Presenter of 3 Presentations
SUSPICIOUS MUSHROOMS - A CASE REPORT
Abstract
Abstract Body
Background and Purpose: Flagellated dermatitis (FLD) is characterized by pruritic papules, papulovesicles or plaques that occur in an erythematous flagellated pattern that most commonly affects the trunk. One of the major causes of FLD is the consumption of raw or undercooked shiitake mushrooms (SM). Even though it is a common occurrence in Asia (local delicacy) it is rare in Western countries.
Methods: Case Report.
Results: 74-year-old man with a personal history of Hypertension, Type 2 Diabetes and Dyslipidemia treated with Indapamide, Metformin and Atorvastatin. Presented with a dorsal rash associated with intense itching with 3 days of evolution that appeared spontaneously, denying other signs or symptoms. A history of changes in usual medication, sun exposure or possible allergens was also denied. After further investigation, he revealed having ingested SM 4 days before. On objective examination, bullous erythematous lesions were observed with linear stretches in a flagellated pattern in the region of the back, shoulders and arms. He was medicated with topical corticosteroids and oral antihistamine with complete resolution of the condition.
Conclusions: This case demonstrates the multiplicity of entities that the Family Doctor (FD) deals with in its daily practice. Although FLD by SM is not a common occurrence, a detailed clinical history combined with its characteristic presentation leads to the diagnosis. In an increasingly globalized world, food consumption of another regions is becoming more common and it is important that the FD recognizes this type of pathologies that can be treated and oriented in the primary health care services.
PHYTOPHOTODERMATITIS – A SYSTEMATIC REVIEW
Abstract
Abstract Body
Background and Purpose: Phytophotodermatitis (PD) is a clinical dermatological diagnosis that refers to the phototoxic reaction caused by contact with parts of plants or fruits (PF) rich in phototoxic agents and subsequent exposure to ultraviolet light (UVL). PD is often underdiagnosed due to lack of knowledge about this entity. Our aim is to analyze evidence about the pathophysiology, clinic and treatment of PD.
Methods: A systematic review (SR) was performed using the Pubmed, Cochrane and Uptodate databases. Meta-analyzes, SR, reviews, clinical trials and documents about the purpose of the study were included.
Results: PD occurs when there is topical exposure to substances derived from PF, more commonly furocoumarins and psoralens, and subsequent exposure to UV light. Typically it presents with erythema, edema and bullous eruptions on the skin exposed to the sun and reflect the manner in wich the person have come in contact with the PF. The lesions may evolve to hyperpigmented macules. Treatment consists in the application of topical corticosteroids and analgesia with non-steroidal anti-inflammatory drugs. If there are bullous eruptions, they must be punctured, cleaned and treated with a dressing in order to protect from infection and promote re-epithelialization.
Conclusions: A complete medical history and the typical clinical findings allow an easy diagnosis of PD. Its conservative treatment can be performed in primary health care. The family doctor is, in most cases, the patient's first contact with health care so it is important his familiarization with this entity wich will allow an early diagnosis and correct treatment.
QUALITY PROTOCOL FOR THE CERVICAL CANCER SCREENING IN PRECONCEPTION CONSULTATION OR IN THE FIRST TRIMESTER OF PREGNANCY
Abstract
Abstract Body
Background and Purpose: Cervical cancer screening (CCS) consists in detecting the human papillomavirus that can lead to the development of cervical cancer, aiming to decrease the incidence of malignant neoplasia. The recommendation of The National Low Risk Pregnancy Surveillance Program is to update the CCS at the preconception consultation (PC) or at one of the first trimester consultations (FTC). Our aim is to sensitize physicians, women who are planning a pregnancy and pregnant women to the importance of performing the CCS when screening is not updated and to emphasize the importance of CCS registration, both by 50%.
Methodology: This is a retrospective assessment, whose target population are patients coded W78-Pregnancy, W79-Unwanted Pregnancy, W84 - Risk Pregnancy, as an active problem, and first consultation at PHC during preconception or before 13 weeks and 6 days of gestation, from the health centers of the authors of the study. September 2021: collecting data from the six months prior. October 2021 to March 2022: implementing corrective steps (such as knowledge verification questionnaires, awareness leaflets, family planning health education sessions and others). April 2022: evaluation of collected data.
Results: The evaluation of the CCS update in the PC or one of the FTC is rated as insufficient if less than 40%, sufficient if between 40% and 60%, and good if greater than 60%.
Conclusions: With the application of the corrective measures conceptualized in this quality protocol, we hope to achieve the goals setted.