INTRODUCTION:Dermatological disorders are common in medical practice. In medical school, however, the time devoted to teaching dermatology is usually very limited. Therefore, online educational systems have increasingly been used in medical education settings to enhance exposure to dermatology.OBJECTIVE:The present study was designed to develop an e-learning program for medical students in dermatology and evaluate the impact of this program on learning.METHODS:This prospective study included second year medical students at the University of Technology and Science, Salvador, Brazil. All students attended discussion seminars and practical activities, and half of the students had adjunct online seminars (blended learning). Tests were given to all students before and after the courses, and test scores were evaluated.RESULTS:Students who participated in online discussions associated with face-to-face activities (blended learning) had significantly higher posttest scores (9.0±0.8) than those who only participated in classes (7.75±1.8, p <0.01).CONCLUSIONS:The results indicate that an associated online course might improve the learning of medical students in dermatology.

Pigmented fungiform papillae of the tongue is a benign condition characterized by localized hyperpigmentation confined to fungiform papillae. Although the condition is not rare and might be easily diagnosed in dark-skinned adults and children, it is seldom mentioned in the medical literature. Here, we describe an 11-year-old boy presenting typical features of pigmented fungiform papillae of the tongue.

Clinical, Epidemiological, Laboratory and Therapeutic InvestigationAbstract: BACKGROUND -Several dermatologic findings have been associated with coronary artery disease and represent easily visualized signs that may contribute to classify cardiac risk by a non-invasive technique. OBJECTIVES -To evaluate the prevalence of some dermatologic findings in patients with or without coronary artery disease. METHODS -A case-control study involving male patients submitted to coronary angiography was performed. We included patients with greater than 50% obstruction of at least one coronary artery. Both groups were assessed as to presence of diagonal earlobe crease and preauricular crease, alopecia and thoracic hairiness. The results were adjusted for known cardiac risk factors: age, body mass index, diabetes, hypertension, dyslipidemia and smoking. RESULTS -One hundred and ten individuals were evaluated (80 patients, 30 controls). The prevalence of diagonal earlobe crease in patients (60%) was greater than controls (30%) (p<0.05). Androgenetic alopecia and thoracic hairiness were not associated to coronary artery disease. The odds ratio for diagonal earlobe crease was 3.1 (1.2-8.3) and for preauricular crease was 5.5 (1.9-16.3). The simultaneous finding of diagonal earlobe crease and preauricular crease resulted in a positive predictive value of 90.0%. CONCLUSIONS -The study detected a positive association between bilateral diagonal earlobe crease and bilateral preauricular crease with coronary artery disease. The simultaneous finding of both folds had high predictivity for coronary artery disease. Keywords: Coronary arteriosclerosis; Ear, external; Male; Risk factors de 3,1 (1,2-8,3) e para prega anterotragal foi de 5,5 (1,9-16,3 Resumo: FUNDAMENTOS -Diversas alterações dermatológicas foram associadas à doença arterial coronariana

Resumo: FUNDAMENTOS: O termo telemedicina faz referência ao uso de tecnologias de comunicação para a transmissão a distância de informações relacionadas à saúde. Esse recurso é utilizado em várias especialidades médicas, principalmente naquelas em que a interpretação de imagens representa uma etapa fundamental na formulação diagnóstica. OBJETIVO: Avaliar a concordância entre o diagnóstico presencial e o diagnóstico a distância de lesões cutâneas, utilizando a teledermatologia, em pacientes atendidos em uma unidade básica de saúde. MÉTODOS: Foi realizado um estudo prospectivo envolvendo pacientes atendidos no serviço de dermatologia da clínica FTC em Salvador -BA. Participaram do estudo um dermatologista responsável pela consulta presencial e dois dermatologistas responsáveis pela consulta a distância. Os diagnósticos obtidos através da teleconsulta foram avaliados quanto à concordância e comparados com os diagnósticos da consulta presencial. RESULTADOS: Foram incluídos neste estudo 60 pacientes. Observou-se um grau de concordância total variando de 86,6% a 91,6% com índice Kappa de 0,62. CONCLUSÃO: A teledermatologia é uma forma de assistência com um grande potencial de uso na dermatologia, podendo representar uma ferramenta útil principalmente em casos clínicos de baixa complexidade, oriundos de unidades básicas de saúde. Palavras-chave: Consulta remota; Diagnóstico; Telemedicina Abstract: Background: Telemedicine can be defined as the use of telecommunication technologies for the transmission of health data. It has been described in different medical specialties, especially those in which interpretation of images represents a fundamental key in formulating diagnosis. OBJECTIVE: To evaluate the role of teledermatology in primary care system. METHODS: A prospective analysis included 60 patients seen in a primary care unit. All patients were seen by a dermatologist as regular outpatient dermatology consultation. A medical student obtained digital images and a brief clinical history of all patients. Using a Telemedicine system these data were reviewed by two dermatologists for distance diagnosis. Agreement between the diagnoses was assessed. RESULTS: Good agreement, ranging from 86.6% to 91.6%, was achieved between direct observation and teleconsultation. Good agreement was also achieved between two telemedicine diagnosis (Kappa = 0.62). CONCLUSION: Teledermatology is a form of care with great potential for use in dermatology, and could represent a useful tool in cases of low complexity from primary health units.

No abstract