Frequency of skin diseases in renal transplant recipients and patients with chronic kidney disease in a tertiary center: a cross-sectional study

ABSTRACT BACKGROUND: The prevalence of chronic kidney disease (CKD) has increased in the recent decades, along with the number of patients in the terminal stages of this disease, requiring transplantation. Some skin disorders are more frequent in patients with CKD and in renal transplant recipients (RTR). OBJECTIVES: To evaluate the frequency of skin diseases in RTR and patients with CKD receiving conservative treatment. DESIGN AND SETTING: This observational cross-sectional study recruited consecutive patients with CKD and RTR from a nephrology clinic at a teaching hospital in Brazil between 2015 and 2020. METHODS: Quantitative, descriptive, and analytical approaches were used. The sample was selected based on convenience sampling. Data were collected from dermatological visits and participants' medical records. RESULTS: Overall, 308 participants were included: 206 RTR (66.9%, median age: 48 years, interquartile range [IQR] 38.0-56.0, 63.6% men) and 102 patients with CKD (33.1%, median age: 61.0 years, IQR 50.0-71.2, 48% men). The frequency of infectious skin diseases (39.3% vs. 21.6% P = 0.002) were higher in RTR than in patients with CKD. Neoplastic skin lesions were present in nine (4.4%) RTR and in only one (1.0%) patient with CKD. Among the RTR, the ratio of basal cell carcinoma to squamous cell carcinoma was 2:1. CONCLUSIONS: This study revealed that an increased frequency of infectious skin diseases may be expected in patients who have undergone kidney transplantation. Among skin cancers, BCC is more frequently observed in RTR, especially in those using azathioprine.

Risk of skin cancer in kidney, liver and heart recipients: A nationwide population-based study in Taiwan

Background: Previous population-based studies in western countries had revealed increased skin cancer risk among transplant recipients compared to the general population. However, population-based studies in Asia on skin cancer among recipients of different transplanted organs were lacking in the literature. Aims: This study aims to estimate skin cancer risk among recipients in Taiwan, examine the association between each specific type of skin cancer and each type of transplanted organ, and compare skin cancer risk between different immunosuppressive regimens. Methods: This population-based retrospective cohort study identified 7550 patients with heart, lung, kidney or liver transplantation and 30,200 controls matched for gender, age and comorbidity index from the National Health Insurance Research Database in Taiwan between 2000 and 2015. Using multivariable Cox proportional hazard models, we estimated the hazard ratios and 95% confidence intervals for the correlation of skin cancer with organ transplantation as well as immunosuppressive regimen. Results: Organ transplant recipients in Taiwan had an increased risk of skin cancer with adjusted hazard ratios of 4.327 (95% confidence intervals 2.740–6.837, P < 0.001), with the greatest risk, observed among heart recipients (adjusted hazard ratios 6.348, 95% confidence intervals 3.080–13.088, P < 0.001). The risk of non-melanoma skin cancer and melanoma was 4.473 (95% confidence intervals 2.568–7.783, P < 0.001) and 3.324 (95% confidence intervals 1.300–8.172, P < 0.001), respectively. When comparing immunosuppressants, those with calcineurin inhibitors carried the highest risk of skin cancer (adjusted hazard ratios 4.789, 95% confidence intervals 3.033–7.569, P < 0.001), followed by those with antimetabolites (adjusted hazard ratios 4.771, 95% confidence intervals 3.025–7.541, P < 0.001). Limitations: We could not evaluate confounding behavioural risk factors of skin cancers that were not documented in the database, nor could we recognize patients’ compliance with immunosuppressants. Conclusion: Organ recipients have a greater risk of skin cancer. Clinicians should inform recipients of the importance of photoprotection and regular dermatologic follow-up

Tratamiento del carcinoma basocelular de la nariz con una combinación de interferones Alpha-2b y Gamma / Treatment of basal cell carcinoma of the nose with a combination of Interferon alpha-2b and gamma

Introducción: El carcinoma basocelular es una neoplasia maligna derivada de las células epidérmicas de los folículos pilosos o células no queratinizadas puede ser desfigurante y originar deformidades o pérdida de la función del órgano afectado, es más frecuente en zonas sobresalientes como la nariz. Objetivo: Describir los resultados de la aplicación de la combinación sinérgica de interferones alpha-2b y gamma en una serie de casos con carcinoma basocelular nasal. Material y métodos: Se realizó un estudio de serie de casos clínicos, se incluyeron 28 pacientes con diagnóstico clínico, dermatoscópico e histopatológico de carcinoma basocelular de la nariz que acudieron a consulta de dermatología del Policlínico Centro de Sancti Spíritus en el período de 17 de enero de 2016 a 28 de diciembre de 2021. Se realizó una evaluación inicial y otra final a las 16 semanas después del comienzo del tratamiento. Se administró 10,5 UI de HeberFERON, 3 veces por semana perilesional e intradérmica hasta completar 9 dosis. Las variables principales fueron la respuesta al tratamiento y presencia o no de evento adversos. Resultados: Predominó el sexo masculino, fototipocutáneo II, localización en el dorso y ala nasal, subtipo clínico nódulo ulcerativo y el histológico sólido. En la mayoría de los pacientes desapreció el tumor al culminar el esquema terapéutico. Como eventos adversos más comunes se presentaron dolor en el sitio de inyección, fiebre, edema y eritema perilesional. Conclusiones: La respuesta al tratamiento fue completa en la mayoría de los pacientes y los eventos adversos los descritos en la literatura sin cambios en la actitud farmacológica(AU)

Introduction: Basal cell carcinoma is a malignant neoplasm derived from epidermal cells of hair follicles or non-keratinized cells with a high potential for local destruction, which can be disfiguring and may invade the surrounding tissue, resulting in deformities or loss of function of the affected organ, being more frequent in protruding areas such as the nose. Objective: To describe the results of the application of the synergistic combination of interferon alpha-2b and gamma in a series of cases with nasal basal cell carcinoma. Material and Methods: An observational, descriptive and longitudinal study was carried out in a series of 28 clinical cases with basal cell carcinoma of the nose who attended the dermatology clinic of Policlínico Centro in Sancti Spiritus in the period from january 2016 to december 2021. Cases with a clinical, dermoscopic and histopathological diagnoses were included. An initial and a final evaluation at the end of the 16 weeks of treatment were carried out; also, 10,5 IU of HeberFERON was administered 3 times per week perilesional and intradermally until completing 9 doses. The main variables were response to treatment and presence or absence of adverse events. Results: Male sex, skin phototype II, location on the dorsum and nasal ala, clinical subtype ulcerative nodule, and solid histological subtype predominated. In most of the patients, the tumor disappeared at the end of the therapeutic regime. The most common adverse events were pain at the injection site, fever, edema and perilesional erythema. Conclusions: There was a complete response to treatment in most patients and the adverse events were those described in the literature with no change in the pharmacological attitude(AU)

Efficacy of combined local flaps in repair of larger defects in the nasal and perinasal region after Mohs micrographic surgery in 11 cases / 中华皮肤科杂志

Objective:To investigate efficacy and advantages of combined local flaps in repairing large defects in patients with nasal and perinasal non-melanoma skin cancers after Mohs micrographic surgery.Methods:From March 2018 to November 2020, 11 patients with nasal and perinasal non-melanoma skin cancers, who underwent Mohs micrographic surgery followed by repair with combined local flaps, were collected from Department of Dermatology, the Second Hospital of Hebei Medical University. According to the location and size of postoperative defects, flaps were designed based on the nasal aesthetic subunit principle. For large defects that could not be directly sutured or covered by a single local flap, 2 or 3 kinds of flaps were applied in combination, such as kite flap, modified diamond flap, nasolabial skin flap, bilobed skin flap, etc.Results:Among the 11 patients, 10 were diagnosed with basal cell carcinoma and 1 with squamous cell carcinoma, and the area of defects ranged from 2.0 cm × 2.3 cm to 2.7 cm × 3.6 cm. After Mohs micrographic surgery combined with local skin flap repair, all skin flaps survived well without blood supply obstruction, the texture, color and contour of the skin flaps were similar to those of the surrounding normal skin, and no obvious scars were formed. During the postoperative follow-up of 4 to 32 months, no recurrence of the tumors occurred, and the patients was satisfied with the appearance.Conclusion:To repair large defects using combined skin flaps of 2 or 3 kinds after Mohs micrographic surgery in patients with nasal and perinasal non-melanoma skin cancers can maintain the normal nasal or perinasal morphological structure and aesthetic appearance, and yield a satisfactory cosmetic effect.

Comparación histopatológica entre biopsia preoperatoria y debulking luego de la cirugía micrográfica de Mohs en carcinomas cutáneos / Histopathological comparison between preoperative biopsy and debulking after Mohs micrographic surgery in cutaneous carcinomas / Comparação histopatológica entre biópsia pré-operatória e citorredução após cirurgia micrográfica de Mohs em carcinomas cutâneos

Resumen: Introducción: el subtipo histopatológico es uno de los determinantes fundamentales en la clasificación de riesgo de los carcinomas cutáneos. Surge de una biopsia incisional que representa solo un porcentaje de la masa tumoral, siendo la principal preocupación la no detección de un subtipo agresivo. De ahí nace el interés de comparar la similitud entre ésta y la pieza de escisión quirúrgica (debulking) de la cirugía micrográfica de Mohs (CMM). Objetivos: comparar los resultados histopatológicos entre la biopsia incisional y el debulking en los carcinomas cutáneos tratados con CMM en el Servicio de Dermatología del Hospital de Clínicas en el período de noviembre de 2013 a marzo de 2019. Metodología: estudio retrospectivo descriptivo, se analizaron 202 pacientes con carcinomas de piel no melanoma (CPNM) sometidos a CMM en el servicio de Cirugía Dermatológica del Hospital de Clínicas "Dr. Manuel Quintela" entre noviembre de 2013 y marzo de 2019. Resultados: únicamente se consideran los casos donde en el debulking se halló tumor. Del total, la biopsia coincidió con el debulking en 61,39% de los casos. El debulking mostró un subtipo agresivo que no fue detectado en la biopsia en 8,41% de los casos. Conclusiones: el estudio histopatológico del debulking ha demostrado ser relevante, siendo la biopsia incisional parcialmente representativa para determinar el subtipo histopatológico de un CPNM, ya que aproximadamente 1 de cada 10 carcinomas podrían ser subdiagnosticados y tratados de manera insuficiente.

Abstract: Introduction: histological subtype is a vital element in determining the risk of skin cancer. It may be determined by an incisional biopsy which represents just a percentage of the tumor mass, the main concern lying in its potential failure to detect an agressive subtype. Therefore, comparing the results of biopsies with the surgically obtained piece with Mohs micrographic surgery is significantly relevant. Objective: to compare histopathologic evaluation results of incisional biospy and debulking in skin cancer treated with Mohs micrographic surgery at the Dermatology Service of the Clinicas University Hospital, between November, 2013 and March, 2019. Methodology: retrospective, descriptive study analysing 202 non-melanoma carcinomas which were treated with Mohs micrographic surgery the Dermatology Service of the "Dr. Manuel Quintela" Clinicas Hospital, between November, 2013 and March, 2019. Results: the study only considered the cases where bulking identified the tumor. Biopsy matched debulking in 61.39% of cases. Debulking detected an agressive subtype that was not detected in the biopsy in 8.41% of the cases. Conclusions: the hystopathological study of debulking has proved to be relevant, and the incisional biopsy was found to be partially representative in determining the histopathological subtype of non-melanoma carcinomas, since approximately 1 out of 10 carcinomas could be underdiagnosed and not appropriately treated.

Resumo: Introdução: o subtipo histopatológico é um dos determinantes fundamentais na classificação de risco dos carcinomas cutâneos. Identifica-se na biópsia incisional que representa apenas uma porcentagem da massa tumoral, sendo a principal preocupação a não detecção de um subtipo agressivo. Daí o interesse de comparar a semelhança entre esta e o material de excisão cirúrgica (citorreduçao - debulking) da Cirurgia Micrográfica de Mohs (CMM). Objetivos: comparar os resultados histopatológicos entre biópsia incisional e citorredução em carcinomas de pele tratados com CTM no serviço de Dermatologia do Hospital de Clínicas de novembro de 2013 a março de 2019. Metodologia: estudo descritivo retrospectivo onde foram analisados 202 carcinomas de pele não melanoma (NSCLC) submetidos a CCM no serviço de Cirurgia Dermatológica do Hospital de Clínicas "Dr. Manuel Quintela" entre novembro de 2013 e março de 2019. Resultados: foram considerados somente os casos em que um tumor foi encontrado em citorredução. Do total, a biópsia coincidiu com a cirurgia citorredutora em 61,39% dos casos. A citorredução mostrou um subtipo agressivo que não foi detectado na biópsia em 8,41% dos casos.

Recidiva y factores de riesgo asociados luego de la cirugía micrográfica de Mohs en el Centro Universitario de referencia nacional en Uruguay / Relapse and associated risk factors after Mohs micrographic surgery at the Uruguayan national reference University Center

Antecedentes: la cirugía micrográfica de Mohs es la técnica de elección, para el tratamiento de cancer de piel no melanoma de alto riesgo. Las características tanto del paciente cmo del tumor que lo definen como de alto riesgo de recidiva son el tamaño, la localización, la recidiva y el estado inmunitario del paciente, entre otros factores. Objetivo: describir el perfil de los pacientes con carcinomas tratados mediante cirugía micrográfica de Mohs en la Cátedra de Dermatología Médico-Quirúrgica del Hospital de Clínicas Dr. Manuel Quintela en período de 7 años y que presentan recidiva. Materiales y métodos: estudio observacional, descriptivo, retrospectivo, unicéntro, de tipo cohorte histórica, en el que se analizaron las características de los pacientes cuyo tumor recidivó tras la cirugía micrográfica de Mohs mediante la revisión de las historias clínicas, y su comparación con las publicaciones sobre el tema. Resultados: en el período mencionado hubo 7 recidivas de las 388 operaciones realizadas (1,8 % del total), con una media de tiempo hasta la recurrencia de 15,3±2,3 meses. Todos eran tumores de alto riesgo, 5 estaban localizados en zonas de alto riesgo, 3 pacientes eran inmunodeprimidos y 2 tenían subtipos histológicos de alto riesgo. Conclusiones: de las 388 operaciones, un 1,8% de los pacientes presentaron recidiva en los 7 años, con un tiempo medio hasta la aparición de esta de 15,3 meses. En general, las características de los pacientes con recidiva coinciden, en parte, con lo referido en la literatura especializada. Sin embargo, se dificulta la comparación con otros estudios porque pocos pacientes cumplieron al menos 5 años de seguimiento. Llama la atención la proporción de tabaquismo y anticoagulación entre los pacientes que evidenciaron recidiva.

Background:Mohs micrographic surgery is the technique of choice for the treatment of high-risk non-melanoma skin cancer.We describe the pacient and tumor´s characteristics that define them as high-risk tumors: size,location,recurrence,immunologicalstateof the patient, within other factors. Objetive: describe the profile of patients with recurrent carcinomas after Mohs micrographic surgery in the Dermatology department of Clinic Hospital Dr. Manuel Quintela in a 7-year period. Methods: observacional, descriptive, single-center, historical cohort study in which patients with recurrent carcinomas after Mohs micrographic surgery were analyzeb by clinical histoty revision and results were compared with the literature. Results: in the mentioned period 7 recurrences within the 388 surgeries were found (1.8%), with a mean time to recurrence of 15.3±2.3 months. It can be highlighted that all of them were high-risk tumors, 5 were at high risk locations, 3 were immunosuppressed and 2 had high risk histological subtypes. Conclusions: within the 7-year period 1.8% of recurrences after Mohs micrographic surgery were found and the mean time to recurrence was 15.3 months. In general, patient´s characteristics were similar to the consulted literature. The high percentage of smokers and anticoagulanted patients is striking compared to all the patients who completed 5 years of follow-up. owever, it is important to take into account that the small number of patients make it dfficult to compare the results with other studies.

Basal Cell Carcinoma in the Department of Dermatology, Hospital Kuala Lumpur

@#Basal cell carcinoma (BCC) is the commonest skin cancer seen worldwide. This study aims to determine the clinical pattern of BCC in the Department of Dermatology, Hospital Kuala Lumpur, Malaysia

Carcinoma basocelular del rostro tratado con HeberFERON / Basal cell carcinoma of the face treated with HeberFERON

RESUMEN Fundamento: El carcinoma basocelular es el cáncer de piel no melanoma más frecuente, es un tumor de invasión local y crecimiento lento; su origen son las células epidérmicas de los folículos pilosos o las células basales de la epidermis; en ocasiones puede sufrir un crecimiento incontrolado, no responder a los tratamientos y ser causa de deformidad; las radiaciones ultravioletas son el principal factor en la génesis de esta enfermedad. Objetivo: Describir los resultados de la aplicación de HeberFERON en una serie de casos con carcinoma basocelular del rostro. Metodología: Se realizó un estudio observacional, descriptivo longitudinal en una serie de 32 casos clínicos de carcinoma basocelular del rostro que acudieron a la consulta de dermatología del Policlínico Centro. Se incluyeron aquellos con diagnóstico clínico, dermatoscópico e histopatológico. Se realizó una evaluación inicial, durante el tratamiento y 16 semanas después del mismo, se le administró 10.5 UI de HeberFERON 3 veces por semana hasta completar 9 dosis. Las variables fueron la respuesta al tratamiento y presencia o no de eventos adversos. Resultados: Predominó el sexo masculino, la piel blanca y la localización de la neoplasia en la nariz, se logró respuesta completa en la mayoría de los pacientes. Como eventos adversos se presentaron dolor en el sitio de inyección, fiebre y malestar general. Conclusiones: La respuesta objetiva al tratamiento fue favorable en la mayoría de los pacientes tratados con HeberFERON.

ABSTRACT Background: Basal cell carcinoma is the most frequent non-melanoma skin cancer, it is a tumor of local invasion and slow growth; it has its origin from the epidermal cells of the hair follicles or the basal cells of the epidermis; sometimes it can suffer uncontrolled growth, not respond to treatments and cause deformity; ultraviolet radiation is the main factor in the genesis of this disease. Objective: To describe the results of the application of HeberFERON in a series of cases with basal cell carcinoma of the face. Methodology: An observational, longitudinal descriptive study was carried out in a series of 32 clinical cases of basal cell carcinoma of the face that attended the dermatology office of the Polyclinic Center. Those with clinical, dermatoscopic and histopathological diagnosis were included. An initial evaluation was carried out, during the treatment and 16 weeks after it, 10.5 IU of HeberFERON was administered 3 times per week until 9 doses were completed. The variables were the response to treatment and the presence or absence of adverse events. Results: Male sex, white skin and the location of the neoplasm in the nose predominated; a complete response was achieved in most patients. Adverse events presented pain at the injection site, fever and malaise. Conclusions: The objective response to treatment was favorable in the majority of patients treated with HeberFERON.

Carcinoma sebáceo extraocular, reporte de un caso / Extraocular sebaceous carcinoma, case report

RESUMEN El carcinoma sebáceo es una neoplasia anexial poco común que puede originarse en cualquier lugar del cuerpo donde existan glándulas sebáceas, siendo la principal ubicación la cabeza y el cuello, existiendo la presentación ocular y extraocular. Alcanza entre 0,2% a 4,6% de todas las neoplasias cutáneas malignas, con mayor incidencia en los adultos mayores caucásicos. La presentación clínica habitual corresponde a un nódulo duro o quístico subcutáneo eritematoso o amarillento, indoloro, de crecimiento acelerado. Sin embargo, puede manifestarse como una amplia gama de lesiones cutáneas, lo que, agregado a su baja incidencia, sea altamente subdiagnosticado. Se presenta el caso de un paciente de 64 años con tumor exofítico malar izquierdo con ulceraciones y áreas de necrosis en la superficie, sin compromiso de párpado inferior, de agudeza visual ni motilidad ocular. Se realiza resección del tumor, cuya biopsia definitiva confirma diagnóstico de carcinoma sebáceo extraocular.

ABSTRACT Sebaceous carcinoma is a rare anexal neoplasm that can develop on any part of the body containing sebaceous glands, but nearly the 70% of sebaceous carcinoma occur on the head and neck, being two ways of presentation, ocular and extraocular. It represents 0.2-4.6 % of all malignant neoplastic cutaneous lesions, whit a peak incidence in the eighth decades of life, in caucasian people. Typical clinical presentation of sebaceous carcinoma is a painless, firm or cystic subcutaneous nodule described as pink to red-yellow, however clinical features can be quite varied, which added to its low incidence leads to the diagnosis is often delayed for months to years. We present the case of a 64 years old patient whit an exofitic malar tumor ulcerated and necrotic in the surface, without compromising the lower eyelid, vision or ocular mobility. The biopsy of the tumor resection shows an extraocular sebaceous carcinoma.

Risk of Second Primary Cancer in People with Non-melanoma Skin Cancer: A Nationwide Cohort Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Previous western studies have found Caucasians with skin cancer, either melanoma or nonmelanoma skin cancer (NMSC), have an elevated risk of second primary cancer. Our objective was to assess the risk of second primary cancer in Taiwanese with NMSC. MATERIALS AND METHODS: By using data from Taiwan's National Health Insurance Research Database, we conducted a population-based cohort study to assess the risk of incident second primary cancer in Taiwanese affected by NMSC. RESULTS: We identified 505 subjects with NMSC and 2,020 matched controls. After adjustment for potential confounders including age, sex, urbanization, and Charlson Comorbidity Index, people who had NMSC had a 1.43-fold (95% confidence interval [CI], 1.05 to 1.96) risk for the development of second primary cancer as comparedwith control group. Menwith NMSC had a 2.99-fold (95% CI, 1.00 to 9.10) risk for second primary cancer involving the lip, oral cavity, and pharynx and a 3.51-fold (95% CI, 1.21 to 10.17) risk for second primary cancer involving the genitourinary organs when compared to the control group. By contrast, women with NMSC did not have an increased risk of second primary cancer. CONCLUSION: This study revealed Asians with NMSC have an increased risk of second primary cancer. Our findings can be a useful reference for health care for people diagnosed with NMSC.

Características epidemiológicas del cáncer de piel no melanoma en militares, 2015-2016: Perú / Epidemiological characteristics of skin cancer no melanoma in military, 2015-2016: Peru

El carcinoma de piel no melanoma (CPNM) es una de las neoplasias más frecuentes en el mundo, su incidencia está en aumento. Una de las principales causas del carcinoma de piel no melanoma es la exposición repetida y prolongada al sol; los militares realizan sus actividades al aire libre, están muy expuestos a sufrir la enfermedad. Objetivos: conocer las características epidemiológicas del cáncer de piel no melanoma en el personal militar. Material y Métodos: se realizó un estudio descriptivo, retrospectivo y transversal de diseño no experimental. Se incluyeron 163 pacientes atendidos en un Hospital Militar, con diagnóstico clínico e histopatológico de CPNM entre los años 2015 y 2016. Se incluyó al Carcinoma Basocelular (CBC) y al Carcinoma Espinocelular (CEC); se analizaron variables como: la edad, sexo, raza, formas clínicas e histológicas y ubicación anatómica de las lesiones. Resultados: el CBC fue el CPNM predominante, sexo masculino (60%) y raza mestiza (87,7%) fueron los más afectados. Edad media de presentación 75,16 años. El CBC nodular fue la forma clínica más frecuente (70,97%) de los CBC y el tipo invasivo de los CEC (76,92%). Los tipos histológicos más comunes CBC sólido (49,19%) y el CEC bien diferenciado (46,15%); ubicación anatómica más frecuentemente afectada por el CPNM, cabeza (79,8%) y tronco (9,2%). Conclusiones: el carcinoma de piel no melanoma de mayor frecuencia en el personal militar es el carcinoma basocelular, siendo la forma clínica nodular la de mayor frecuencia.

Non-melanoma skin carcinoma (NSCLC) is one of the most common neoplasms in the world, and its incidence is increasing. One of the major causes of non-melanoma skin carcinoma is repeated and prolonged exposure to the sun; the military perform their activities outdoors, are very exposed to suffering the disease. Objectives: to know the epidemiological characteristics of non-melanoma skin cancer in military personnel. Material and Methods: a descriptive, retrospective and cross-sectional study of a non-experimental design was performed. We included 163 patients attended at a Military Hospital with clinical and histopathological diagnosis of NMSC between the years 2015 and 2016. We included Basal Cell Carcinoma (CBC) and Spinocellular Carcinoma (CPB), we analyzed variables: age, sex, race, clinical forms and histological and anatomical locations Results: BCB was the predominant neoplasm, male (60%) and mestizo (87,7%) were the most affected. Average age of presentation 75,16 years. The nodular BBC was the most frequent clinical form (70,97%) of SCC and the invasive type of CPB (76,92%). The most common histological types Solid Basal Cell Carcinoma (49,19%) and well differentiated squamous cell carcinoma (46,15%); anatomical location most frequently affected by NSCLC, head (79,8%) and trunk (9,2%). Conclusions: the most frequent non-melanoma skin carcinoma in military personnel is basal cell carcinoma, with the most frequent nodular clinical form.

Repair and treatment with local skin flap after primary surgical resection of non melanoma skin cancer / 局解手术学杂志

Objective To investigate the clinical effect of treatment with local skin flap after primary surgical resection of non melanoma skin cancer.Methods A total of 176 patients with head and facial skin cancer who were admitted into our hospital from September 2008 to September 2015 were divided into three groups according to different repair plans.Namely,the suture group (41 cases),the local skin flap group (81 cases) and the skin graft group (54 cases).The repair effect of the three groups were compared after the operation.Results The good rate was 68.39%(28/41) in the suture group,98.77%(80/81) in the local skin flap group,and 83.33%(45/54) in the skin graft group,and it was significantly higher than any of the other two groups with statistically significant difference(P0.05).The 3 groups were followed up for a period of 1 year,as a result,there was no recurrence and distant metastasis.Conclusion For patients with head and facial non melanoma skin cancer,repaired with local skin flap healing treatment after primary surgical resection can not only get high healing rate but also significant improvement of patient satisfaction rate.In addition,it can lower the rate of recurrence and distant metastasis after operation.

A Clinical Study of Multiple Non-melanoma Skin Cancers over 4 Years in a Single Institution Center / 대한피부과학회지

BACKGROUND: Non-melanoma skin cancers (NMSCs, basal cell carcinoma [BCC], and squamous cell carcinoma, [SCC]) are skin conditions, and the propensity of NMSCs to develop multiple tumors may be associated with some genodermatoses, arsenic poisoning, and chronic exposure to radiation or coal tar. OBJECTIVE: To report our experience of treating multiple NMSCs and to investigate the clinical characteristics of NMSCs. METHODS: We retrospectively evaluated 16 patients who had been diagnosed with NMSCs from May 2010 to December 2014. RESULTS: The male-female sex ratio was 0.6:1 in the patients with multiple BCCs and SCCs. The most frequent age group was the seventh decade (75%). The mean patient age was 76.36 years. The most common involved site was the face, particularly the cheek (54.3%). Nodular BCCs were the most frequent (61.9%), followed by infiltrate BCCs (28.6%) and superficial BCCs (9.5%). Among the SCCs, the moderately differentiated SCCs were the most frequent (50%). More NMSCs were found on the left than on the right side of the head and neck areas in both sexes. Development of BCC (68.8%) was more frequent than that of SCC in sun-exposed areas. CONCLUSION: In our study, differences in the demographic variables, such as age, sex, or residence were found between the patients with multiple BCCs and SCCs. The incidence of BCC has markedly increased, which is mainly because of the increment of aged people in their residence, along with environmental factors. Further cohort studies that include cumulative lifetime sun exposure and a large sample size are needed.

Research advances in the treatment of non-melanoma skin cancer using photodynamic therapy / 实用肿瘤学杂志

Non-melanoma skin cancers( NMSC) are one of the most common malignancy in humans.A-mong NMSC types,basal cell carcinoma(BCC)has the highest incidence and squamous cell carcinoma(SCC)is less common although it can metastasize.Over 30 years ago,Photodynamic therapy( PDT) was applied for the stud-y of human tumor,it showed the advantage of being a non-invasive option,and capable of field treatment,provi-ding optimum cosmetic outcomes.Numerous clinical research studies have shown the efficacy of PDT for treating NMSC.The purpose of this systematic review is to summarize the previous results,current evidence and the possi-bilities for PDT in patients with NMSC.

Sun-related behaviors among individuals previously diagnosed with non-melanoma skin cancer.

Compared to the general population, the risk of developing non-melanoma skin cancer is considerably higher among individuals with a previous history of this condition. Protection from ultraviolet (UV) radiation is the primary evidence-based approach for minimizing this risk. This review was aimed to assess the prevalence of sun-safe behaviors in non-melanoma skin cancer survivors. Searches were conducted in six electronic databases including PubMed, Psyclnfo, CINAHL, EMBASE, ERIC and Science Direct. A narrative approach was adopted to synthesize the data. The fi ndings demonstrated that respondents do not protect themselves optimally from UV radiation exposure. Low levels of perceived skin cancer risk, a lack of knowledge about effective sun protection strategies and the inconvenience associated with sun-safe behaviors appear to explain this fi nding. A note of caution is required here, as there is a potential for publication bias. Moreover, the results of this study cannot be generalized to all non-melanoma skin cancer patients. Skin cancer survivors must be educated about their increased risk of future skin cancers. Behavioral interventions must be developed to increase the adoption of skin protective behaviors in this high-risk population group.

Características clínicas y epidemiológicas de carcinoma basoescamoso en cinco años en un hospital de alta complejidad / Clinical and epidemiological features of basosquamous carcinoma in five years in a high complexity hospital

Introducción: el carcinoma basoescamoso es un tipo histológico poco frecuente y de mal pronóstico, presenta características clínicas e histológicas intermedias entre carcinoma espinocelular y basocelular; su diagnóstico es mediante la biopsia y el tratamiento es principalmente quirúrgico. Objetivo: determinar características epidemiológicas y clínicas de casos de carcinomas basoescamosos, diagnosticados en el Hospital Dr. Hernán Henríquez Aravena de Temuco, durante el período 2003-2007 y comparar nuestra realidad con la literatura. Materiales y Métodos: estudio descriptivo retrospectivo, donde se incluyeron todos los individuos con diagnóstico histológico de carcinoma basoescamoso, registrados entre 2003 y 2007 en el Hospital Dr. Hernán Henríquez Aravena de Temuco. Se estudiaron las variables epidemiológicas de sexo y edad al momento del diagnóstico; apellidos mapuches y las variables clínicas de ubicación, forma de presentación (única o múltiple) y correlación clínico-histológica. Resultados: se encontraron 36 casos, 52,8% presentó sexo masculino, el promedio de edades al diagnóstico fue de 74,6 años. 5,6% tenía algún apellido mapuche. Un 80,6% se presentó en cabeza y cuello. En un 63,9% de los casos, el diagnóstico clínico en base a la morfología de la lesión, fue de carcinoma basocelular, no existiendo correlación clínico-histológica en ningún caso. Discusión: los resultados obtenidos por nosotros, mantienen la tendencia respecto de lo que se registra en la literatura en cuanto a: distribución por sexo, edad y ubicación. No encontramos trabajos donde se hable de las características de esta enfermedad en población mapuche. La macroscopía lleva a confusión diagnóstica, por lo que en todos los casos el diagnóstico es histológico.

Introduction: basosquamous cell carcinoma is a rare and poor prognosis histological type, that presents intermediate clinical and histological features between squamous and basal cell carcinoma. The diagnosis is made by biopsy, and the treatment is primarily surgical. Objective: determine epidemiological and clinical characteristics of cases of diagnosed basosquamous cell carcinomas, at Dr. Hernán Henríquez Aravena Hospital of Temuco, during the period 2003-2007 and proceed to compare the results with the literature. Materials and Methods: a retrospective review including all individuals with histological confirmation of basosquamous carcinoma, between 2003 and 2007 at Dr. Hernán Henríquez Aravena Hospital of Temuco. Were considered epidemiological variables of sex, age at diagnosis and mapuche surname, and clinical variables of location of the lesion, presentación (single or multiple) and the clinical-pathologic correlation. Results: 36 cases were found, 52.8% male, the average age at diagnosis was 74.6 years. 5.6% had a mapuche surname. 80.6% occurred in the head and neck. In the 63.9% of the cases, the clinical diagnosis based on the morphology of the lesion was basal cell carcinoma. We did not found clinical-pathologic correlation in any case. Discussion: our results maintain the trend recorded in the literature in relation to sex distribution, age of presentation and location. We did not found works about characteristics of this disease in mapuche population. The macroscopic diagnosis leads to confusion, so the diagnosis it has to be histological in every case.

Carcinoma espinocelular sobre radiodermitis crónica / Squamous cell carcinoma on chronic radiation dermatitis

Varios estudios epidemiológicos de la radiación ionizante y el cáncer de piel, han demostrado que la radiación causa cáncer de piel no melanoma, principalmente carcinoma basocelular. Poco se sabe sobre la dosis de radiación ionizante, que podría causar carcinoma de células escamosas. Todos los estudios disponibles muestran que el riesgo de cáncer de piel es mayor, cuando la exposición a la radiación se produce a edades más tempranas que en más avanzadas; las pruebas indican que el exceso de riesgo para este tipo de cáncer, tiene una duración de varios años después de la irradiación. Por lo tanto, los pacientes previamente tratados con radiaciones ionizantes requieren un seguimiento permanente, para identificar el carcinoma cutáneo en una etapa temprana.

Several epidemiologic studies of ionizing radiation and skin cancer have shown that radiation causes non melanoma skin cancer, mainly basal cell carcinoma. Little is known about the dose of ionizing radiation that could cause squamous cell carcinoma. All available studies show that skin cancer risk is greater from radiation exposure at young ages than at older ages and the evidence indicates that the excess risk of skin cancer lasts for several years following irradiation. Therefore patients previously treated with ionizing radiation require lifelong monitoring to identify skin cancer at an early stage.

Diagnóstico y seguimiento de cáncer de piel no-melanoma utilizando 99mTc-MIBI: estudios en un modelo animal / Usefulness of 99mTc-MIBI for the diagnosis and follow up of non-melanoma skin cancer: study in an animal model

El objetivo consistió en evaluar la utilidad del 99mTc-MIBI como marcador para diagnóstico y seguimiento de la progresión tumoral del NMSC en un modelo de carcinogénesis completa en ratones. Los animales en estudio fueron inyectados con 99mTc-MIBI a diferentes tiempos y eutanasiados. Se disecaron muestras de tumor y piel sana para evaluar la captación del radiofármaco y realizar el diagnóstico histológico. En animales con 22 semanas de progresión tumoral se observó una diferencia significativa en la captación del 99mTc-MIBI entre piel sana y NMSC. El protocolo que mejor se adapta al uso del 99mTc-MIBI como marcador para el diagnóstico y seguimiento de la progresión tumoral en ratones portadores de NMSC inducidos es la administración i.v de 1 mCi de 99mTc-MIBI con adquisición de datos a los 30 minutos post inyección. Se observó que a medida que los tumores progresan, la captación de 99mTc-MIBI disminuye respecto a la piel normal.

The aim of the work was to evaluate the usefulness of 99mTc-MIBI as a tracer for the tumor diagnosis and progression of NMSC in a chemically induced model in mice. After administration of 99mTc-MIBI animals were sacrificed at different times. Samples of tumor and healthy skin were dissected in order to perform histological analysis and to evaluate 99mTc-MIBI uptake. Animals under 22 weeks of tumor evolution showed a statistically difference in 99mTc-MIBI uptake between healthy skin and NMSC. Our results showed that the better protocol for the study of the tumor diagnosis and progression of NMSC in mice is the administration of 1 mCi of 99mTc-MIBI and acquisition of images 30 minutes post injection. Results showed that, as tumor progresses, the uptake of 99mTc-MIBI is significantly lower than healthy skin.

Treatment of cutaneous tumors with topical 5 percent imiquimod cream

INTRODUCTION: There are various approaches to the treatment of cutaneous tumors; one of them is treatment with imiquimod, a synthetic toll-like receptor agonist with a low molecular weight that offers a topical, noninvasive, and non-surgical therapeutic option. The main objective of our study was to provide data on 89 patients who used a 5 percent imiquimod cream for the treatment of cutaneous tumors at the Cutaneous Oncology Group of the Dermatology Department of Hospital das Clinicas from 2003 to 2008. MATERIALS AND METHODS: Here, we present our experience in the treatment of 123 cutaneous tumors of various types, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), Bowen's disease, erythroplasia of Queyrat, Paget's disease, and trichoepithelioma, with 5 percent imiquimod cream from 2003 to 2008 in the Cutaneous Oncology Group of the Dermatology Department of Hospital das Clinicas. Patients were divided into two separate groups according to their diagnosis and comorbidities; these comorbidities included epidermodysplasia verruciformis, xeroderma pigmentosum, albinism, basal cell nevus syndrome, Brooke-Spiegler syndrome, HIV, chronic lymphocytic leukemia, B-cell lymphoma, and kidney transplantation. Treatment duration, response to imiquimod, follow-up, recurrence, and local and systemic reactions associated with use of the drug were analyzed. Epidemiological data were obtained and cure rates were calculated. RESULTS: The ratio of women to men was 1.28:1, and the mean age was 63.1 years. Tumors were located mainly on the face, back, trunk, and legs. For patients with comorbidities, the overall cure rate was 38 percent. These specific patients demonstrated cure rates of 83.5 percent for superficial BCC and 50 percent for Bowen's disease. Aggressive BCC and superficial and nodular BCC did not present a good response to treatment. Trichoepitheliomas and nodular BCC showed a partial response, and erythroplasia of Queyrat showed ...

Aspectos epidemiológicos del cáncer no melanoma de piel en un servicio de dermatología de la ciudad de Santa Fe - Argentina 2007 / Epidemiologic aspects to the skin cancer non melanoma in a dermatologic office of the Santa Fe city - Argentine 2007

Antecedentes: la incidencia del cáncer no melanoma de piel (CNMP), principalmente en países tropicales ha aumentado en grandes proporciones. La identificación de lesiones sospechosas y aquellas relacionadas directamente con el cáncer de piel es efectuada en ocasiones por colegas de muchas especialidades médicas. Objetivos: estudiar las características de la frecuencia del CNMP en relación con ciertos factores de riesgo en el Hospital José María Cullen, de la ciudad de Santa Fe, capital de la provincia del mismo nombre, Argentina. Materiales y métodos: estudio retrospectivo, no experimental, descriptivo y de corte transversal. La muestra quedó conformada por 61 pacientes de ambos sexos y de 1 a 83 años. Se confeccionó una historia clínica completa de los pacientes candidatos a la toma de biopsia, que luego fue analizada por el Servicio de Anatomía Patológica. Se realizó un análisis descriptivo utilizando el programa SPSS 11.5, mediante el cual se usó la prueba de Chi cuadrado y tablas de contingencia para relacionar las variables y comparar los datos. Se estableció una asociación estadísticamente significativa cuando se halló un valor de p<0,05. Resultados: Se observó que la frecuencia del CNMP fue del 29,5%, afectando mayormente al sexo masculino (72,2%). Se halló diferencia estadísticamente significativa (p=0,008), con respecto al género femenino. Los pacientes entre 61 y 70 años fueron los más afectados con el 38,9% de frecuencia entre las demás edades (p=0,001). El tipo más frecuente de CNMP fue el carcinoma basocelular (77,8%), y la localización más frecuente fue en cabeza y cuello (61,1%). El factor de riesgo encontrado con mayor frecuencia (94,4 %) fue la foto-exposición solar (p=0,00) y el fototipo de piel más afectado fue el II (61,1%). Conclusión: la frecuencia del cáncer no melanoma de piel es alta.

Background: The incidence of non-melanoma skin cancer (NMSC), mainly in tropical countries has increased in large proportions. The identification of suspicious lesions and those directly related to the skin cancer is made by colleagues of many medical specialities. Objectives: Study the characteristics of the frequency of NMSC and their relation with certain risk factors in the Hospital José María Cullen, city of Santa Fe, capital of the province of the same name, Argentina. Materials and Methods: This was a retrospective, not experimental, descriptive and transversal cut study. The sample was composed by 61 patients of both sexs and from 1 to 83 years old. A complete clinical history of patients with suspected lesions were developed. After the biopsy collection, the Department of Pathology analyze them. A descriptive analysis was performed using SPSS 11.5 program; Chi-square test and contingency tables were used to relate variables and compare data. It stablished a statistically significant association when it founded a value of p<0,05. Results: We observed that the frequency of NMSC was 29.5%, affecting mostly male (72.2%). Statistically significant difference were found (p=0,008), with respect to the female gender. Patients between 61 and 70 years were the most afected age group with a frequency of 38.9% (p=0,001).The most common type of NMSC was basal cell carcinoma (77.8%) and the most frequent location was head and neck (61.1%). The risk factor found most frequently (94.4%) was the photoexposure (p=0,00) and the skin phototype most affected was the type II (61.1%). Conclusion: The incidence of non-melanoma skin cancer is high.