Kaposi's sarcoma of the hand mimicking squamous cell carcinoma in a woman with no evidence of HIV infection: a case report

<p>Abstract</p> <p>Introduction</p> <p>Kaposi's sarcoma is a vascular neoplasm mainly affecting the skin of the lower extremities. Although it is the most common neoplasm affecting patients with AIDS, sporadic cases in HIV-negative people have been reported. It is a lesion mainly affecting men and its clinical presentation presents a challenge, as it can resemble other benign or malignant skin lesions.</p> <p>Case presentation</p> <p>We report a rare case of Kaposi's sarcoma presenting in a 68-year-old Mediterranean woman with no evidence of HIV infection. The patient had a 6-month history of a slowly progressing pigmented lesion on the dorsum of her left hand. The lesion clinically resembled a squamous cell carcinoma. The patient was treated with a wide excision of the lesion and primary reconstruction with a full thickness skin graft. Histopathological and immunohistochemical analysis of the excised lesion revealed the presence of Kaposi's sarcoma. Serologic investigation for HIV was negative but polymerase chain reaction for human herpes virus type 8 infection was positive. Thorough clinical and imaging investigation of the abdomen and chest were both negative for loci of disease.</p> <p>Conclusion</p> <p>Kaposi's sarcoma, although rare in its sporadic form, should be considered in the differential diagnosis of indeterminate skin lesions, especially those affecting the extremities.</p

The Assessment of Patient Satisfaction and Attendance of Community Pharmacies in Slovakia

Aim: Patient-oriented pharmaceutical care in pharmacies could improve patient satisfaction and influence patient’s choice of a community pharmacy. The aim of the work was to assess patient satisfaction and attendance in community pharmacies in Slovakia. Methods: A self-administered, anonymous questionnaire was distributed to patients visiting 33 community pharmacies in a total of 23 Slovak cities during October-December 2013. The questionnaire contained 29 items and three dimensions were supposed (managing therapy, interpersonal relationship, general satisfaction). A 5-point Likert-type scale (1 = very satisfied, 2 = satisfied, 3 = neither satisfied nor dissatisfied, 4 = dissatisfied, 5 = very dissatisfied) was used for assessing patient satisfaction. The results are presented in percentages and by the level of satisfaction within the range: high satisfaction (score 1.00-2.50), moderate satisfaction (score 2.51-3.50) and low satisfaction (score 3.51-5.00). Reasons for attendance in the community pharmacy and factors influencing pharmacy choice were evaluated either. Results: A total 2 844 respondents were included into the survey. Patient satisfaction with pharmaceutical care achieved high satisfaction level: interpersonal relationship (1.85 ± 0.598; 86.7% highly satisfied respondents) and general satisfaction (2.02 ± 0.643; 71.3% highly satisfied respondents). Managing therapy scored lower (2.24 ± 0.704; 65.4% highly satisfied respondents). The most frequently reported reasons for attending community pharmacy were to obtain prescription (70.4%) and over-the-counter medications (70.4%). The patient choice of a particular pharmacy was influenced by its location (74.1%). Conclusion: This study presents the first nationwide patientreported outcomes about patient satisfaction and attendance in community pharmacies in Slovakia. Future development and advancement of pharmacy practice leading to higher patient satisfaction requires modification of community pharmacists’ professional behaviour in Slovakia namely in managing therapy of patients