REVISTA IBERO-AMERICANA DE PODOLOGIA

Tratamento de Onicomicose por Terapia Fotodinâmica

Ariane Cristina Bueno da Costa Nunes — 2024-09-07

Photodynamic therapy (PDT) is a technique that uses a light-emitting device and a photosensitizing chemical agent (PS) to treat diseases caused by microorganisms, such as fungi, bacteria and viruses. Several studies have been carried out and suggest that PDT can be an efficient alternative in the treatment of onychomycosis. Based on these data, the objective of this work was to carry out a review of the literature on onychomycosis and the response to treatment based on PDT. For this purpose, a search was carried out in the literature using the descriptors: onychomycosis, photodynamic therapy, LED, leisure, methylene blue or photosensitizer, with the time interval of 2014-2024. Studies have demonstrated the efficiency of PDT in the treatment of onychomycosis caused by different pathogens, making this an alternative to the use of antifungals. However, there are several light sources and FS evaluated for the application of therapy. Therefore, the most used light source was LED associated with methylene blue, which demonstrated considerable antifungal action in all selected articles, reducing or even eliminating the pathogen. Other light sources used were LASER (Light Amplification by Radiation Emission), both low (LBI) and high intensity (LAI), however LBI did not show satisfactory results when compared to LAI and LED. Thus, PDT is an effective method for the control and treatment of onychomycosis; however, its results depend on the degree of the pathology, the photosensitizer and the light source used.

Severity of peripheral neuropathy, in different domains, in type II diabetic patients

Liliana Avidos — 2024-04-02

Introduction: Diabetes mellitus is a chronic degenerative disease that can significantly impact both life expectancy and quality of life among affected populations, primarily by disrupting metabolic control and exacerbating disease complications. Objective: To assess the severity of neuropathy across four domains (pain, loss of sensation, postural instability, and depression) in individuals with diabetes mellitus. Materials and Methods: This was a cross-sectional, descriptive-correlational, and qualitative study The study population comprised diabetic individuals attending outpatient clinics for diabetic foot care at Hospital de S. João - Unidade de Valongo and Centro Hospitalar do Alto Ave in Guimarães. Variables included gender, age, type and duration of diabetes, neuropathic characteristics, balance, dependency/independence, and depression. Results: Regarding neuropathy severity, most diabetic patients exhibited loss of sensation and moderate pain, with no apparent postural instability or depression. However, both instability and depression were observed when neuropathic signs were present. Conclusions: The presence of neuropathic signs was associated with increased postural instability, reduced functionality, and a higher prevalence of depressive symptoms. Furthermore, a positive relationship was observed between pain severity and depressive symptomatology.

Un Epidermal cyst in the foot: Biomechanical impact and treatment in a clinical case.

Sergi Sánchez Hernández — 2024-07-10

Introducción: El artículo presenta un caso clínico de quiste epidérmico en el pie, explorando su impacto biomecánico y el tratamiento quirúrgico realizado. Se pretende resaltar la importancia de considerar estos quistes como diagnóstico diferencial en nódulos cutáneos, especialmente en localizaciones inusuales como el talón.

Métodos: Se describe el caso de un hombre de 36 años con tumor nodular en el borde plantar medial del talón izquierdo, de 5 años de evolución. Se realizarán exploraciones clínicas, radiografías, ecografías y resonancias magnéticas para evaluar la lesión. Finalmente se realizó una escisión quirúrgica completa bajo anestesia local.

Resultados: La intervención quirúrgica fue exitosa y los análisis histopatológicos confirmaron el diagnóstico de quiste epidérmico roto con granuloma de queratina. La paciente presentó una evolución postoperatoria favorable, con adecuada cicatrización y ausencia de complicaciones. Tras dos meses de la cirugía, el paciente reanudó su trabajo sin incidencias, y un año después, sin dolores ni limitaciones funcionales.

Conclusiones: Este caso resalta la importancia de incluir los quistes epidérmicos como diagnóstico diferencial en los nódulos cutáneos, incluso en zonas menos comunes como el talón. La confirmación histopatológica es fundamental para un diagnóstico preciso. La intervención quirúrgica sobre el terreno mejora la calidad de vida del paciente al eliminar la lesión y el dolor asociado, lo que además proporciona la confirmación diagnóstica necesaria.