Actas dermo-sifiliográficas
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Actas Dermosifiliogr · May 2011
Review[Portfolios: a tool for the training and assessment of residents in dermatology, part 1].
The medical resident's portfolio is a collection of materials that show reflective learning in the context of clinical practice. A portfolio contains documents (such as case histories and questionnaires the resident has used), images, and video recordings that reveal that an individual has acquired the competencies needed for professional practice. A portfolio is an assessment tool that simultaneously supports learning and gives evidence for certifying competence. ⋯ The first step in creating a portfolio is to list required skills and abilities, along with the actions that will allow the resident to acquire them during each year of residency training. The ultimate goal is to define the resident's professional competence. We describe a model on which to base a training and assessment portfolio for residents in dermatology.
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Actas Dermosifiliogr · Oct 2010
Review[Immunofluorescence mapping for diagnosis of congenital epidermolysis bullosa].
The tools for diagnosis of epidermolysis bullosa have advanced greatly since Hintner's group introduced antigen mapping as a diagnostic test for this family of genodermatoses. Monoclonal or polyclonal antibodies raised against some of the specific proteins found in the epidermis and basement membrane of the epidermis have allowed 4 types of epidermolysis bullosa de be identified and all variants to be classified. ⋯ Examination under an optical microscope can suggest epidermolysis bullosa, but immunofluorescence mapping and electron microscopy are required for confirmation of the diagnosis and further classification of congenital epidermolysis bullosa. This article explains the importance of immunofluorescence antigen mapping and describes the methods employed for classification and subclassification of epidermolysis bullosa.
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Numerous therapeutic options are now available for the treatment of basal cell carcinoma. However, few randomized controlled trials with 5-year follow-up have compared the effectiveness of the different treatments. Such a comparison is difficult, probably because efficacy depends on several factors: those related to the tumor, the patient, the technique, and the dermatologist's experience. ⋯ We have divided them into 2 main groups-surgical and nonsurgical-and focus on the indications, advantages, and disadvantages of each one, as well as on the cure and recurrence rates. Then, based on the evidence reviewed, we attempt to provide an outline of the therapeutic strategies recommended in basal cell carcinoma, and the approach to be used in specific situations. We also describe our own experience.