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1.
An. bras. dermatol ; 94(5): 503-520, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054862

ABSTRACT

Abstract Oculocutaneous albinism is an autosomal recessive disease caused by the complete absence or decrease of melanin biosynthesis in melanocytes. Due to the reduction or absence of melanin, albinos are highly susceptible to the harmful effects of ultraviolet radiation and are at increased risk of actinic damage and skin cancer. In Brazil, as in other parts of the world, albinism remains a little known disorder, both in relation to epidemiological data and to phenotypic and genotypic variation. In several regions of the country, individuals with albinism have no access to resources or specialized medical care, and are often neglected and deprived of social inclusion. Brazil is a tropical country, with a high incidence of solar radiation during the year nationwide. Consequently, actinic damage and skin cancer occur early and have a high incidence in this population, often leading to premature death. Skin monitoring of these patients and immediate therapeutic interventions have a positive impact in reducing the morbidity and mortality associated with this condition. Health education is important to inform albinos and their families, the general population, educators, medical professionals, and public agencies about the particularities of this genetic condition. The aim of this article is to present a review of the epidemiological, clinical, genetic, and psychosocial characteristics of albinism, with a focus in skin changes caused by this rare pigmentation disorder.


Subject(s)
Humans , Male , Female , Albinism/genetics , Albinism/pathology , Skin Neoplasms/etiology , Skin Neoplasms/physiopathology , Ultraviolet Rays/adverse effects , Brazil/epidemiology , Carcinoma, Basal Cell/etiology , Carcinoma, Basal Cell/pathology , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/pathology , Albinism/complications , Albinism/epidemiology , Prevalence , Risk Factors , Keratosis, Actinic/etiology , Keratosis, Actinic/pathology , Melanins/deficiency
2.
An. bras. dermatol ; 94(2): 157-163, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001134

ABSTRACT

Abstract BACKGROUND: Skin cancer is common in Brazil and is related to sun exposure, among other risk factors. There are no data on the incidence of malignant skin neoplasm in rural workers in western Paraná. OBJECTIVE: To analyze the incidence and profile of rural workers who were diagnosed with skin cancer at a reference service in Cascavel, western Paraná, in the last five years (2011-2016). METHODS: This retrospective cross-sectional study was carried out through a review of the anatomopathological reports of rural workers diagnosed with skin cancer at Cascavel Oncology Center (CEONC), in Cascavel. The following variables were collected: year of diagnosis, age, gender, injury location and histological subtype. RESULTS: A total of 681 cases of malignant epithelial neoplasia were identified, with a higher frequency in the 61-70 age group. Data analysis showed an increase of about 210% in the occurrence of skin cancers in the last 5 years. The cephalic region was the most affected, and the most common histological subtype was nodular basal cell carcinoma. There was no association between gender and location. STUDY LIMITATIONS: This is a retrospective study and analysis of a secondary data bank. CONCLUSION: This study is a regional estimation of the incidence of cutaneous neoplasms and provides evidence of a considerable increase in the number of diagnoses in rural workers from western Paraná, Brazil. Moreover, it is possible to conclude that the sample group studied is at risk of developing skin cancer.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Melanoma/epidemiology , Rural Population/statistics & numerical data , Skin Neoplasms/etiology , Sunlight/adverse effects , Brazil/ethnology , Brazil/epidemiology , Carcinoma, Basal Cell/etiology , Carcinoma, Squamous Cell/etiology , Incidence , Cross-Sectional Studies , Retrospective Studies , Age Distribution , Face , Melanoma/etiology
3.
Rev. Asoc. Méd. Argent ; 131(3): 17-22, Sept. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1009234

ABSTRACT

Se presenta un caso clínico con un cuadro de hidradenitis supurativa crónica que evolucionó a carcinoma epidermoide. Se realiza una revisión de la literatura de esta enfermedad. (AU)


A clinical case with a chronic suppurative hidradenitis syndrome that progressed to squamous cell carcinoma is presented. A review of the literature of this disease is made. (AU)


Subject(s)
Humans , Male , Female , Adult , Young Adult , Carcinoma, Squamous Cell/etiology , Hidradenitis Suppurativa/surgery , Hidradenitis Suppurativa/complications , Hidradenitis Suppurativa/drug therapy , Disease Progression , Early Diagnosis
5.
Rev. chil. cir ; 70(1): 59-65, 2018. tab, ilus
Article in Spanish | LILACS | ID: biblio-899657

ABSTRACT

Resumen Introducción La rehabilitación oral con implantes es en la actualidad la mejor opción para el tratamiento de pacientes parcial o totalmente edéntulos. Sin embargo, no es un procedimiento exento de complicaciones. La aparición de carcinoma epidermoide en la encía circundante de los implantes, aunque infrecuente puede ser una de ellas y aunque no hay muchos casos descritos en la literatura, sería conveniente establecer qué relación, si es que existiera, pueden tener los implantes en el desarrollo de esta enfermedad. Caso clínico Presentamos el caso de una mujer de 85 años de edad con antecedentes personales de liquen plano oral, exfumadora y portadora de implantes osteointegrados colocados en las áreas correspondientes a 34, 45 y 46, que desarrolló un carcinoma epidermoide en la encía periimplantaria.


Introduction Currently, dental implants is considered as the best choice for edentulism partial or complete treatment. However, this treatment has some associated medical complications such as surrounding gum squamous cell carcinoma. Even though there are not that many cases described in medical literature, it could be appropriated to determine whether there is any relation between this neoplasic disease and the dental implants. Clinical case Presenting a 85-year-old women with PMH of lichen planus, ex-smoker and osseointegrated dental implant in areas 34, 45 and 46, with surrounding implant gum area Squamous cell carcinoma.


Subject(s)
Humans , Female , Aged, 80 and over , Mouth Neoplasms/diagnosis , Carcinoma, Squamous Cell/diagnosis , Dental Implantation/adverse effects , Mouth Neoplasms/surgery , Mouth Neoplasms/etiology , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/etiology
6.
Rev. ADM ; 74(5): 239-244, sept.-oct. 2017. ilus
Article in Spanish | LILACS | ID: biblio-973043

ABSTRACT

El carcinoma epidermoide cutáneo, es una neoplasia maligna la cual se origina a partir de los queratinocitos de la piel o mucosa, siendo considerado el segundo cáncer con más frecuencia en cabeza y cuello después del carcinoma basocelular. Su etiología es multifactorial, siendo el factor predisponente la exposición solar prolongada (radiación ultravioleta), la cual afecta directamente el ADN celular. Asimismo se ha asociado la infección por virus del papiloma humano, influyendo en el estado inmune del paciente. Es de suma importancia conocer factores de pronóstico como son: tamaño tumoral, profundidad, tipo histológico, invasión perineural, zonas de riesgo y zonas de drenaje, los cuales incrementaránel riesgo de recidiva y metástasis a distancia, impactando de manera importante en el pronóstico del paciente. El tratamiento del carcinoma epidermoide puede ser multimodal, desde cirugía, radioterapia y quimioterapia. En este artículo presentamos nuestra experienciaen el tratamiento del carcinoma epidermoide cutáneo de pacientefemenino de 64 años de edad, la cual es referida a nuestra consulta porla presencia de una lesión ulcerada en región frontal. Apegándonos a protocolos establecidos en la literatura internacional y nacional, se realiza resección quirúrgica más rotación de colgajos cutáneos para la reconstrucción del defecto residual, obteniendo resultados satisfactorios tanto funcionales como estéticos, los cuales impactan de forma directa en la calidad y pronóstico de vida de la paciente.


Cutaneous squamous cell carcinoma is a malignant tumor which originates from keratinocytes of the skin or mucosa, being consideredthe second most common cancer in the head and neck after basal cellcarcinoma. Its etiology is multifactorial, being the predisposing factorprolonged sun exposure (ultraviolet radiation), which directly affects thecell’s DNA, so it has been associated infection human papilloma virus,influencing the immune status of the patient. It is extremely important toknow prognostic factors such as: tumor size, depth, histological type,perineural invasion, risk areas and drainage areas, which will increasethe risk of recurrence and distant metastases, impacting significantlyon the forecast patient. Treatment of squamous cell carcinoma may bemultimodal, from surgery, radiotherapy and chemotherapy. We presentour experience in the treatment of squamous cell carcinoma skin of afemale 64 years old, which is referred to our clinic by the presenceof an ulcerated lesion in the frontal region, by adhering to protocolsestablished in international and national literature. Surgical resectionis performed more rotation skin flaps for reconstruction of the residualdefect, obtaining both functional and aesthetic satisfactory results,which directly impact the quality of life and prognosis of the patient.


Subject(s)
Female , Humans , Middle Aged , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/surgery , Skin Neoplasms/classification , Surgical Flaps , Oral Surgical Procedures/methods , Prognosis , Follow-Up Studies , Mexico
7.
An. bras. dermatol ; 92(4): 492-498, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-886986

ABSTRACT

Abstract: Background: Many factors are currently being identified as potential inductors of skin cancer in patients after a liver transplant, among them, immunosuppressive regimen. Objective: To study the factors that influence the incidence of skin cancer in patients after liver transplant. Methods: We have carried out a retrospective and observational study with 170 transplanted patients who had undergone transplantation from 1997 to 2010. We have adjusted the multiple logistic regression model (saturated model) to the ensemble of collected data using skin cancer as dependent variable, indicated in anatomopathological analysis between 1997 and 2014. Results: Incidence of skin cancer was 9.4%. Predictors were incidence of diabetes in the third year after the transplantation (p=0.047), not using tacrolimus in the first year after the transplantation (p=0.025) and actinic keratosis (p=0.003). Study Limitations: An important limitation is that the interpretation of the results was based on information collected of patients undergoing transplantation at a single center. Future research, multicentric and involving larger and more diverse populations, are needed. Conclusions: Factors found might contribute to Brazilian surveillance programs associated with decreased incidence of skin cancer.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Immunosuppression/adverse effects , Liver Transplantation/adverse effects , Skin Neoplasms/etiology , Skin Neoplasms/pathology , Brazil/epidemiology , Carcinoma, Basal Cell/etiology , Carcinoma, Basal Cell/pathology , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/pathology , Logistic Models , Incidence , Retrospective Studies , Risk Factors , Age Factors , Diabetes Mellitus/epidemiology , Immunosuppressive Agents/therapeutic use
8.
J. coloproctol. (Rio J., Impr.) ; 37(1): 72-79, Jan.-Mar. 2017.
Article in English | LILACS | ID: biblio-841301

ABSTRACT

ABSTRACT Background: Anal canal carcinoma is a rare neoplasm, representing 2% of the digestive tumors, and the most common is squamous cell carcinoma, with an increasing incidence. Objective: The study aims to elucidate the pathogenesis of an increasingly prevalent disease, as well as to update treatment and prognosis. Methods: A literature search in Pubmed database, including articles from 2005 to 2015 and cross-research articles with the initial research. Results: Several studies prove the role of HPV as a major risk factor in the development of squamous cell carcinoma of anal canal, as well as a greater prevalence of this neoplasia in HIV-positive people and in those who practice receptive anal intercourse. In the last two decades chemoradiotherapy remains the treatment of choice, and abdominoperineal resection is reserved for those cases of treatment failure or recurrence. Evidence advances in order to adapt the treatment to each patient, taking into account individual prognostic factors and biological tumor characteristics. Conclusions: Squamous cell carcinoma of the anal canal is a neoplasm associated with HPV; therefore, screening and vaccination programs of male individuals, by way of prevention, should be started. Many studies are needed in order to achieve development in the treatment as well as in the evaluation of the biological characteristics of the tumor.


RESUMO Introdução: O carcinoma do canal anal é uma neoplasia rara, representando 2% dos tumores digestivos, sendo o epidermóide o mais comum com uma incidência crescente. Objetivo: Este estudo pretende elucidar sobre a etiopatogenia desta patologia cada vez mais prevalente, assim como atualizar sobre o tratamento e prognóstico. Métodos: Pesquisa bibliográfica na base de dados Pubmed, incluindo artigos de 2005 a 2015, assim como artigos de pesquisa cruzada com os artigos iniciais. Resultados: Diversos estudos provam o papel do HPV como um fator de risco major no desenvolvimento de carcinoma epidermóide do canal, assim como uma maior prevalência desta neoplasia na população HIV positiva e nos que praticam sexo anal recetivo. O tratamento continua a ser desde há duas décadas a quimioradioterapia, reservando a resseção abdominoperineal para casos de falência do tratamento ou recorrência. A evidência avança no sentido de adequar o tratamento a cada doente, tendo em conta fatores prognósticos individuais e as características biológicas do tumor. Conclusões: O carcinoma epidermóide do canal anal é uma neoplasia associada ao HPV, logo deveria iniciar-se programas de rastreio e vacinar o sexo masculino como prevenção. Muitos estudos são necessários para evoluir no tratamento, assim como na avaliação das características biológicas do tumor.


Subject(s)
Humans , Anus Neoplasms/pathology , Papillomaviridae/physiology , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/pathology , HIV/physiology , Papillomavirus Infections/complications , Anal Canal/injuries
9.
São Paulo; s.n; 2017. 55 p. ilust, tabelas.
Thesis in Portuguese | LILACS, Inca | ID: biblio-1178352

ABSTRACT

A osteorradionecrose (ORN) dos maxilares é uma grave complicação do tratamento radioterápico do câncer de cabeça e pescoço. A realização de exodontias em pacientes que realizaram radioterapia de cabeça e pescoço aumenta o risco de ocorrer osteorradionecrose. Foi realizado estudo prospectivo randomizado e duplo cego com dois protocolos antibióticos utilizados para prevenir a ocorrência de ORN. Pacientes do grupo 1 (G1) utilizaram cobertura antibiótica com amoxicilina 500 mg, a cada 8 horas, via oral, por 8 dias iniciando um dia antes da exodontia, pacientes do grupo 2 (G2) utilizaram cobertura antibiótica com amoxicilina 500mg a cada 8 horas via oral, por 4 dias, iniciando um dia antes do procediemento, continuando por 3 dias após a cirurgia, e utilizando placebo de igual aparência por 4 dias. Onze pacientes foram incluídos no estudo sendo 10 deles do sexo masculino. A idade média dos pacientes foi de 56± 7anos, e 63,6% utilizaram mais de 6.000 cGy durante a radioterapia. Foram realizados 36 procedimentos cirúrgicos, e 51 dentes foram extraídos. Dois pacientes (18,1%) apresentaram três áreas (5,9%) com sinais de ORN em um período médio de acompanhamento de 10± 7 meses. Todos as áreas necróticas ocorreram em região posterior (pré-molares e molares), apresentavam um ou os dois dentes com presença de lesão radiográfica, ocorreram após cirurgias com duração maior que 13 minutos, e apresentavam 1 ou 2 dentes com doença periodontal como motivo da exodontia. Duas áreas necróticas ocorreram em mandíbula, e um em maxila. Não houve diferença estatisticamente significante entre a prevalência de sinais de ORN quando considerado o número de pacientes, procedimentos cirúrgicos realizados, dentes extraídos ou o protocolo antibiótico utilizado. O protocolo utilizado por G2 reduziu o risco de sinais de ORN em pacientes que receberam tratamento radioterápico em região de cabeça e pescoço e que necessitaram remover dentes devido a doença periodontal.


Osteoradionecrosis (ORN) of jaws is a severe complication of head and neck cancer radiotherapy. Dental extractions in irradiated head and neck cancer patients increases ORN risk. A prospective, randomized, double blind study with two different ORN prevention antibiotics protocols were performed. Group 1 patients (G1) received 8th hourly oral amoxicillin 500mg for 8 days starting 1 day pre extraction, and group 2 patients (G2) received 8th hourly oral amoxicillin 500mg for 4 days starting 1 day pre extraction, followed by 4 days of a same appearance placebo drug. A total of 11 patients (10 male and one female) underwent extractions of teeth. Mean age of the patients was 56± 7 years, and 63,6% received more than 6.000cGy radiation dosages. Thirty-six surgery procedures were performed, and 51 teeth were extracted. After a mean follow-up period of 10± 7 months three ORN signals (maxilla 1/mandible 2) were reported, in 2 (18,1%) patients. Necrotic areas envolve theposterior region of jaws, presented previous radiographic lesion, had more than 13 minutes of surgery time, and envolved teeth with periodontal disease. No difference in ORN prevalence beetwen groups of patients, surgical procedures, or removed teeth were detected. The G2 protocol decreased ORN risk when teeth with periodontal problems were extracted.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Osteoradionecrosis/prevention & control , Radiotherapy/adverse effects , Oral Surgical Procedures/adverse effects , Head and Neck Neoplasms/radiotherapy , Amoxicillin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Time Factors , Carcinoma, Squamous Cell/etiology , Jaw Diseases/etiology , Double-Blind Method , Prospective Studies , Risk Factors , Sex Distribution , Age Distribution
10.
Rev. méd. Chile ; 144(11): 1382-1390, nov. 2016. tab
Article in Spanish | LILACS | ID: biblio-845459

ABSTRACT

Background: Identifying risk factors for lung cancer in the population could improve the cost-effectiveness of early detection programs using thoracic computed tomography (CT). Aim: To examine the risk factors of lung cancer in a cohort of adult smokers. Patients and Methods: An annual clinical and respiratory functional assessment, chest computed tomography for three years and clinical follow up for five years was carried out in 270 patients aged 65 ± 9 years, 55% males, active or former smokers of 10 or more pack-years. Results: Thirty seven percent of patients were active smokers, consuming 37 ± 26 packs/year, 85% had comorbidities, especially chronic obstructive pulmonary disease (COPD) (66%), hypertension (48%), diabetes (22%) and dyslipidemia (42%). Thirteen percent of patients had family history of lung cancer. Twenty-one cases of lung cancer were detected in the five years follow up, especially squamous cell carcinoma and adenocarcinoma. In the univariate analysis, the main risk factors for lung cancer identified were an age older than 60 years, history of COPD, family history of lung cancer, active smoking, tobacco consumption more than 30 pack/year and lung hyperinflation. In multivariate analysis, the three independent risk factors for lung cancer were a family history of lung cancer, active smoking and the number of packs per year of tobacco consumption. Conclusions: The identification of risk groups probably will improve the performance of programs for early detection of lung cancer.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/etiology , Adenocarcinoma/etiology , Smoking/adverse effects , Lung Neoplasms/etiology , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/epidemiology , Adenocarcinoma/diagnosis , Adenocarcinoma/epidemiology , Smoking/epidemiology , Tomography, X-Ray Computed , Comorbidity , Chile/epidemiology , Prospective Studies , Risk Factors , Follow-Up Studies , Risk Assessment , Pulmonary Disease, Chronic Obstructive/etiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Diabetes Mellitus/etiology , Diabetes Mellitus/epidemiology , Dyslipidemias/etiology , Dyslipidemias/epidemiology , Early Detection of Cancer , Hypertension/etiology , Hypertension/epidemiology , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology
11.
An. bras. dermatol ; 91(5,supl.1): 166-168, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837959

ABSTRACT

Abstract Verrucous epidermal nevi are hamartomatous lesions of the epidermis that, unlike other epidermal nevi (such as sebaceous nevus or nevus comedonicus), are rarely associated with malignant neoplasms. The majority of squamous cell carcinoma develop in linear or multiple epidermal nevus and rarely in solitary epidermal nevus. In general, the prognosis is favorable. We report a case of well-differentiated invasive squamous cell carcinoma arising from a multiple verrucous epidermal nevus. Although there is no consensus on prophylactic removal of epidermal nevus, its removal and biopsy should be considered if changes occur.


Subject(s)
Humans , Male , Adult , Skin Neoplasms/etiology , Carcinoma, Squamous Cell/etiology , Nevus, Sebaceous of Jadassohn/complications , Skin Neoplasms/pathology , Skin Ulcer/pathology , Biopsy , Carcinoma, Squamous Cell/pathology , Epidermis/pathology , Nevus, Sebaceous of Jadassohn/pathology , Neoplasms, Multiple Primary/complications , Neoplasms, Multiple Primary/pathology
12.
Rev. bras. queimaduras ; 15(3): 179-184, jul.-set. 2016. ilus
Article in Portuguese | LILACS | ID: biblio-914940

ABSTRACT

Objetivo: Revisão narrativa de literatura e descrição de um caso de úlcera de Marjolin conduzido nas dependências do Hospital Escola Luiz Gioseffi Jannuzzi, enfatizando a conduta e evolução a partir da literatura e a adotada no caso abordado. Relato de Caso: Homem de 52 anos, com história de queimadura térmica em membro inferior direito há cerca de 25 anos, que evoluiu tardiamente com o aparecimento de lesão eritematosa, puntiforme e pruriginosa, tornando-se ulcerada e, posteriormente, úlcero-vegetante, com aumento progressivo e sem cicatrização, associada a dor e episódios de sangramento por traumas. Realizada biópsia incisional, o histopatológico confirmou tratar-se de carcinoma epidermoide bem diferenciado, desenvolvido em tecido cicatricial antigo. Foi realizada ressecção ampla da lesão, com enxertia local, sendo ainda necessária a realização de desbridamento no pós-operatório devido à necrose da enxertia. Conclusões: As lesões cicatriciais ou ulceradas crônicas que sofrem modificações no seu aspecto clínico evolutivo devem ser avaliadas como potencialmente carcinomatosas e as ulcerações com tendência à cronificação devem ser prontamente tratadas, com o emprego de enxerto, retalho ou até mesmo amputação se necessário. As áreas cicatriciais precisam sempre ser protegidas e deve-se sempre considerar o risco potencial de malignidade associada com úlceras venosas crônicas nos membros inferiores, realizando biópsias repetidas para descartar a possibilidade de transformação maligna. O paciente em questão necessitou de ressecção ampla da lesão, com enxertia local, a qual evoluiu com necrose no pós-operatório, sendo realizado desbridamento e curativos diários até que apresentasse recuperação e, posteriormente, cicatrização por segunda intenção.(AU)


Objective: A literature narrative review and description of a Marjolin ulcer case conducted at the Luiz Gioseffi Jannuzzi School Hospital, emphasizing the conduct and evolution from the literature and adopted in the case discussed. Case Report: 52 year old male, with a history of thermal burn in the lower right limb for about 25 years, who developed late with the onset of an erythematous, punctiform and pruritic lesion, becoming ulcerated and subsequently ulcer-creasing, progressive increase without healing, associated with pain and bleeding episodes due to trauma. An incisional biopsy was performed; the histopathological examination confirmed that it was a well differentiated squamous cell carcinoma, developed in old scar tissue. A wide resection of the lesion with local graft was performed, and postoperative debridement was still necessary due to the infectious complication. Conclusions: Scarring injuries or ulcerated chronic suffering changes in its evolving clinical aspect should be evaluated as potentially carcinomatous and ulcerations with a tendency to chronicity should be promptly treated with the use of graft, flap or even amputation if required. Scarring areas should be protected and should always consider the potential risk of malignancy associated with chronic venous ulcers of the lower limbs, and repeated biopsies should be performed to rule out the possibility of malignant transformation. The patient in question required extensive resection of the lesion with local graft, which evolved with postoperative necrosis, and debridement and daily dressings were performed until recovery and later, it heals by second intention. (AU)


Objetivo: Revisión narrativa de la literatura e informe de cso clínico de úlcera de Marjolin atendida en el Hospital Escuela Luiz Gioseffi Jannuzzi, haciendo hincapié en la gestión y la evolución de la literatura y cuidados adoptados en el caso discutido. Caso clínico: Hombre de 52 años, con historia de quemadura térmica en la extremidad inferior derecha de unos 25 años, que se desarrolló más tarde con la aparición de lesiones eritematosas, putiforme y pririginosa, convirtiéndose en úlcera y posteriormente ulcerada-vegetante, aumentando de forma progresiva y sin dejar cicatrices asociadas con el dolor y episodios de sangramiento por trauma. Se realiza biopsia incisional histopatología confirmó que este es el carcinoma de células escamosas bien diferenciado desarrollado en el tejido de la cicatriz antigua. Se realizó una resección amplia con lesión sitio de injerto, siendo necesario para llevar a cabo el desbridamiento postoperatorio debido a necrosis. Conclusiones: Cicatrización de heridas crónicas o cambios sufridos ulceradas en su aspecto clínico evoluciona deben ser evaluados como potencialmente carcinomatosa y ulceraciones con tendencia a la cronicidad se debe tratar oportunamente con el uso de injerto, aleta o incluso la amputación si necesario. Áreas de cicatrización siempre deben ser protegidos. El paciente en cuestión requiere una resección extensa del sitio de la lesión con el injerto, que se desarrolló con necrosis después de la operación, que se ha llevado a cabo desbridamiento y curativos diarios para que la recuperación y más tarde, la cicatrización por segunda intención.(AU)


Subject(s)
Humans , Male , Middle Aged , Skin Neoplasms/etiology , Burns/complications , Carcinoma, Squamous Cell/etiology , Cicatrix/complications , Leg Ulcer/etiology , Skin Neoplasms/surgery , Carcinoma, Squamous Cell/surgery , Disease Progression , Leg Ulcer/surgery
13.
An. bras. dermatol ; 91(4): 455-462, July-Aug. 2016. tab, graf
Article in English | LILACS | ID: lil-792448

ABSTRACT

Abstract: Background: Cancer is currently among the three leading causes of death after solid organ transplantation and its incidence is increasing. Non-melanoma skin cancer - squamous cell carcinoma and basal cell carcinoma - is the most common malignancy found in kidney transplant recipients (KTRs). The incidence of non-melanoma skin cancer in KTRs has not been extensively studied in Portugal. Objectives: To determine the incidence of non-melanoma skin cancer in KTRs from the largest Portuguese kidney transplant unit; and to study risk factors for non-melanoma skin cancer. Methods: Retrospective analysis of clinical records of KTRs referred for the first time for a dermatology consultation between 2004 and 2013. A case-control study was performed on KTRs with and without non-melanoma skin cancer. Results: We included 288 KTRs with a median age at transplantation of 47 years, a male gender predominance (66%) and a median transplant duration of 3.67 years. One fourth (n=71) of KTRs developed 131 non-melanoma skin cancers, including 69 (53%) squamous cell carcinomas and 62 (47%) basal cell carcinomas (ratio squamous cell carcinoma: basal cell carcinoma 1.11), with a mean of 1.85 neoplasms per patient. Forty percent of invasive squamous cell carcinomas involved at least two clinical or histological high-risk features. The following factors were associated with a higher risk of non-melanoma skin cancer: an older age at transplantation and at the first consultation, a longer transplant duration and the presence of actinic keratosis. KTRs treated with azathioprine were 2.85 times more likely to develop non-melanoma skin cancer (p=0.01). Conclusion: Non-melanoma skin cancer was a common reason for dermatology consultation in Portuguese KTRs. It is imperative for KTRs to have access to specialized dermatology consultation for early referral and treatment of skin malignancies.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Kidney Transplantation/adverse effects , Transplant Recipients , Portugal/epidemiology , Skin Neoplasms/etiology , Carcinoma, Basal Cell/etiology , Carcinoma, Squamous Cell/etiology , Incidence , Retrospective Studies , Risk Factors , Age Factors , Kaplan-Meier Estimate , Young Adult , Immunosuppressive Agents/adverse effects
14.
Article in English | IMSEAR | ID: sea-159514

ABSTRACT

Oral submucous fibrosis (OSMF) is a well-recognized, potentially malignant disorder of the oral cavity that can affect any part of the oral mucosa, characterized by mucosal rigidity of varying intensity caused by fibro elastic transformation of the juxta epithelial layer of connective tissue. OSMF occurs in Indians and other population of the Indian subcontinent with certain oral habits. Betel quid chewing is a popular oral habit with potential links to the occurrence of oral cancer. In patients with submucous fibrosis, the oral epithelium becomes atrophic and thereby becomes more vulnerable to carcinogens. Since the ingredients of betel quid, tobacco are crucial for tumor initiation, promotion and progression, exposure to these toxicants simultaneously has been shown to markedly potentiate the oral cancer incidence in OSMF patients. The rate of malignant transformation of OSMF has been estimated to be 2-10%. Most cases with malignant transformation in OSMF have occurred gradually over a long period of time. This paper presents a case of oral submucous fibrosis turning into malignancy in a 34-year-old male patient.


Subject(s)
Adult , Areca/adverse effects , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/epidemiology , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/secondary , Humans , Male , Mouth Neoplasms/diagnosis , Mouth Neoplasms/epidemiology , Mouth Neoplasms/etiology , Mouth Neoplasms/secondary , Oral Submucous Fibrosis/complications , Oral Submucous Fibrosis/diagnosis , Oral Submucous Fibrosis/epidemiology
15.
Arq. bras. cardiol ; 104(3): 226-233, 03/2015. tab, graf
Article in English | LILACS | ID: lil-742792

ABSTRACT

Background: Stress is associated with cardiovascular diseases. Objective: This study aimed at assessing whether chronic stress induces vascular alterations, and whether these modulations are nitric oxide (NO) and Ca2+ dependent. Methods: Wistar rats, 30 days of age, were separated into 2 groups: control (C) and Stress (St). Chronic stress consisted of immobilization for 1 hour/day, 5 days/week, 15 weeks. Systolic blood pressure was assessed. Vascular studies on aortic rings were performed. Concentration-effect curves were built for noradrenaline, in the presence of L-NAME or prazosin, acetylcholine, sodium nitroprusside and KCl. In addition, Ca2+ flux was also evaluated. Results: Chronic stress induced hypertension, decreased the vascular response to KCl and to noradrenaline, and increased the vascular response to acetylcholine. L-NAME blunted the difference observed in noradrenaline curves. Furthermore, contractile response to Ca2+ was decreased in the aorta of stressed rats. Conclusion: Our data suggest that the vascular response to chronic stress is an adaptation to its deleterious effects, such as hypertension. In addition, this adaptation is NO- and Ca2+-dependent. These data help to clarify the contribution of stress to cardiovascular abnormalities. However, further studies are necessary to better elucidate the mechanisms involved in the cardiovascular dysfunction associated with stressors. (Arq Bras Cardiol. 2014; [online].ahead print, PP.0-0) .


Fundamento: Estresse está associado com complicações cardiovasculares. Objetivos: O objetivo do presente estudo foi avaliar se o estresse crônico induz alterações vasculares, e se essas alterações são dependentes de óxido nítrico (NO) e Ca2+. Métodos: Ratos machos Wistar com 30 dias de idade foram separados em 2 grupos: controle (C) e Estresse (St). Utilizou-se estresse crônico de imobilização por 1 hora/dia, 5 dias/semana, 15 semanas. Pressão arterial sistólica foi avaliada. A função vascular foi avaliada em anéis aórticos. Curvas de concentração-efeito foram realizadas para noradrenalina, na presença de L-NAME ou prazosina, cloreto de potássio (KCl), acetilcolina e nitroprussiato de sódio. Também foi efetuado um estudo para avaliação para fluxo de Ca2+. Resultados: Estresse crônico induziu hipertensão e resposta vascular diminuída para noradrenalina e KCl e aumentada para acetilcolina. A pré-incubação com L-NAME eliminou a diferença para noradrenalina. A resposta contrátil vascular para Ca2+ foi reduzida em animais estressados. Conclusão: Nossos dados sugerem que a resposta vascular ao estresse crônico seria uma adaptação aos efeitos deletérios do estresse, incluindo a hipertensão. Além disso, esses mecanismos adaptativos dependem de liberação de NO e fluxo de Ca2+. Esses resultados ajudam a esclarecer os mecanismos envolvidos nas alterações cardiovasculares associadas ao estresse. Entretanto, mais estudos são necessários para a melhor compreensão desses mecanismos. .


Subject(s)
Humans , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/epidemiology , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/epidemiology , Cell Transformation, Neoplastic , Carcinoma, Squamous Cell/etiology , Diagnostic Imaging , Head and Neck Neoplasms/etiology , Incidence , Mouth Diseases/complications , Oropharyngeal Neoplasms/diagnosis , Oropharyngeal Neoplasms/epidemiology , Oropharyngeal Neoplasms/etiology , Papillomaviridae , Predictive Value of Tests , Risk Factors , Tobacco Use Disorder/complications , Biomarkers, Tumor/analysis
17.
An. bras. dermatol ; 89(5): 745-750, Sep-Oct/2014. tab
Article in English | LILACS | ID: lil-720804

ABSTRACT

BACKGROUND: Nonmelanoma skin cancer is the most common form of cancer in humans and also the malignant disease that is increasingly common among kidney transplant recipients. OBJECTIVE: To determine the epidemiological characteristics of renal transplant recipients with nonmelanoma skin cancer seen at a referral transplantation center. METHODS: Cross-sectional descriptive study with renal transplant recipients presenting nonmelanoma skin cancer, treated at a transplantation referral center between 08/01/2004 and 08/31/2009. Analyzed variables were: gender, age, skin phototype, occupational and recreational sun exposure, use of photoprotection, personal and family history of non-melanoma skin cancer, clinical type and location, time between transplantation and the appearance of the first nonmelanoma skin cancer, occurrence of viral warts, timing of transplantation, type of donor, cause of kidney failure, previous transplants, comorbidities, pre-transplant dialysis, type and duration of dialysis. RESULTS: 64 subjects were included. Males - 71.9%; low skin phototypes (up to Fitzpatrick III) - 89%; mean age - 57.0 years - and mean age at transplant - 47.3 years; sun exposure - 67.2% occupational - and 64.1% recreational; photoprotection - 78.2% (although only 34.4% in a regular manner); squamous cell carcinoma - 67.2%; squamous cell carcinoma/basal cell carcinoma ratio - 2:1; personal history of nonmelanoma skin cancer - 25% - and family history - 10.9%; location at photoexposed area - 98.4%; average latency time between transplantation and first nonmelanoma skin cancer appearance - 78.3 months; viral warts (HPV) after transplant - 53.1%; average timing of transplantation - 115.5 months; living donor - 64.1%; triple regimen (antirejection) - 73.2%; comorbidities - 92.2%; pre-transplant dialysis - 98.4%; hemodialysis - 71.7%; average duration of dialysis - 39.1 months; previous transplants - 3.1%; hypertension as cause of renal failure ...


Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Carcinoma, Basal Cell/etiology , Carcinoma, Squamous Cell/etiology , Kidney Transplantation/adverse effects , Skin Neoplasms/etiology , Brazil , Cross-Sectional Studies , Carcinoma, Basal Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Immunocompromised Host , Immunosuppression/adverse effects , Immunosuppressive Agents/adverse effects , Risk Assessment , Risk Factors , Skin Neoplasms/epidemiology , Time Factors
18.
J. bras. pneumol ; 40(3): 286-293, May-Jun/2014. tab
Article in English | LILACS | ID: lil-714692

ABSTRACT

Objective: To assess smoking habits and nicotine dependence (ND) in patients with head and neck cancer Methods: This study involved 71 smokers or former smokers with squamous cell carcinoma in the oral cavity, pharynx, or larynx who were treated at a university hospital in the city of São Paulo between January and May of 2010. We used the Fagerström Test for Nicotine Dependence to evaluate smoking habits and ND in the sample. Data regarding cancer treatment were collected from medical records. Depending on the variables studied, we used the chi-square test, Fisher's exact test, Student's t-test, or Spearman's correlation test. Results: Of the 71 patients, 47 (66.2%) presented with high or very high ND, 40 (56.3%) smoked more than 20 cigarettes/day, and 32 (45.1%) smoked their first cigarette within 5 min of awakening. Advanced disease stage correlated significantly with the number of cigarettes smoked per day (p = 0.011) and with smoking history (p = 0.047). We found that ND did not correlate significantly with gender, disease stage, smoking cessation, or number of smoking cessation attempts, nor did the number of cigarettes smoked per day correlate with smoking cessation or gender. Treatment for smoking cessation was not routinely offered. Conclusions: In most of the patients studied, the level of ND was high or very high. The prevalence of heavy smoking for long periods was high in our sample. A diagnosis of cancer is a motivating factor for smoking cessation. However, intensive smoking cessation treatment is not routinely offered to smoking patients diagnosed with cancer. .


Objetivo: Avaliar o perfil tabágico (PT) e a dependência nicotínica (DN) em pacientes com câncer de cabeça e pescoço. Métodos: Estudo realizado com 71 pacientes portadores de carcinoma epidermoide de cavidade oral, faringe e laringe, tabagistas ou ex-tabagistas, atendidos em um hospital universitário da cidade de São Paulo entre janeiro e maio de 2010. Utilizou-se o Teste de Fagerström para Dependência de Nicotina para avaliar PT e DN na amostra. Informações sobre o tratamento oncológico foram coletadas dos prontuários. Foram utilizados os testes do qui-quadrado, exato de Fisher ou t de Student, assim como o teste de correlação de Spearman conforme as variáveis estudadas. Resultados: Dos 71 pacientes, 47 (66,2%) apresentavam DN elevada ou muito elevada, 40 (56,3%) fumavam mais de 20 cigarros/dia, e 32 (45,1%) fumavam seu primeiro cigarro até 5 min após acordar. Houve associações significativas do estádio avançado da doença com a quantidade de cigarros fumados por dia (p = 0,011) e a carga tabágica (p = 0,047). Não houve diferenças significativas da DN em relação a sexo, estádio da doença, cessação tabágica ou tentativas anteriores de cessação, nem como do número de cigarros fumados ao dia em relação a cessação ou sexo. O tratamento do tabagismo não foi rotineiramente oferecido. Conclusões: A DN foi elevada ou muito elevada na maioria dos pacientes estudados. A prevalência de grandes fumantes por longos períodos foi alta em nossa amostra. O diagnóstico de câncer é um fator motivador para a cessação tabágica; entretanto, o tratamento intensivo do tabagismo ainda não é rotineiramente oferecido a fumantes diagnosticados com câncer. .


Subject(s)
Female , Humans , Male , Middle Aged , Carcinoma, Squamous Cell/etiology , Laryngeal Neoplasms/etiology , Mouth Neoplasms/etiology , Pharyngeal Neoplasms/etiology , Smoking/adverse effects , Tobacco Use Disorder/complications , Neoplasm Staging , Surveys and Questionnaires , Smoking Cessation/psychology , Smoking/psychology , Tobacco Use Disorder/psychology
19.
J. bras. patol. med. lab ; 50(1): 67-74, 02/2014. tab
Article in English | LILACS | ID: lil-704689

ABSTRACT

The oral squamous cell carcinoma (OSCC) very often affects subjects above the sixth decade of life. However an increasing incidence has been observed in younger individuals, below 40 years. We conducted a systematized review of the current clinical, histopathological and therapeutic aspects of OSCC in young patients. Our work included studies that addressed OSCC involving young patients in the period 2007 2012, and which were indexed in PubMed. Initially, 499 articles were obtained; after refinement, 340 articles had their titles and abstracts evaluated, with 17 included in the sample. The majority of studies reported male predominance (87.5%), association with tobacco and/ or alcohol use (66.6%), advanced clinical stages at diagnosis (77.7%) and, at histopathology, moderately differentiated tumors (72.7%). Based on the results, we believe there are differences in the factors associated with pathogenesis, biological behavior and prognosis in young patients, since most studies show more rapid and aggressive tumor progression in this age group. We suggest the conduction of research focusing on the pathogenesis and carcinogenesis of OSCC in young patients, thereby searching for better scientific evidence...


O carcinoma de células escamosas oral (CCEO) acomete mais frequentemente indivíduos em uma faixa etária acima da sexta década de vida. No entanto, tem-se observado uma crescente incidência em indivíduos mais jovens, abaixo dos 40 anos de idade. Realizou-se uma revisão sistematizada dos aspectos clínicos, histopatológicos e terapêuticos atuais do CCEO em pacientes jovens. Foram incluídos os estudos que abordavam o CCEO envolvendo indivíduos jovens no período de 2007-2012 e indexados na base de dados PubMed. Dos 499 artigos obtidos inicialmente, 340 tiveram os títulos e resumos avaliados, com 17 sendo incluídos na amostra. A maioria dos estudos relatou predominância do sexo masculino (87,5%), associação com uso de tabaco e/ou álcool (66,6%), estágios clínicos mais avançados da doença (III e IV) ao diagnóstico (77,7%) e, histopatologicamente, tumores moderadamente diferenciados (72,7%). Com base nos resultados encontrados, acredita-se que possa haver diferenças quanto aos fatores associados à etiopatogenia, ao comportamento biológico e ao prognóstico em pacientes jovens, uma vez que grande parte dos estudos mostra uma progressão tumoral mais rápida e agressiva nessa faixa etária. Sugere-se o desenvolvimento de pesquisas com foco na etiopatogenia e na carcinogênese do CCEO em pacientes jovens, buscando, assim, melhores evidências científicas...


Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/epidemiology , Prognosis
20.
J. bras. patol. med. lab ; 50(1): 75-84, 02/2014. tab, graf
Article in English | LILACS | ID: lil-704697

ABSTRACT

The human papillomavirus (HPV) is an epitheliotropic agent whose high-risk genotypes have a well-established link with the development of cervical cancer. Although the relation of HPV to the oral squamous cell carcinoma (OSCC) has been studied since the beginning of the 1980s, its role in the oral carcinogenesis and the probable underlying molecular mechanisms are still not fully elucidated. We performed a systematic review of the worldwide scientific literature, published until the preparation of the present paper, concerning the association of HPV with OSCC, scrutinizing the samples, prevalence levels, the techniques utilized and relevant findings of the studies. The results showed that HPV is associated with approximately one quarter of OSCCs. Another interesting feature is the distinct pattern of infection in these oral tumors, including the participation of genotypes that are uncommon in cervical malignant lesions, such as HPV-38, 44, 53 and 70. Equally interesting is the possibility of carcinogenic action without the occurrence of viral integration, verified by the high expression of messenger ribonucleic acid (mRNA) of E6 and E7 from high-risk genotypes in cases whose virus remain in the episomal form. These findings support the assumption of HPV involvement in the genesis of OSCC, whereas warn about the possibility of unexpected viral behaviors that sometimes are not perceived or understood due to the technological limitations of the time and to the shortage of studies with the adequate approaches...


O papilomavírus humano (HPV) é um agente epiteliotrópico cujos genótipos de alto risco têm uma ligação já bem estabelecida com o desenvolvimento de cânceres cervicais. Embora a relação do HPV com o carcinoma de células escamosas oral (CCEO) venha sendo estudada desde o início da década de 1980, seu papel na carcinogênese oral e os prováveis mecanismos moleculares subjacentes ainda não estão completamente elucidados. Realizou-se uma revisão sistemática dos trabalhos existentes na literatura científica internacional até o momento da elaboração deste manuscrito concernente à associação do HPV com o CCEO, esquadrinhando as características das amostras, das prevalências verificadas, das técnicas utilizadas e os achados relevantes dos estudos. Os resultados demonstram que o HPV está associado a cerca de um quarto dos CCEO. Outro aspecto interessante refere-se ao padrão distinto das infecções nesses tumores orais, incluindo a participação de genótipos incomuns em lesões malignas cervicais, tais como HPV-38, 44, 53 e 70. Igualmente interessante é a possibilidade de atuação carcinogênica sem a ocorrência de integração viral, constatada pela elevada expressão de ácido ribonucleico mensageiro (RNAm) de E6 e E7, de genótipos de alto risco, em casos cujo vírus encontrava-se em estado epissomal. Essas evidências reforçam a tese do envolvimento do HPV na gênese dos CCEO, ao mesmo tempo em que alertam para a possibilidade de comportamentos virais inesperados que, por vezes, não são percebidos ou compreendidos devido à limitação tecnológica da época e à carência de estudos com abordagem apropriada...


Subject(s)
Humans , Carcinoma, Squamous Cell/etiology , Papillomavirus Infections/complications
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