Squamous cell cancer – 31-year epidemiological study in a city of south Brazil

BACKGROUND: The incidence and morbidity of squamous cell cancers are increasing worldwide. Epidemiological studies with morbidity coefficients about this type of cancer are scarce in Brazil. OBJECTIVES: To determine morbidity coefficients, analyze and classify the squamous cell cancers diagnosed in the city of Blumenau - SC from 1980 to 2011, according to clinical and histological features. METHODS: The authors revised 4000 histopathological exams with respect to sex, age, anatomic site and histological type. The morbidity coefficients were calculated using the number of squamous cell cancers found and the annual population estimated by the Brazilian Institute of Geography and Statistics between 1980 and 2011. RESULTS: A total of 4000 tumors were identified, 2249 (56.2%) in male and 1751 (43.8%) in female patients. The standard incidence rates varied from 40 cases in 1980 to 120 cases/100,000 inhabitants in 2011. The morbidity above 70 years of age reached 1484 cases/100,000 inhabitants in male and 975 in female patients. As to primary anatomic site, we found more tumors on the lips and ears in male and on the face and legs in female patients. As to the degree of involvement, the more frequent were Well Differentiated Squamous cell carcinomas (70%) and Moderate Squamous cell carcinomas (19,1%). The Low Differentiated Squamous cell carcinomas, which represented those with the worst prognosis, were found in 4.5% of the tumors. CONCLUSION: Squamous cell cancers in Blumenau - SC have similar patterns of distribution regarding age, primary anatomic site and histological types as found in the international literature. The morbidity increased by 300% in the last 31 years, which indicates that we need to dedicate special attention to the older population. .

Poroceratose de Mibelli com lesões gigantes: relato de caso / Porokeratosis of Mibelli with huge injuries: case report

Poroceratose de Mibelli é uma genodermatose disceratósicade forma crônica, progressiva e rara, comrisco de evolução para malignidade. É de transmissãoautossômica dominante e a patogenia é ainda desconhecida.O caso clínico mostra um paciente com 78anos de idade, com 75 anos de evolução de Poroceratosede Mibelli com lesões gigantes, exuberantes ehistória médica familiar da genodermatose. As lesõesda poroceratose de Mibelli são assintomáticas e maiscomumente encontradas nas extremidades, preferencialmentedorso das mãos e pés. Pode apresentar progressãoe regressão espontânea e ocasionar cicatrizeslevemente atróficas. O diagnóstico é clínico-histológico,apresentando a lamela coróide no histológico. A policeratosede Mibelli deve ser tratada para evitar a transformaçãoem células escamosas, doença de Bowen oucarcinoma basocelular.

Porokeratosis of Mibelli is a chronic, progressiveand rare genodermatosis disceratosica, that has therisk to become a malignant tumor. Its transmissionis mainly autosomal and the pathogenesis is stillunknown. The clinic case shows a patient with 78years, 75 years of those with evolving Porokeratosisof Mibelli, huge injuries, and familiar historic ofgenodermatosis. The injuries from the Porokeratosisof Mibelli are asymptomatic and generally found inthe ends of the body, preferably in the back of thehand or feet. The injuries can increase or diminishspontaneously and lead to scars a little atrophic.The diagnosis is clinical-histological, and it is representedby a choroid lamella in the histological. ThePorokeratosis of Mibelli may be treated to avoid thetransformation into squamous cells, Bowen diseaseor basal cell carcinoma.

Incontinência pigmentar: relato de caso / Incontinentia pigmenti: case report

A incontinência pigmentar é uma afecção hereditáriarara, dominante ligada ao cromossomo X. A condiçãoacomete o neonato afetando a pele, cabelos esistema nervoso central, tem maior incidência no sexofeminino, sendo letal, na maioria das vezes, quandoafeta o sexo masculino. A doença se caracteriza pormanifestações cutâneas e extra cutâneas, sendo a primeiramais prevalente. As lesões cutâneas são progressivasevoluindo em quatro estágios de acordo comcada fase evolutiva da doença. O diagnóstico baseia--se no quadro clínico e na apresentação histológica.A boa resposta ao tratamento clínico no relato de umcaso de incontinência pigmentar estimulou os autoresa discutir os aspectos etiológicos, diagnósticos e terapêuticosda enfermidade.

Incontinent pigment is a rare inherited disorder, Xchromosome-linked dominant The condition affectsthe newborn affecting the skin, hair and centralnervous system, has a higher incidence in females,being lethal in most cases, when it affects males.The disease is characterized by cutaneous and extraskin, the former being more prevalent. The skin lesionsare progressive evolving in four stages accordingto each phase of the disease diagnosis basedon clinical and histological presentation. The goodresponse to treatment in clinical report of a case ofpigmentary incontinence motivated the authors todiscuss the etiological aspects, diagnosis and treatmentof disease.

Linfocitoma cútis na região fronto- parietal: relato de caso / Front-parietal region lymphocytoma cutis: case report

O linfocitoma cútis é uma doença rara, pode simularum linfoma de células B tanto histológica como clinicamentee ocorre de forma idiopática na maioria dos casos.É necessário diagnóstico preciso das lesões para umaorientação terapêutica e prognóstica corretas. Mesmotratando-se de uma doença benigna, seu curso é crônicoe é necessário o acompanhamento destes pacientes alongo prazo, a fim de diagnosticar e tratar precocementeos raros casos necessários. Descreve-se um caso de linfocitomacútis na região fronto-parietal direita responsivaao tratamento clínico. Os autores abordam em seguidaos fatores etiológicos, o diagnóstico e a terapêutica.

The lynphocytoma cutis is a rare disease, it can simulatea B-cell lymphoma, both, clinically and histologically,and it is idiopathic in most cases. Is necessary accuratelesions diagnosis to a correct therapeutics and prognostics.Even being a benign disease, its course is chronicand it is necessary a long term follow up of these patients,in order to an early diagnose and treatment whenit is necessary due to its rare cases. A right front-parietallymphocytoma cutis responsive to medical treatmentcase is described. The authors then discuss the etiologicfactors, the diagnosis and the therapeutics.

Giant basal cell carcinoma / Carcinoma basocelular gigante

The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no signs of dissemination or local recurrence have been detected after follow up of five years.

O carcinoma basocelular é o tipo mais comum de câncer de pele, mas o carcinoma basocelular gigante vegetante não atinge 0,5% de todos os tipos de carcinomas basocelulares. O Carcinoma Basocelular Gigante, definido como lesão maior que 5 cm no maior diâmetro, é uma forma rara de carcinoma basocelular e comumente ocorre no tronco. Este paciente apresenta um Carcinoma Basocelular Gigante com 180cm² no ombro direito e foi negligente em procurar tratamento. Foi realizado tratamento cirúrgico e nenhum sinal de disseminação ou recorrência local foi detectada após 5 anos.

Criptococcose cutânea primária em paciente imunocompetente / Primay cutaneous cryptococcosis in an immunocompetent patient

Os autores relatam caso de Criptococcose cutânea primária, causada pelo Cryptococcus neoformans, em paciente imunocompetente, fazendeiro que desenvolveu extensivas lesões, no antebraço, após injúria provocada por galináceo, quando fazia limpeza de seu celeiro. Tratamento oral com fluconazol resultou em cura total. A literatura relata raridade de criptococcose cutânea primária em imunocompetentes e sua relativa frequência em imunodeprimidos.

The authors report a primary cutaneous cryptococcosis, caused by Cryptococcus neoformans in immunocompetent patient, a farmer who developed extensive lesions at the site of an injury caused by one of the chickens on his right forearm, while he was cleaning out his barn. Oral treatment with fluconazole was totally successful. A review of the literature showed the rarity of cutaneous cryptococcosis in immunocompetent patients and in contrast, that skin lesions frequently occur in immunocompromised patients.