תוצאת חיפוש

דני סלודובניק, אריה אינגבר

המח' לרפואת העור, בית-החולים האוניברסיטאי, הדסה עין-כרם 

במאמר להלן נסקרת הספרות הרפואית העדכנית לגבי יישומי הטקרולימוס ברפואת העור, תוך התמקדות בעיקר על המריחה המקומית של החומר.

יעילותו של טיפול במריחה מקומית הוכחה במספר מחלות עור, ובעיקר בדלקת עור אטופית. עובדה זו נעוצה במנגנון הפעולה של התרופה, שאתר הפעילות העיקרי שלה הוא לימפוציטים מסוג T. לפיכך, צפוי כי התרופה תספק מענה למחלות העור הדלקתיות, ביניהן ספחת, ליכן פלנוס, פיודרמה גנגרנוזום ועוד.

טקרולימוס אינו גורם להשפעות-הלוואי הנפוצות במריחה מקומית ממושכת של סטרואידים. רמתו הבטיחותית גבוהה, ולכן צפוי כי בעתיד יגבר הטיפול בתרופה זו בתחום הדרמטולוגיה.

Malignant Eccrine Poroma

R. Silfen, A. Amir, M. Feinmesser, D.J. Hauben

Dept. of Plastic and Reconstructive Surgery, and Pathology Dept., Rabin Medical Center (Beilinson Campus), Petah Tikva

Malignant eccrine poroma (MEP) is rare and both clinical and histologic diagnosis is often difficult. Therefore, diagnosis is sometimes delayed or even incorrect. We report a case in a 70-year old man with MEP of the leg. He demonstrated typical MEP behavior and the problems of differential diagnosis.

Burns in Children in Israel: Epidemiology, Prevention and Treatment

Arieh Eldad

Medical Corps, Israel Defense Forces and Burns Unit, Hadassah University Hospital, Ein Kerem, Jerusalem

45% of all hospitalized burn casualties in Israel are children younger than 16 years old. In various hospitals they make up 30-60% of all burn casualties, depending on the proportion of children in the area of hospital intake, social and economic factors and the type of hospital. Length of hospitalization of children is shorter than that of the general population (7.3 vs 9.0 days). Scalding is the main cause of thermal injuries among babies and infants (70%), while fire burns are the most common causes among adolescents (56.5%); 90% of babies are injured at home; only 40% of adolescents are burned in home accidents.

In Israel, burned children are treated in 25 different hospitals and in departments of pediatric surgery, plastic surgery, general surgery, pediatrics or burn departments. There is no pediatric burn unit in Israel.

Kimura's Disease and Angio- Lymphoid Hyperplasia

Henia Lichter, Karol Segal, Celia Mor, Raphael Feinmesser

Depts. of Ophthalmology, Otolaryngology and Pathology, Rabin Medical Center (Beilinson Campus), Petah Tikva, and Sackler Faculty of Medicine, Tel Aviv University

Kimura's disease is a rare angiolymphoid proliferative disorder of soft tissue characterized by subcutaneous swelling and a predilection for the head and neck. There are usually enlarged regional lymph nodes, eosinophilia and elevated sedimentation rate and IgE levels. A 26-year-old women with subcutaneous masses in the submandibular area is reported. The diagnosis of Kimura's disease versus angiolymphoid hyperplasia is discussed.

Primary Dermatology Who is the Gate Keeper?

A. Biton, D. Vardy, S. Naimer

Regional Dermatology Clinic, Kupat Holim Clalit, and Ben-Gurion University of the Negev, Beer Sheba

For several years health funds in Israel have allowed patients to see dermatologists, gynecologists, orthopedic surgeons and ENT specialists without being referred by their primary care physician. There is heated debate about whether this practice is justified and if it is cost effective. Is it better medicine for the patient? What are the roles of the primary care physician and of the primary dermatologist in the care of skin diseases? What do patients want? We examined the practices of 4 dermatology clinics and discuss the issues involved.