE’s) are institutions that serve higher education whose function is to develop the academy through teaching, research, extension and dissemination of culture; each year they sign an agreement with the Ministry of Public Education (SEP) and their respective state government for the fulfillment of their substantive functions. The objective of this research is to analyze whether the UPE’s receive subsidies in proportion to the enrollment served, and thus, be on equal terms for the fulfillment of their objectives. For this purpose, a non-experimental quantitative and descriptive study was used through grouped data, considering as a sample 100% of the population; the analysis contemplates the years 2019, 2020, 2021 and 2022 referring to the federal subsidy received and the enrollment attended in the indicated periods, having as main result that the average federal subsidy delivered per student is from 58,000 pesos to 68,000 pesos and a deviation of 16,000 pesos; It is determined that there are no clear criteria or rules for the designation, demonstrating that the increases are subject to political factors; the enrollment indicator is an excellent reference for the equitable allocation of the federal subsidy.As universidades públicas do México (UPEs) são instituições de ensino superior cuja função é desenvolver o meio acadêmico por meio do ensino, da pesquisa, da extensão e da disseminação da cultura; a cada ano, elas assinam um acordo com o Ministério da Educação Pública (SEP) e seu respectivo governo estadual para o cumprimento de suas funções substantivas. O objetivo desta pesquisa é analisar se as UPEs recebem subsídios proporcionais às matrículas atendidas e, portanto, se estão em pé de igualdade no cumprimento de seus objetivos. Para isso, foi utilizado um estudo quantitativo e descritivo não experimental, com dados agrupados, considerando 100% da população como amostra; a análise contempla os anos de 2019, 2020, 2021 e 2022 em relação ao subsídio federal recebido e à matrícula atendida nos períodos indicados, com o principal resultado de que o subsídio federal médio concedido por aluno é de 58.000 pesos a 68.000 pesos e um desvio de 16.000 pesos; Determinou-se que não há critérios ou regras claras para a designação, demonstrando que os aumentos estão sujeitos a fatores políticos; o indicador de matrícula é uma excelente referência para a alocação equitativa do subsídio federal

Anagen Effluvium after Neurointerventional Radiation: Trichoscopy as a Diagnostic Ally

Minimally invasive procedures for vascular brain lesions are being performed more frequently. Radiation exposure caused by endovascular embolization of cerebral aneurysms may give rise to nonscarring scalp alopecia located in the treated area. Clinical and trichoscopic features of this type of alopecia are similar to alopecia areata (AA). Herein, we performed a comprehensive review to describe the clinical and trichoscopic characteristics of radiation-induced anagen effluvium. Predominant trichoscopic findings include black dots, yellow dots, short vellus hairs, and absence of exclamation marks hairs. It is important to consider this diagnosis in patients who have recently undergone such procedures that can easily be misdiagnosed as AA

Glioblastoma talámico bilateral

Se presenta el caso de un paciente con glioma talámico bilateral e independiente, con mayor afección del lado izquierdo. Esto se demuestra por resonancia magnética con gadolinio, confirmando que no hay continuidad entre ambas lesiones. Se somete a cirugía resecando un 60% aproximadamente, de ambos tumores. El estudio histopatológico reporta glioblastoma multiforme

Tomographic index (ONSD/ETD) as a predictor of short-term neurological outcome in children with severe traumatic brain injury: A single-center retrospective observational study from Mexico

Background: Traumatic brain injury (TBI) is a prevalent condition in the pediatric population. An index between the diameter of the optic nerve sheath diameter (ONSD) and the transverse eyeball transverse diameter (ETD) measured in the tomographic scan has been described in adults, with a cutoff value of ≥0.25 for predicting poor neurologic prognoses. This study was conducted to analyze the relationship between the index ONSD/ETD with the neurological outcome in children with severe TBI. Subjects and Methods: This was single-center, retrospective study, conducted from March 2021 to November 2022. Patients older than 30 days and up to 16 years of age admitted with severe TBI were included in the study. Measurements of the ONSD/ETD index by cranial tomography were calculated. The population was divided into two groups, one with index ≥0.25 and other with index <0.25. Glasgow Outcome Scale-Extended (GOSE) and outcome were compared between groups. Results: Thirty patients were recruited. Patients with inde × 0.25 or higher had a lower GOSE (60% (1–2 points) vs. 60% (7–8 points)), more days of mechanical ventilation (MV) (8 days, interquartile range IQR 5–17 days vs. 3 days, IQR 2–4 days P = 0.005), and more length of pediatric intensive care unit (PICU) stay (12 days, IQR 9–23 days vs. 5 days, IQR 4–8 days P = 0.007) than patients with index <0.25. Conclusions: The ONSD/ETD index was a reliable indicator for predicting the neurological outcome of patients with severe TBI. An index ≥0.25 was associated with more days of PICU stay and MV with worse neurological outcomes

Basal cell carcinoma treated with Mohs micrographic surgery in young Ibero-American patients

The incidence of basal cell carcinoma (BCC) in younger individuals has increased in recent decades. However, the characteristics of BCCs in this population, especially in Ibero-Latin American countries, have not been completely defined. To describe the demographic, clinical, and histopathological characteristics of BCCs in patients younger than 40 treated with Mohs Micrographic Surgery (MMS). A multicenter, retrospective study conducted between January 2009 and December 2014, in five Ibero-American countries, included biopsy-proven BCCs in patients younger than 40 that were treated with MMS. Demographic, clinical, histopathological, and surgical characteristics were described. The study included 301 tumors in 241 patients, of whom 61% were female. The most common Fitzpatrick phototype was III. The most common histological subtypes were nodular (37.5%) and infiltrative (18.9%). Perineural invasion was encountered in 1.7%, and tumor clearance was achieved in 87.4% within two stages of MMS. This is the first Ibero-Latin American transnational study describing the characteristics of BCCs in young patients treated with MMS. Despite darker skin phototypes in this population, BCCs can occur in early ages and may present with aggressive features. Therefore, MMS may be considered an appropriate first-line treatment option in this population