By Alberto J. Machado

ISBN-10: 9872427577

ISBN-13: 9789872427573

ABC en emergencias fue pensado como una herramienta de trabajo. Un ayuda memoria, o una guía rápida acerca de cómo enfrentamos, y que puntos relevantes no dejar de considerar, en distintas situaciones frecuentes en Emergencias.

Emergencias es l. a. especialidad médica que estudia los hechos y situaciones patológicas de aparición súbita que ponen en riesgo o comprometen los angeles salud.

En Emergencias el tiempo nos corre, y el momento en que tomamos diferentes conductas, durante l. a. evolución del paciente, inftuye directamente en el pronóstico.

En ninguna otra especialidad, se pone en juego los angeles capacidad de decisión tiempo dependiente.

La acción organizada y sistematizada frente a una emergencia, es los angeles que redundará en mayores beneficios, permitiéndonos valorar que "es" y que "no es" de riesgo important. Un manejo desorganizado, transforma los angeles situación, que de por sí ya es crítica, en un caos con el perjuicio directo sobre el paciente.

ABC en emergencias es un instructional de consulta rápida, cuando tenemos poco tiempo para consultar.

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Sevila A, Escudero A. Guillen C. Melanotic pigmentation in ex cision sc ars of melanocytic and non-m elanocytic skin tumors . J Cutan Pathol 1999:26:13 7-/44 . Gilchrest BA . Effect of aging and chronic sun exposures on melanocytes. J ln vestig Dermatol / 979: 73: 141-43. Jones SK . Moseley H. UVA-indu ced melanocytic lesions. Brit J Dermatol /987: 117: 1I 1-//5. Kietzmann H. Chr istophers E. Pigmentary lesions aft er PUVA treatm ent . Dermatologica 1984; 168: 306-308 . Sagebiel RW . Atlas ofskin path ology Pigmented lesions.

Usually, Hutchinson's sign is absent in melanonychia striata, namely the pigmentation does not extend beyond the periungual skin fold (but exceptions exist). Nail melanotic macules are often multiple, especially in dark skinned people (melanoma of the nail bed is, as a rule, a single lesion). The site is important too: melanotic macules are randomly distributed whereas 92% of subungual melanomas occur on the thumb or on the great toe. The lesion is very frequent amongst blacks (77% of the subjects above 20 years of age) and is not very rare even in Caucasians (1% of the population).

A sign of benignity may be the stability of the lesion that is maintained after the phase of initial growth (although exceptions occur) . Histologically (Fig. 4) lesions have the same appearance as their vulvar counterpart. Other associated conditions with multiple melanotic macules are the Peutz-Jeghers syndrome where the macules appear in the perioral region and in the oral cavity, on the extremities and also on the nail bed and matrix; the macules are associated with intestinal polyps. (see next pag e) • Melanotic macules of the nail bed and matrix Nail melanosis (Pappert) presents itself as a narrow, pigmented and longitudinal strip that includes the matrix and the nail bed.

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ABC en emergencias by Alberto J. Machado

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