Trichilemmal carcinoma is a rare adnexal neoplasia with histologic features reminiscent of the outer root sheath of hair follicles. The clinical presentation of trichilemmal carcinoma is variable, as it may mimic basal cell carcinomas and squamous cell carcinomas, thus requiring histologic diagnosis. We report the case of a patient with aggressive trichilemmal carcinoma in the auricle.
Background Psoriasis is a chronic disease that derives great costs to the health care system. In Colombia, due to deficiencies in this system, patients are more likely to incur in out-of-pocket expenses; money that has never been quantified in this country. Objectives To quantify out-of-pocket expenses and to analyze their relation to patients' clinical and labor characteristics in a cohort of psoriatic patients. Methods A single-center, cross-sectional study was performed, evaluating psoriasis patients. Results A total of 100 psoriasis patients were analyzed. We identified that patients with higher dermatology life quality index and in phototherapy treatment were the ones that had higher out-of-pocket costs (p = 0.006 and 0.005, respectively). We found no correlation between out-of-pocket costs and occupational status, psoriasis area severity index or other types of treatment. The largest amount of money was used to buy medications and bus transportation with a maximum up to 440.50 and 528.60 USD, respectively. Among the 100 participants the total expense was 11131.90 USD in a 6-month period. Study limitations Lack of measurement of the labor productivity and labor absenteeism secondary to sick leave. Conclusion Out-of-pocket costs are similar with what was shown in previous studies. We found statistically significant differences for the DLQI in comparison with out-of-pocket expenses, regardless of the PASI level. Phototherapy treatment also had statistically significant differences in relationship with out-of-pocket expenses, when compared to other treatments, because it requires higher expenses in transportation, copayments, and alimentation during appointment assistance.
La inmunología es una ciencia joven dentro de las diferentes disciplinas de la medicina moderna. Nace finalizando el siglo XIX, con estudios basados en microbiología y el descubrimiento de la fagocitosis por Elias Metchnikoff. De allí surgen los primeros hallazgos de la inmunidad innata y se complementa con el descubrimiento de los anticuerpos neutralizantes por parte de Emil Behring y Paul Ehrlich. Luego de este descubrimiento, se empieza a hablar de inmunidad adquirida. Esta visión dicotómica dio lugar a cierta confusión y controversia y se necesitó algún tiempo hasta que se transformara en una perspectiva de complementariedad entre ambas vías, que consideraba a la inmunidad innata y adquirida como un par interactivo, un concepto entrelazado, parcialmente superpuesto y mutuamente beneficioso.
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