Tirbanibulina: revisión de su mecanismo de acción novedoso y de cómo encaja en el tratamiento de la queratosis actínica

Actinic keratosis (AK) is a skin condition characterized by the proliferation of mutated keratinocytes that can develop into squamous cell carcinoma. Available therapies, although effective, are associated with a high frequency of severe local skin reactions. Tirbanibulin, one of the treatments for AK currently in development, is a new synthetic chemical entity with anti-proliferative and anti-tumor effects, both in vitro and in vivo, with proved efficacy in the treatment of AK, which has been recently demonstrated in two phase III clinical trials. In the present review, the tirbanibulin mechanism of action, based on the relevant literature and the results of several unpublished preclinical studies, is shown. In addition, the current scenario regarding the available treatments and how the novel tirbanibulin mechanism of action fits into the treatment of AK is raised.     

Síndrome de Osler-Weber-Rendu y su relación con la dermatología

Osler-Weber-Rendu syndrome, also known as hereditary hemorrhagic telangiectasia, is a rare autosomal dominant disorder with an estimated worldwide prevalence of 1 case per 10,000 population. Its clinical manifestations are the result of arteriovenous malformations characterized by telangiectases that can affect the skin, mucous membranes, and solid organs and cause life-threatening conditions, such as liver disease, systemic emboli, and heart failure. Timely diagnosis is thus essential in order to prevent disease-related complications and offer genetic counseling to families. We review the clinical features of Osler-Weber-Rendu syndrome with a focus on mucocutaneous manifestations and their treatment.     

Actualización del consentimiento informado en dermatología

Spanish legislation recognizes patients’ right to be informed about various aspects of their illness and to make autonomous decisions regarding diagnosis and treatment. As dermatologists, we need to become familiar with this legislation, heed its stipulations, and implement them in our practice.     

Anticoagulación y antiagregación en Dermatología

An increasing number of patients who are receiving anticoagulation or antiplatelet therapy require cutaneous surgery. Such pharmacotherapies are usually suspended based on experience in gynecologic, thoracic, and abdominal surgery. However, this practice may increase the risk of suffering a thromboembolic event. We review perioperative management of anticoagulant and antiplatelet therapy, complications associated with suspending therapy, and side effects.     

Proyecto CUDERMA: Consenso Delphi de los indicadores de calidad para la certificación de las unidades de dermatología de atención en dermato-oncología

Quality indicators are crucial for standardizing and guaranteeing the quality of health care practices. The Spanish Academy of Dermatology and Venereology (AEDV) launched the CUDERMA Project to define quality indicators for the certification of specialized units in dermatology; the first 2 areas selected were psoriasis and dermato-oncology. The aim of this study was to achieve consensus on what should be evaluated by these indicators using a structured process comprising a literature review and selection of an initial list of indicators to be evaluated in a Delphi consensus study following review by a multidisciplinary group of experts. The selected indicators were evaluated by a panel of 28 dermatologists and classified as either «essential» or «of excellence». The panel agreed on 84 indicators, which will be standardized and used to develop the certification standard for dermato-oncology units.     

Demografía y distribución de los dermatólogos en Chile

IntroductionAt present, the demand for medical specialists is a subject of discussion and debate in Chile, with variable gaps existing between attention and offer. The objective of this study is to characterize and update the information on the geographic and demographic distribution of dermatologists in Chile until January 2019.Materials and methodsThe information search was developed through the Superintendence of Health, the Chilean Society of Dermatology and Venereology and National Autonomous Corporation for the Certification of Medical Specialties. The Ministry of Health was asked about the number of dermatologists and their hours hired in the public system. The data was tabulated and analyzed in Excel and Stata 14 and GeoDA 1.18.0 software.ResultsDermatologists in Chile: 512, with a distribution rate of 2.9 dermatologists per 100,000 inhabitants, 64% is concentrated at the Metropolitan Region (MR), which has the highest proportion of dermatologists (4.7 per 100,000 inhabitants). 56% registered a degree granted by a Chilean University. 162 dermatologists work at the public system, mainly at MR (52%). Antofagasta, and Arica and Parinacota regions have the lowest amount of hired hours per week (44 hrs per week).ConclusionChile presents a similar number of dermatologists than Ecuador, but a lower number than Brazil, Argentina and a large part of the European countries. We observed heterogeneous distribution of dermatologists among Chilean regions. The highest concentration is at Metropolitan Region. More studies are needed to characterize dermatology in Chile.