Caracterización de pacientes con cáncer de piel y otras afecciones causadas por fotodaño / Characterization of patients with skin cancer and other affections caused by photodamage

Introducción: El fotodaño es la agresión producida por la radiación solar en la piel. A su vez, la radiación ultravioleta es uno de los primeros agentes considerados como generadores de cáncer. Objetivo: Caracterizar a los pacientes con neoplasias cutáneas y otras afecciones causadas por fotodaño, según variables clínicas seleccionadas. Métodos: Se realizó un estudio transversal, observacional, clínico, descriptivo y retrospectivo de 64 pacientes diagnosticados con alguna afección causada por fotodaño, pertenecientes al área de salud del consultorio médico No. 11 del Policlínico Aquiles Espinosa Salgado de Las Tunas, desde enero del 2020 hasta igual periodo del 2022. Se analizaron variables, tales como edad, sexo, color de la piel, fototipo de piel, ocupación, uso regular de medios de protección solar antes de los 18 años de edad y actualmente, así como enfermedad dermatológica causada por fotodaño. Resultados: Predominaron el grupo etario de 60 años y más (43,7%), el sexo femenino (54,7 %), el color de la piel blanco (98,5 %), el fototipo de piel III (59,4 %) y los trabajadores estatales (53,1%).Se halló, que 90,6 % de los pacientes no tenían antecedentes de exposición a radiaciones no ultravioletas; 25,0 % refirió usar regularmente algún medio de protección antes de los 18 años de edad y 51,5 % lo emplean actualmente. La enfermedad dermatológica causada por fotodaño que primó fue el cáncer de piel (37,5 %). Conclusiones: Este estudio denotó la pertinencia y necesidad de identificación de las características clínicas de los pacientes con afecciones causadas por fotodaño en el consultorio médico referido.

Introduction: Photodamage is the aggression caused by solar radiation in the skin. In turn, the ultraviolet radiation is one of the first agents considered as cancer generators. Objective: Characterize the patients with cutaneous neoplasms and other affections caused by photodamage, according to selected clinical variables. Methods: A cross-sectional, observational, clinical, descriptive and retrospective study of 64 patients diagnosed with some affection caused by photodamage was carried out, belonging to the health area of the doctor office No. 11 of Achiles Espinosa Salgado Polyclinic in Las Tunas, from January, 2020 to the same period in 2022. Some variables were analyzed, such as age, sex, color of the skin, skin photo type, occupation, regular use of solar protection means before the 18 years and now, as well as dermatologic disease caused by photodamage. Results: There was a prevalence of the 60 years and over age group (43.7 %), female sex (54.7 %), color of the skin white (98.5 %), skin photo type III (59.4 %) and the state workers (53.1 %). It was found that 90.6 % of the patients didn't have history of exhibition to non ultraviolet radiations; 25.0 % referred to use some means of protection regularly before the 18 years and 51.5 % use it at the moment. The dermatologic disease caused by photodamage that prevailed was the skin cancer (37.5 %). Conclusions: This study denoted the relevance and necessity to identify the clinical characteristics of the patients with affections caused by photodamage in the doctor office abovementioned.

Utilidad del dermatoscopio en la correlación clínica e histológica de nevus pigmentados / Usefulness of Dermatoscopy in the clinical and histological correlation of Pigmented Nevi

Introducción: La precisión diagnóstica de los nevus pigmentados ha sido una constante preocupación por los dermatólogos. Objetivo: Identificar la utilidad del dermatoscopio en la correlación de las características clínicas y los patrones dermatoscópicos de nevus pigmentados y su asociación con el diagnóstico histológico. Métodos: Se realizó una investigación observacional, analítica, de tipo correlacional, con pacientes de la zona sur de Ciego de Ávila que acudieron a la consulta de dermatología del Hospital Provincial General Docente Dr. Antonio Luaces Iraola en el periodo de abril 2017 a diciembre 2019. Resultados: Predominó el sexo femenino, el grupo de edad de 21 a 30 años, el fototipo II de piel y la zona expuesta (cara y V del escote) (18 ;35,3 por ciento) sin relación entre estas variables. El diagnóstico histológico de nevus de la unión se encontró asociado a la simetría (p < 0,004), la pigmentación homogénea (p < 0,000), así como al patrón dermatoscópico reticular (p < 0,000), globular (p < 0,002) y homogéneo (p < 0,008). El nevus intradérmico se observó asociado a la característica clínica de pigmentación homogénea (p < 0,007), y al patrón dermatoscópico reticular (p < 0,000) y homogéneo (p < 0,005). El nevus compuesto no presentó relación con las características clínicas ni dermatoscópicas. El nevus azul solo se correlacionó con el patrón dermatoscópico homogéneo (p < 0,025). Conclusión: Los patrones dermatoscópicos fueron útiles para el diagnóstico clínico e histológico de los nevus pigmentados(AU)

Introduction: The diagnostic precision of pigmented nevi has been a constant concern of dermatologists. Objective: To determine the usefulness of the Dermatoscope in the correlation of the clinical characteristics and the dermoscopic patterns of pigmented nevi and their association with the histological diagnosis. Methods: An analytical observational investigation of a correlational type was carried out in patients from the southern area of Ciego de Ávila who attended the Dermatology consultation at the Antonio Luaces Iraola Provincial Hospital in the period from April 2017 to December 2019. Results: The female sex, the age group of 21 to 30 years, skin phototype II and the exposed area (face and V of the neckline) (18; 35.3 percent) predominated with no relationship between these variables. The histological diagnosis of junctional nevus was found associated with symmetry (p <0.004), homogeneous pigmentation (p <0.000), as well as the reticular dermoscopic pattern (p <0.000), globular (p <0.002) and homogeneous (p <0.008). The intradermal nevus was observed associated with the clinical characteristic of homogeneous pigmentation (p <0.007), and with the reticular (p <0.000) and homogeneous (p <0.005) dermoscopic pattern. The composite nevus was not related to clinical or dermoscopic characteristics. The blue nevus only correlated with the homogeneous dermoscopic pattern (p <0.025). Conclusions: The dermoscopic patterns were useful for the clinical and histological diagnosis of pigmented nevi(AU)

Mortality from malignant skin melanoma in elderly Brazilians: 2001 to 2016

Abstract Background: Malignant skin melanoma is a serious public health problem, especially among the elderly population. Knowing the dynamics of the mortality rates of this disease in Brazil is essential to support the creation of public health policies. Objective: To analyze the temporal trend of mortality from malignant skin melanoma in elderly people in Brazil, from 2001 to 2016. Methods: This was a descriptive analytical study of mortality rates from malignant skin melanoma in the elderly. The data were obtained from the Mortality Information System, and information related to the population was obtained from the 2010 population census and population estimates from the Brazilian Institute of Geography and Statistics. Mortality coefficients were calculated and simple linear regression analysis of the coefficients was performed by sex and macro-region. Results: A total 12,712 deaths due to malignant skin melanoma in the elderly were registered. The majority (56.8%) occurred in the male population. In females, a tendency of increase in mortality rates due to malignant skin melanoma was observed in the Northeast (p ≤ 0.001), Midwest (p = 0.002), and Brazil as a whole (p = 0.003). In males, an upward trend was observed in all regions, except for the Southeast region. For both sexes, there was also an upward trend in all regions, with the exception of the Southeast region. Study limitations: Secondary databases are directly influenced by the quality of death certificate completion and their heterogeneous scope in Brazilian regions. Conclusion: The increase in mortality indicates a potential public health challenge for the coming decades. The prevention of skin cancer among the elderly should become a priority, mainly through the implementation of preventive measures.

Accuracy of B-mode ultrasonography for detecting malignancy in canine cutaneous neoplasms: preliminary results / Acurácia da ultrassonografia modo-B na detecção de malignidade em neoplasmas cutâneos de caninos: resultados preliminares

The aim of this study was to verify the applicability and accuracy of B-mode ultrasonography in detecting malignancy in dog cutaneous neoplasms. Forty-two neoplasms (12 benign and 30 malignant) of mesenchymal, round cells, epithelial and melanocytic origins from 24 dogs of different breeds and ages were included. The ultrasound evaluation was performed with a linear multi-frequency transducer (7.0 to 12MHz), with frequency dependent on the mass dimension. Ultrasonographic characteristics of echogenicity (hypo/hyperechogenic), echotexture (homogeneous/heterogeneous), regularity, invasiveness in adjacent tissues were classified. Dimensions were also measured to calculate the depth/width ratio. Neoplasms were classified as malignant or benign after cytological and/or histopathological analysis and the results were associated with ultrasound characteristics. There was a significant association (P<0.05) between malignancy and echogenicity, echotexture and invasiveness in adjacent tissues, so that 84.6% of hypoechogenic neoplasms, 76.9% of heterogeneous masses and 88.2% of invasive neoplasms were classified as malignant. However, for all these associations, moderate predictive values were obtained, which may be due to the small experimental number included in this study. Therefore, although it has been observed that hypoechogenic, heterogeneous and invasive neoplasms were more prone to malignancy, these findings should be used with caution until new studies are developed with a greater number and variety of cutaneous neoplasms in dogs.(AU)

O objetivo deste estudo foi verificar a aplicabilidade e acurácia da ultrassonografia modo-B na detecção de malignidade em neoplasmas cutâneos de cães. Foram incluídos 42 neoplasmas (12 benignos e 30 malignos) de origens mesenquimal, células redondas, epitelial e melanocítica provenientes de 24 cães de diferentes raças e idades. O exame ultrassonográfico foi realizado com transdutor linear multifrequencial (7.0 a 12MHz), com frequência dependente da dimensão da massa. Foram classificadas características ultrassonográficas de ecogenicidade (hipo/hiperecogênicos), ecotextura (homogêneos/heterogêneos), regularidade, invasividade em tecidos adjacentes. As dimensões foram mensuradas para cálculo da razão profundidade/largura. Os neoplasmas foram classificados como malignos ou benignos após análise cito e/ou histopatológica e os resultados foram associados com as características ultrassonográficas. Verificou-se associação significativa (P<0.05) entre malignidade e ecogenicidade, ecotextura e invasividade em tecidos adjacentes, de forma que 84.6% dos neoplasmas hipoecogênicos, 76.9% das massas heterogêneas e 88.2% dos neoplasmas invasivos foram classificados como malignos. Entretanto, para todas essas associações, foram obtidos valores preditivos moderados, que podem ser decorrentes do baixo número experimental incluso neste estudo. Sendo assim, embora tenha sido observado que os neoplasmas hipoecogênicos, heterogêneos e invasivos tiveram maior propensão à malignidade, esses achados devem ser utilizados com cautela até novos trabalhos sejam desenvolvidos com maior número e variedade de neoplasmas cutâneos de cães.(AU)

Accuracy of B-mode ultrasonography for detecting malignancy in canine cutaneous neoplasms: preliminary results

ABSTRACT: The aim of this study was to verify the applicability and accuracy of B-mode ultrasonography in detecting malignancy in dog cutaneous neoplasms. Forty-two neoplasms (12 benign and 30 malignant) of mesenchymal, round cells, epithelial and melanocytic origins from 24 dogs of different breeds and ages were included. The ultrasound evaluation was performed with a linear multi-frequency transducer (7.0 to 12MHz), with frequency dependent on the mass dimension. Ultrasonographic characteristics of echogenicity (hypo/hyperechogenic), echotexture (homogeneous/heterogeneous), regularity, invasiveness in adjacent tissues were classified. Dimensions were also measured to calculate the depth/width ratio. Neoplasms were classified as malignant or benign after cytological and/or histopathological analysis and the results were associated with ultrasound characteristics. There was a significant association (P 0.05) between malignancy and echogenicity, echotexture and invasiveness in adjacent tissues, so that 84.6% of hypoechogenic neoplasms, 76.9% of heterogeneous masses and 88.2% of invasive neoplasms were classified as malignant. However, for all these associations, moderate predictive values were obtained, which may be due to the small experimental number included in this study. Therefore, although it has been observed that hypoechogenic, heterogeneous and invasive neoplasms were more prone to malignancy, these findings should be used with caution until new studies are developed with a greater number and variety of cutaneous neoplasms in dogs.

RESUMO: O objetivo deste estudo foi verificar a aplicabilidade e acurácia da ultrassonografia modo-B na detecção de malignidade em neoplasmas cutâneos de cães. Foram incluídos 42 neoplasmas (12 benignos e 30 malignos) de origens mesenquimal, células redondas, epitelial e melanocítica provenientes de 24 cães de diferentes raças e idades. O exame ultrassonográfico foi realizado com transdutor linear multifrequencial (7.0 a 12MHz), com frequência dependente da dimensão da massa. Foram classificadas características ultrassonográficas de ecogenicidade (hipo/hiperecogênicos), ecotextura (homogêneos/heterogêneos), regularidade, invasividade em tecidos adjacentes. As dimensões foram mensuradas para cálculo da razão profundidade/largura. Os neoplasmas foram classificados como malignos ou benignos após análise cito e/ou histopatológica e os resultados foram associados com as características ultrassonográficas. Verificou-se associação significativa (P 0.05) entre malignidade e ecogenicidade, ecotextura e invasividade em tecidos adjacentes, de forma que 84.6% dos neoplasmas hipoecogênicos, 76.9% das massas heterogêneas e 88.2% dos neoplasmas invasivos foram classificados como malignos. Entretanto, para todas essas associações, foram obtidos valores preditivos moderados, que podem ser decorrentes do baixo número experimental incluso neste estudo. Sendo assim, embora tenha sido observado que os neoplasmas hipoecogênicos, heterogêneos e invasivos tiveram maior propensão à malignidade, esses achados devem ser utilizados com cautela até novos trabalhos sejam desenvolvidos com maior número e variedade de neoplasmas cutâneos de cães.

Prevalência do uso de fotoproteção e fatores associados em feirantes / Prevalence of the use of photoprotection and associated factors in marketers / Prevalencia del uso de fotoprotección y factores asociados en feirantes

Objetivo: estimar a prevalência do uso de fotoproteção e associar aos fatores sociodemográficas, fototipo e fatores de riscos em feirantes. Métodos: trata-se de um estudo transversal com amostra de 150 feirantes cadastrados na Central de Abastecimento do Norte de Minas. Utilizou-se questionário acerca do perfil sociodemográfico, hábitos de exposição solar, medidas de fotoproteção e fatores de risco para neoplasia cutânea. Descreveram-se as frequências simples e porcentagens. A análise bivariada realizou-se por meio do teste qui-quadrado (x²) e Teste Exato de Fisher's. Considerou-se relevância estatística p < 0,05. Resultado: observou-se elevada prevalência do não uso da fotoproteção solar pelos feirantes (50%). Ademais, houve uma associação significativa entre fotoproteção e as variáveis cor dos olhos (p = 0,039), tempo de exposição (p = 0,000), horário de exposição (p = 0,057) e assistência médica (p = 0,005). Conclusão: feirantes de olhos escuros, que se expõem ao sol por mais de 3 horas, o dia inteiro e não procuram assistência médica, não usam fotoproteção

Objective: to estimate the prevalence of photoprotection use and to associate sociodemographic factors, phototype and risk factors in marketers. Methods: this is a cross-sectional study with a sample of 150 marketers registered at the Northern Minas Supply Center. A questionnaire about the sociodemographic profile, habits of sun exposure, measures of photoprotection and risk factors for cutaneous neoplasia was used. Simple frequencies and percentages were described. The bivariate analysis was performed using the chi-square test (x²) and Fisher's Exact Test. Statistical relevance was considered p <0.05. Results: there was a high prevalence of solar photoprotection not being used by farmers (50%). In addition, there was a significant association between photoprotection and the variables eye color (p = 0.039), exposure time (p = 0.000), exposure time (p = 0.057) and medical care (p = 0.005). Conclusion: dark-eyed marketers, who are exposed to the sun for more than 3 hours, all day and do not seek medical attention, do not use photoprotection

Objetivo: estimar la prevalencia del uso de fotoprotección y asociar a los factores sociodemográficos, fototipo y factores de riesgo en feriantes. Métodos: se trata de un estudio transversal con muestra de 150 feriantes registrados en la Central de Abastecimiento del Norte de Minas. Se utilizó un cuestionario sobre el perfil sociodemográfico, hábitos de exposición solar, medidas de fotoprotección y factores de riesgo para neoplasia cutánea. Se describieron las frecuencias simples y porcentajes. El análisis bivariado se realizó por medio de la prueba qui-cuadrado (x²) y la prueba exacta de Fisher's. Se consideró relevancia estadística p <0,05. Resultado: se observó elevada prevalencia del no uso de la fotoprotección solar por los feirantes (50%). Además, hubo una asociación significativa entre fotoprotección y las variables color de los ojos (p = 0,039), tiempo de exposición (p = 0,000), horario de exposición (p = 0,057) y asistencia médica (p = 0,005). Conclusión: los ojos oscuros, que se exponen al sol durante más de 3 horas, todo el día y no buscan asistencia médica, no usan fotoprotección

Epidermodisplasia verruciforme y carcinoma epidermoide - diagnóstico y tratamiento / Verruciform epidermodysplasia and epidermoid carcinoma - diagnosis and treatment

La epidermodisplasia verruciforme es una genodermatosis precancerosa de tipo autosómica recesiva, infrecuente, de distribución mundial. Los portadores de esta enfermedad presentan una inmunodepresión celular selectiva contra determinados tipos de virus papiloma humano, sobre todo con los genotipos 5 y 8, desarrollando desde edades tempranas de la vida lesiones semejantes a pitiriasis versicolor, verrugas planas y queratosis seborreicas, muy extendidas, crónicas y refractarias al tratamiento. Es habitual la aparición de carcinomas escamosos múltiples, especialmente en el contexto de cofactores carcinogénicos como el sol. Presentamos a un paciente con diagnóstico de epidermodisplasia verruciforme, que evidenciaba lesiones tipo verrugas planas, queratosis seborreicas y carcinoma escamoso, la cual fue tratada con excéresis con margen de seguridad y reconstrucción con injerto de piel parcial y colocación de sistema de aspiración sellada al vacío con buena evolución.

Verruciform epidermodysplasia is a rare, autosomal recessive precancerous genodermatosis with a worldwide distribution. Carriers of this disease present a selective cellular immunosuppression against certain types of human papilloma virus, especially with genotypes 5 and 8, developing from early ages of life lesions similar to pityriasis versicolor, flat warts and seborrheic keratoses, very widespread, chronic and refractory to treatment. Multiple squamous cell carcinomas are common, especially in the context of carcinogenic cofactors such as the sun. We present a patient with a diagnosis of verruciform epidermodysplasia, who evidenced flat wart-like lesions, seborrheic keratoses and squamous carcinoma, which was treated with excision with a margin of safety and reconstruction with partial skin graft and placement of a vacuum-sealed aspiration system with good evolution.

Canine cutaneous neoplasms in the metropolitan region of Goiânia, Goiás state, Brazil / Neoplasias cutâneas caninas na região metropolitana de Goiânia, Goiás, Brasil

ABSTRACT: The present study aimed to describe the occurrence and epidemiological features of skin neoplasms diagnosed in dogs in the metropolitan region of Goiânia, Goiás state, Brazil. Diagnoses from dog biopsies from 2011 to 2016 provided by a private veterinary pathology laboratory were analyzed. The main diagnoses were mast cell tumor, hemangiosarcoma, squamous cell carcinoma, malignant melanoma, and hemangioma. Highest frequency of neoplasms was found in female dogs, dogs aged > 8 years, and purebred dogs, particularly the American Pit Bull Terriers and the Poodles. Most common sites affected by the neoplasms were the limb and the head. Using multiple correspondence analysis, groups of neoplasms were found to be associated with different epidemiological features and the size of the neoplasms was associated with the biological behavior. The results of this study described predispositions and verified the importance of different types of skin neoplasms in dogs in the region being studied.(AU)

O objetivo deste estudo foi determinar a prevalência e as características epidemiológicas das neoplasias cutâneas em cães na região metropolitana de Goiânia, Goiás. Foram analisados os diagnósticos de um laboratório do setor privado de 2011 a 2016. Mastocitoma, hemangiossarcoma, carcinoma de células escamosas, melanoma maligno e hemangioma representaram os principais diagnósticos. A maioria dos casos ocorreram em cães de raças definidas, fêmeas e com idade >8 anos. American Pit Bull Terrier e Poodle foram as raças mais encontradas. As neoplasias acometeram principalmente regiões de membros e cabeça. Pela análise de correspondência múltipla, associou-se os grupos de neoplasias com diferentes características epidemiológicas e o tamanho da neoplasia com o comportamento biológico. A comparação dos resultados com pesquisas prévias possibilitou confirmar predisposições previamente descritas e verificar a importância dos diferentes tipos de neoplasias cutâneas em cães na região estudada.(AU)

Prevalencia de cáncer de piel en pacientes de 18 a 50 años en el Hospital Teodoro Maldonado Carbo durante el periodo 2014 -2019 / Prevalence of skin cancer in patients aged 18 to 50 years at the Teodoro Maldonado Carbo Hospital during the 2014 -2019 period

Introducción: El cáncer de piel consta como una de las neoplasias másfrecuentes y el número de casos ha aumentado significativamente a través de los años, la OMS indica que en las últimas dos décadas la incidencia del cáncer de piel aumentó en un 300%. Es más frecuente en pacientes mayores de 50 años, sin embargo, en los últimos años han aumentado los casos en pacientes jóvenes y hay escasos estudios epidemiológicos al respecto, por lo que en este trabajo se busca encontrar la prevalencia del cáncer de piel en pacientes de 18 a 50 años. Métodos: Se realizó un estudio de prevalencia, retrospectivo, observacional y descriptivo, utilizando las historias clínicas registradas en el AS400 del Hospital de Especialidades Teodoro Maldonado Carbo durante el periodo 2014 ­2019. El estudio contó con una población de 105 pacientes que tienen de 18 a 50 años. Resultados:Se obtuvo una muestra de 51 pacientes donde la media de edad fue de 40,94 años con un predominio del sexo femenino (79,47 %) en comparación con el sexo masculino (23,53 %). El tipo de cáncer más frecuente fue el basocelular (54,90 %), seguido del melanoma (27,45 %) y el espinocelular (7,84 %). Con respecto a los factores de riesgo y comorbilidades, se encontró que la mayoría no los tiene; 80.4% sin factores de riesgo y 90,20 % sin comorbilidades. Conclusión:La edad media fue de 40.94 años. El tipo de cáncer de piel más frecuente fue el basocelular y el sexo predominante fue el femenino. No se encontraron factores de riesgos ni comorbilidades de importancia en este estudio

Introduction: Skin cancer is one of the most common cancers and the number of cases has increased rapidly over the years, the WHO announces that skin cancer incidence increasedby 300% during the last two decades. It is more frequent that patients over 50 years old develop skin cancer, however, in the lasts years rates have risen in young patients and there are few epidemiological studies regarding this, therefore this research seeks to find the prevalence of skin cancer in patients that are from 18 to 50 years old. Methods: This is a retrospective, observational and descriptive prevalence study, where the medical records registered in the AS400 of the Teodoro Maldonado Carbo Specialties Hospital during the period 2014 ­2019 were used. The study had a population of 105 patients who have from 18 to 50 years old. Results:A sample of 51 patients was obtained where the median age was 40.94 years with a predominance of the female sex (79.47%) compared to the male sex (23.53%). The most frequent type of cancer was basal cell (54.90%), followed by melanoma (27.45%) and squamous cell (7.84%). It was found that most patients have neither risk factors nor comorbidities; 80.4% without risk factors and 90.20% without comorbidities. Conclusion:The average age was 40.94 years. The most frequent type of skin cancer was basal cell cancer and the predominant sex was female. No significant risk factors or comorbidities were found in this study

Reconstrução de couro cabeludo após ampla ressecção de angiossarcoma / Scalp reconstruction after wide resection of an angiosarcoma

Introdução: O couro cabeludo é uma área de difícil reconstrução devido à sua pouca elasticidade e por sobrepor-se a uma estrutura rígida e convexa. Existem diferentes técnicas cirúrgicas para reparação dos defeitos, que podem ser produto de diversas etiologias, como: traumas, deformidades e consequência de doenças, principalmente oncológicas, como é o caso do paciente apresentada neste trabalho. O angiossarcoma cutâneo é um tumor vascular maligno raro e extremamente agressivo, que afeta principalmente idosos. É caracterizado clinicamente pelo aparecimento de placas eritêmato-violáceas e de rápida evolução. O tratamento depende da extensão da doença. A maioria dos casos são tratados com ampla ressecção cirúrgica e reconstrução. O objetivo é relatar um caso de reconstrução de grande defeito do couro cabeludo depois de uma dissecção oncológica, realizado no Hospital Central do Exército (HCE) - RJ. Métodos: O caso foi tratado com enxerto autólogo e uso de matriz dérmica, em 2 tempos cirúrgicos, até a total cobertura da área lesionada. Resultados: Obteve-se resultado satisfatório após as cirurgias de enxertia de pele na área ressecada. Conclusão: O enxerto autólogo, juntamente a matriz dérmica mostrou-se uma opção viável na reconstrução do couro cabeludo.

Introduction: It is difficult to reconstruct the scalp due to its poor elasticity and presence of layers over a rigid convex structure. Different surgical techniques are used to repair defects that may develop due to several etiologies, such as trauma, deformities, and disease sequelae, especially cancer, as noted in the present case. Cutaneous angiosarcoma, a rare and extremely aggressive malignant vascular tumor that mainly develops in elderly individuals, is clinically characterized by the onset of rapidly evolving erythematous purple plaques. The treatment depends on disease extent. Most patients are treated with wide surgical resection and reconstruction. The objective is to report a case of reconstruction of a major scalp defect after an oncologic dissection performed at the Hospital Central do Exército in Rio de Janeiro. Methods: An autologous graft and dermal matrices were applied during two surgical periods till the damaged area was fully covered. Results: Satisfactory results were obtained after performing skin grafting surgery in the resected area. Conclusion: The autologous graft and dermal matrix proved to be a viable option for scalp reconstruction.

Incidence of skin tumors in dogs in Salvador, Bahia state, Brazil (2007-2016) / Frequência de dermatopatias tumorais em cães da cidade de Salvador, Bahia (2007-2016)

This study aimed to establish the incidence of skin tumors (cutaneous proliferative lesions of neoplastic or non-neoplastic nature) in dogs diagnosed by histopathological evaluation at the Veterinary Pathology Laboratory (LPV) of the Federal University of Bahia (UFBA) in a 10-year (2007-2016) historical series. Of the 1945 histopathological diagnoses made in this period, 503 were skin biopsies, and 617 dermatological problems (87 dogs, 17.3%, presented more than one positive diagnosis) were found. Of the 617 diagnoses of dermatopathy, 546 (88.49%) were tumors and 71 (11.51%) were non-tumorous alterations. The 546 conditions more profoundly studied were from 453 dogs, 468 (85.7%) neoplastic and 78 (14.3%) non-neoplastic tumors. The 468 neoplasms were classified as follows: 230 benign (49.14%), 215 malignant (45.94%), 23 borderline (epitheliomas) (4.91%), 51.92% (243/468) mesenchymal, 42.74% (200/468) epithelial, 4.91% (23/468) melanocytic, and 0.43% (2/468) metastatic (mammary gland). The most commonly diagnosed neoplastic dermatopathies were mastocytoma (14.7%) and lipoma (7.48%). Among the 78 non-neoplastic conditions (14.3%), epidermal inclusion cyst (39.74%) and trichogranuloma (15.38%) were the most frequent. Canine dermatopathies accounted for 26% of the biopsy files of the LPV-UFBA. Distinct simultaneous dermatological problems were frequently found in the dogs assessed (one in six). Considering that these conditions can present with different cellular origin and biological behavior, it is crucial that histopathological evaluation be performed in fragments from the different cutaneous lesions.(AU)

Objetivou-se com esse estudo determinar a frequência de dermatopatias tumorais (lesões proliferativas cutâneas que cursam com aumento de volume de natureza neoplásicas ou não neoplásicas) em cães, diagnosticadas por exame histopatológico no Laboratório de Patologia Veterinária (LPV) da Universidade Federal da Bahia (UFBA) na série histórica de 10 anos (2007-2016). Dos 1.945 exames histopatológicos realizados no período, 503 tratava-se de biópsias cutâneas, dentre os quais, foram diagnosticados 617 dermatopatias (87 cães, 17,3%, apresentavam mais de um diagnóstico). Dos 617 diagnósticos de dermatopatias 546 (88,49%) foram tumorais e 71 (11,51%) não tumorais. As 546 dermatopatias tumorais, estudadas com mais ênfase, foram diagnosticadas em 453 cães, 468 (85,7%) eram neoplásicas e 78 (14,3%) não neoplásicas. Das 468 dermatopatias tumorais neoplásicas encontradas 230 foram benignas (49,14%), 215 malignas (45,94%), 23 borderline/epiteliomas (4,91%), 51,92% (243/468) de origem mesenquimal, 42,74% (200/468) epiteliais, 4,91% (23/468) melanocíticas e 0,43% (2/468) metastáticas para a pele (primárias de glândula mamária). As dermatopatias neoplásicas mais diagnosticadas foram o mastocitoma (14,7%) e o lipoma (7,48%). Dentre as 78 dermatopatias tumorais não neoplásicas (14,3%), os cistos de inclusão epidermal (39,74%) e o tricogranuloma (15,38%) foram os mais frequentes. As dermatopatias caninas representaram 26% da casuística no LPV/UFBA. A ocorrência de dermatopatias tumorais simultâneas distintas foi comum nos cães desse estudo (um a cada seis); como podem ter origens celulares e comportamentos biológicos diferentes, enfatiza-se a importância da coleta e envio para exame histopatológico de fragmentos das diferentes lesões cutâneas.(AU)

Angiolymphoid hyperplasia with eosinophilia versus Kimura's disease: a case report and a clinical and histopathological comparison

Abstract Angiolymphoid hyperplasia with eosinophilia is a rare and benign vascular tumor whose etiology remains uncertain. It clinically presents itself by angiomatous papules or nodules located on the head and neck. Many controversies in the literature are found in relation to angiolymphoid hyperplasia with eosinophilia and Kimura's disease - its main differential diagnosis - due to their clinical and histopathological similarities. However, currently, most studies agree that they are distinct diseases. The present case illustrates a characteristic description of angiolymphoid hyperplasia with eosinophilia and also highlights the main differences with Kimura's disease.

Cutaneous involvement as the initial presentation of metastatic breast adenocarcinoma - Case report

Cutaneous metastasis is an uncommon manifestation of visceral malignancy. It occurs late in the course of the disease but can be a sign of an unknown neoplasm. A case of local cutaneous metastasis by contiguity with breast adenocarcinoma is reported. It presented as initial manifestation and main complaint of a 68-year-old woman, with no family history and negative screening tests for the disease. Biopsies of ulcers which do not heal, persistent hardened erythema and cutaneous nodules of unknown cause must be performed, since the evidence of cutaneous metastasis can be of extreme importance for the diagnosis, staging and prognosis of an internal cancer. In this scenario, the dermatologist plays a fundamental role and should be always attentive to this diagnostic possibility.

Caracterización de la población con carcinoma basocelular en el Centro Dermatológico Federico Lleras Acosta / Characteristics of patients with basal cell carcinoma in Centro Dermatológico Federico Lleras Acosta

Introducción: el cáncer de piel no melanoma es el tumor maligno más frecuente en el humano. De éstos, el 80 % corresponde a carcinomas basocelulares. Objetivo: caracterizar la población de los pacientes con carcinoma basocelular que consultaron al Centro Dermatológico Federico Lleras Acosta. Métodos: estudio descriptivo de todos los casos confirmados histológicamente de carcinoma basocelular en un periodo de tres años. Se obtuvo información acerca de las características socio-demográficas, subtipos clínicos e histológicos y los tiempos transcurridos desde la detección de la lesión por parte del paciente y la confirmación histológica del tumor, hasta la fecha de realización del tratamiento. Resultados: el estudio incluyó un total de 769 casos de carcinoma basocelular. El 75 % de los tumores se localizaron en la cara, el cuello y la piel cabelluda. El subtipo clínico e histológico más frecuente fue el nodular (67 % y 57 %, respectivamente), los subtipos histológicos mixtos fueron el 28%, y de estos el 75% correspondian a histologías de alto riesgo de recidiva tumoral. El tiempo transcurrido entre la detección de la lesión por parte del paciente y la consulta por primera vez a un servicio de salud fue de 28 meses. El tiempo transcurrido entre la toma de la biopsia y el tratamiento definitivo fue de un mes. Dentro de los tratamientos sugeridos, el más frecuente fue la cirugía convencional (89 %), seguida de la cirugía micrográfica de Mohs (7 %). Conclusiones: el subtipo clínico e histológico de carcinoma basocelular más frecuente fue el nodular. La mayoría de subtipos histológicos mixtos eran de alto riesgo para recidiva tumoral, lo cual refuerza la importancia de una buena aproximación clínica y la toma de biopsia antes de elegir el tratamiento del tumor. Los pacientes con carcinomas basocelular tienden a consultar tardíamente a su servicio de salud, lo que retarda el diagnóstico y el tratamiento.

ABSTRACT Introduction: non melanoma skin cancer is the most frequent malignant tumor in humans, 80% of these tumors are basal cell carcinomas (BCC). Objectives: To characterize the population of patients with BCC, who consulted at Centro Dermatologico Federico Lleras Acosta in a time lapse of 3 years. Methods: we performed a descriptive study of all the BCC cases confirmed by biopsy, within a 3 years period. Information was obtained related to the socio-demographic characteristics, clinical and histological subtypes, and the time elapsed since the patient's detection of their lesion and histological confirmation of the tumor, until the definitive treatment was performed. Results: A total of 769 BCC cases were included in the study, 75% of the lesions were located on the face, neck and scalp. The most frequent clinical and histological subtype was nodular BCC (67 and 57% respectively), mixed histological subtypes were seen in 28% of the cases, 75% of them showed high risk features of tumor relapse. The time elapsed between the detection of the lesion by the patient and the first time consultation to a health service was 28 months. The time elapsed between the biopsy and the definitive treatment was 1 month. The most frequent treatment was conventional surgery (89%) followed by Mohs micrographic surgery (7%). Conclusions: The most frequent clinical and histological subtype was nodular BCC, mixed histological subtypes showed high risk features of tumor relapse in more than 50%, this confirm the importance to suspect a BCC and take a skin biopsy before treat the tumor. BCC patients tend to consult late to health services, with the consequent delay in the diagnosis and treatment.

Análise do tratamento do carcinoma basocelular / Analysis of basal cell carcinoma treatment

Introdução: O câncer de pele na população brasileira é a neoplasia mais comum. Localiza-se com mais frequência na face, causando morbidade tanto funcional quanto estética aos pacientes. O tratamento consiste na ressecção oncológica da lesão, preservando a função com a menor deformidade possível. O câncer de pele mais comum é o carcinoma basocelular (CBC), correspondendo entre 70-80% dos casos. Método: Avaliamos retrospectivamente 73 pacientes com 95 carcinomas basocelulares no período de março de 2010 a maio de 2012. Foram analisados os seguintes critérios: idade, sexo, cor, comorbidades, exposição solar, presença de consulta prévia com dermatologia, localização da lesão, tamanho da lesão, tipo clínico, tipo histológico, tipo de reconstrução, complicações cirúrgicas, margem cirúrgicas, conduta na margem cirúrgica comprometida, anatomopatológico após reintervenção, presença de recidiva e aparecimento de outra lesão primária no mesmo paciente. Resultados: A idade média foi de 60,73 anos. O sexo feminino correspondeu a 56,16%. A Exposição solar foi referida em 73,97% dos casos. O tamanho médio da lesão foi 0,91 cm. O local mais frequente foi a face (71,58%). O retalho local foi utilizado em 54,74% dos casos. O CBC sólido circunscrito foi o mais frequente. As margens comprometidas ocorreram em 8,42% dos casos, demonstrando relação com lesões maiores de 2cm e com o nariz sem significância estatística. Conclusão: No tratamento do carcinoma basocelular é importante a participação do cirurgião plástico, objetivando a ressecção sob princípios oncológicos, realizando a reparação da área afetada, a manutenção funcional e a menor alteração estética possível.

Introduction: Skin cancer is the most common neoplasm in the Brazilian population. It most frequently presents on the face, causing functional and aesthetic morbidity in patients. Its treatment consists in resection of the lesion while preserving the skin's function with the least possible deformity. The most common skin cancer is basal cell carcinoma (BCC), representing 70­80% of all cases. Methods: We retrospectively evaluated 73 patients with 95 BCCs from March 2010 to May 2012. The following characteristics were analyzed: age, sex, skin color, comorbidities, sun exposure, prior dermatological consultation, lesion site, lesion size, clinical type, histological type, reconstruction type, surgical complications, surgical margins, management of compromised surgical margins, anatomical pathology after reintervention, recurrence, and appearance of another primary lesion in the same patient. Results: The mean age of the patients was 60.73 years. Female patients accounted for 56.16%. Sun exposure was reported in 73.97% of patients. The mean lesion size was 0.91 cm, and the most common lesion site was the face (71.58%). A local flap was used in 54.74% of cases. Circumscribed solid BCC was the most common type. Compromised margins occurred in 8.42% of cases, demonstrating a relation between lesions >2 cm and the nose but without statistical significance. Conclusion: The plastic surgeon plays an important role in the treatment of BCC, aiming to perform resection following oncological principles, repair the affected area, and maintain the skin's functionality with the least possible cosmetic alterations.

Prevalência de neoplasmas cutâneos em cães da região metropolitana de Porto Alegre, RS: 1.017 casos (2002-2007) / Prevalence of cutaneous neoplasms in dogs from the metropolitan area of Porto Alegre, RS, Brazil: 1,017 cases (2002-2007)

O objetivo deste trabalho foi realizar um estudo retrospectivo sobre neoplasias cutâneas diagnosticadasem cães. A avaliação foi realizada pela análise dos arquivos diagnósticos do Setor de Patologia Veterinária (SPV) da Universidade Federal do Rio Grande do Sul (UFRGS), Brasil, considerando-se um intervalo de seis anos (2002 a 2007). Neste intervalo, um total de 1.869 (37,3 por cento) amostras de pele canina foram obtidas de 5.016 amostras variadas de tecidos de cães encaminhadas ao SPV. Dentre as amostras cutâneas, 1.002 pertenciam a cães diagnosticadoscom um tipo de neoplasia cutânea e 15 animais apresentaram mais de uma neoplasia de pele, totalizando 1.017 (20,3 por cento) amostras. Os resultados revelaram que 50,5 por cento (514/1017) das neoplasias cutâneas apresentaram origem mesenquimal, 45,1 por cento (459/1017) paraepitelial e 3,9 por cento (40/1017) para melanocítica. Mastocitoma foi o tipo neoplásico cutâneo mais frequente, diagnosticado em 228 casos (22,4 por cento), seguido por carcinoma de células escamosas (7,5 por cento), lipoma (7,3 por cento), adenoma de glândula perianal (7,1 por cento) e tricoblastoma (5,8 por cento). Cocker Spaniel, Boxer, Poodle e Pastor Alemão foram as raças mais representadas em diversos neoplasmas. Os dados obtidos, comparados aos estudos prévios, ressaltam as variáveis raças, idade e sexo, relacionadas a alguns tumores cutâneos e salientam a importância e prevalência dos diferentes tipos de neoplasia cutânea em cães.

The aim of this study was to perform a retrospective study of cutaneous neoplasms diagnosed in dogs. The evaluation was established by analyzing the diagnostic files at the Veterinary Pathology Sector, UFRGS, Brazil, over a 6-year period (2002 to 2007). During this period a total of 1869 (37.3 percent) skin samples were obtained from 5016 different tissue samples of dogs submitted for examination. Among the referred skin samples, 1002 were from dogs with the diagnosis of cutaneous neoplasia and 15 dogs exhibited more than one type of skin tumor, what amounted to a total of 1017 (20.3 percent) cutaneous tumor samples. Results confirmed 50.5 percent (514/1017), 45.1 percent (459/1017), and 3.9 percent (40/1017) of respectively mesenquimal, epithelial, and melanocytic origin. Mast cell tumor was the most frequent neoplasia, diagnosed in 228 cases (22.4 percent), and was followed by squamous cell carcinoma (7.5 percent), lipoma (7.3 percent), perianal gland adenoma (7.1 percent), and trichoblastoma (5.8 percent). Purebred dogs such as Cocker Spaniel, Boxer, Poodle and German Sheepdog were the most representative breeds affected by various neoplasms. The data obtained, compared to data from previous studies, emphasize the variables breed, age and sex related to some skin tumors, and reinforce the importance and prevalence of different types of skin tumors in dogs.

Imiquimod creme a 5 por cento no tratamento do carcinoma basocelular superficial: experiência em Porto Alegre – RS / Imiquimod 5 percent cream in the treatment of superficial basal cell carcinoma: experience in Porto Alegre – RS

Em um estudo aberto, quatro pacientes foram selecionados para avaliação da eficácia do imiquimod creme 5% no tratamento do carcinoma basocelular superficial. Os pacientes utilizaram o medicamento no regime de uma aplicação diária, por 12 semanas. A taxa de resposta foi avaliada pela remissão clínica e histológica. O uso do imiquimod creme a 5% no tratamento do carcinoma basocelular resultou na remissão completa dos tumores neste estudo.

In an open label study 4 patients were selected in order to evaluate the efficacy of imiquimod cream 5% in the treatment of superficial basal cell carcinoma. The patients applied the medication once a day for 12 weeks. The response rate was evaluated through the clinical and histological response. The use of imiquimod cream 5% in the treatment of basal cell carcinoma resulted in complete remission of tumors in this trial.

Expression of c-myc, bcl-2 and Apoptosis in the Human Cutaneous Squamous Cell Carcinoma / 中国医师杂志

Objective To explore the clinicophathological significance of expressions of c-myc,bcl-1 and apoptosis in the human cutaneous squamous cell carcinoma(SCC) canceration course.Methods The expressions of c-myc proteins,bcl-2 protein and apoptosis were detected in 80 cases of SCC by using TdT-mediated dUTP-biotin nick end labeling and immunohistochemical staining.Results The positive rates of c-myc and bc1-2 proteins were 62.5%,38.8% respectively,in SCC tissue(P