Clinical case of plantar verrucous carcinoma versus diabetic foot.

Caso Clínico: Se presenta un caso de un carcinoma verrucoso en el hallux del pie derecho, que inicialmente fue extirpado completamente, evolucionando de forma tórpida hasta una posterior amputación transmetatarsiana sin evidencia de recidiva tumoral, durante su seguimiento en un periodo de 3 años, para evolucionar a otra entidad patológica como es el Pie Diabético. Discusión: Este carcinoma se caracteriza clínicamente por un lento crecimiento de aspecto similar a la verruga plantar, siendo su histología típica la invasión local mínima con algo de displasia y baja incidencia de metástasis y presenta buen pronóstico. Para el diagnóstico correcto, es imprescindible la biopsia quirúrgica. La resección radical es el tratamiento de elección con confirmación histológica de los márgenes de resección libres del tumor. Conclusiones: El carcinoma verrucoso plantar presenta una evidente dificultad diagnóstica, constituyendo la resección quirúrgica completa de la lesión el tratamiento de elección. Posee un buen pronóstico y mejor resolución. Excepcionalmente hay pacientes que presentan complicaciones a este tratamiento.Case report: A case of a verrucous carcinoma in the hallux of the right foot is presented, which was initially completely removed, evolving torpidly until a subsequent transmetatarsal amputation without evidence of tumor recurrence, during its follow-up over a period of 3 years, to evolve to another pathological entity such as the Diabetic Foot. Discussion: Verrucous carcinoma is clinically characterized by a slow growth similar in appearance to the plantar wart. The typical histology is a minimal local invasion with low incidence of metastasis and a good prognosis. Surgical biopsy is essential for correct diagnosis. Radical resection is the treatment of choice with histological confirmation of free resection margins of the tumor. Conclusions: The plantar verrucous carcinoma usually presents diagnostic difficulty. The complete surgical resection of the lesion is the treatment of choice presenting a good prognosis and prompt healing. As an exception, there are patients who present complications to this treatment.Medicin

Chronic wounds in Murcia area health

Objetivo: Identificar la prevalencia de heridas crónicas en el Área VI del Servicio Murciano de Salud e identificar, dentro de ellas, la proporción en base a las siguientes variables: por presión, vasculares, diabéticas, traumáticas o no conocidas/otros. Material y Método: Estudio descriptivo, transversal y retrospectivo. La muestra estuvo compuesta por todas las personas mayores de 13 años de edad, que presentaron al menos una herida crónica, en base a los registros clínicos del año 2014. La fuente de datos utilizada fue la historia clínica electrónica del paciente, en el ámbito de atención primaria de un Área de Salud de Murcia. Análisis estadístico descriptivo. Resultados: Se identificaron 639 personas con alguna herida crónica identificada en su historia clínica. La media de edad fue de 75,7 años. El género femenino fue significativamente el más frecuente (p<0,05). Se obtuvo una prevalencia de 1 individuo con úlcera por cada 225 analizados. Las proporciones y distribución de úlceras encontradas fueron: úlcera por presión (44%), úlceras vasculares (29%), úlceras traumáticas (15%), diabéticas (11%) y úlceras no conocidas (1%). Conclusiones: La prevalencia de úlceras en las zonas estudiadas asciende a un 0,45% lo que va en sintonía con otros estudios. La úlcera más frecuente es la úlcera por presión, seguidas por vasculares, traumáticas, diabéticas y otras.Objective: To identify the prevalence of chronic wounds in the area VI of Murcia Health Service and identify, within them, the share on the basis of the following variables: by pressure, vascular, diabetic, traumatic or not known/other. Material and Method: Descriptive, cross-sectional and retrospective study. The sample was composed of all persons over 13 years of age, who presented at least a chronic wound, on the basis of the clinical records of the year 2014. The data source used was the electronic clinical history of the patient, in the field of primary care in a Health Area of Murcia. Descriptive statistical analysis. Results: We identified 639 people with some chronic wound identified in its history. The average age was 75.7 years. The female gender was significantly the most frequent (p<0.05). It was obtained a prevalence of 1 individual with ulcer by each 225 analyzed. The proportions and distribution of ulcers found were: pressure ulcer (44%), vascular ulcers (29%), traumatic ulcers (15%), diabetes (11%) and ulcers do not know (1%).Enfermerí

Prevention of skin lesions after the use of personal protective equipment against infection.

Una de las grandes preocupaciones actuales que padecen los profesionales sanitarios que precisan del uso continuado de equipos de protección individual (EPI), sobre todo para el manejo del paciente con enfermedad COVID, es la protección y prevención de las lesiones en piel que dichos equipos producen como evento adverso. El presente artículo revisa esta afectación y sus causas: oclusión de la piel, evaporación del agua intradérmica, fricción, presión, humedad y reacciones químicas. Como conclusiones, la estrategia de prevención incluye abordar aspectos como el lavado e hidratación de la piel, prevención de la presión local y prevención de la humedad.One of the major concerns of today's healthcare professionals who require the continued use of personal protective equipment (PPE), especially for the management of patients with COVID disease, is the protection and prevention of skin injuries that such equipment produces as an ad-verse event. This article reviews this affectation and its causes: skin occlusion, intra-dermal water evaporation, friction, pressure, humidity and chemical reactions. As conclusions, the prevention strategy includes addressing aspects such as washing and moisturizing the skin, preventing local pressure and preventing moisture.Medicin

Frequency and Characteristics of familial melanoma in Spain: the FAM-GEM-1 Study.

Familial history of melanoma is a well-known risk factor for the disease, and 7% melanoma patients were reported to have a family history of melanoma. Data relating to the frequency and clinical and pathological characteristics of both familial and non-familial melanoma in Spain have been published, but these only include patients from specific areas of Spain and do not represent the data for the whole of Spain. PATIENTS AND METHODS: An observational study conducted by the Spanish Group of Melanoma (GEM) analyzed the family history of patients diagnosed with melanoma between 2011 and 2013 in the dermatology and oncology departments. RESULTS: In all, 1047 patients were analyzed, and 69 (6.6%) fulfilled criteria for classical familial melanoma (two or more first-degree relatives diagnosed with melanoma). Taking into account other risk factors for familial melanoma, such as multiple melanoma, pancreatic cancer in the family or second-degree relatives with melanoma, the number of patients fulfilling the criteria increased to 165 (15.8%). Using a univariate analysis, we determined that a Breslow index of less than 1 mm, negative mitosis, multiple melanoma, and a history of sunburns in childhood were more frequent in familial melanoma patients, but a multivariate analysis revealed no differences in any pathological or clinical factor between the two groups. CONCLUSIONS: Similar to that observed in other countries, familial melanoma accounts for 6.6% of melanoma diagnoses in Spain. Although no differences in the multivariate analysis were found, some better prognosis factors, such as Breslow index, seem more frequent in familial melanoma, which reflect a better early detection marker and/or a different biological behavior

Frequency and characteristics of familial melanoma in Spain: The FAM-GEM-1 Study

Similar to that observed in other countries, familial melanoma accounts for 6.6% of melanoma diagnoses in Spain. Although no differences in the multivariate analysis were found, some better prognosis factors, such as Breslow index, seem more frequent in familial melanoma, which reflect a better early detection marker and/or a different biological behavior

Successful rehabilitation of a homonymous hemianopia patient with binocular ground-in sectorial prisms: considerations concerning prism power and location

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