Trends in breast cancer surgery in private patients under opportunistic screening / Tendências na cirurgia de câncer de mama em pacientes de um serviço privado sob rastreio oportunístico

Objective: This study aims to determine the evolution of staging and surgical treatment in patients with breast cancer in a private clinic over the last 40 years. Methods: Retrospective descriptive observational study, through statistical analysis of the medical records of 2105 patients treated at a private clinic in Curitiba, Paraná, between 1977 and 2017. Results: Data analyzed from 2,105 patients diagnosed with breast cancer revealed that, over time, radical surgeries predominated when compared to conservative ones. However, when analyzed proportionally over the years, it is possible to observe an inversion of the surgical modalities. It was demonstrated that from 1977 to 2017, there was a 273% increase in the number of conservative surgeries and a 45.5% decrease in mastectomies. In addition to this data, there was a decrease in the number of axillary emptying and, consequently, of positive sentinel lymph nodes. In addition, tumors diagnosed early (T1) have increased over the years. Conclusion: Patients had an early diagnosis of the disease, resulting in less invasive surgical treatments and, consequently, lower morbidity and mortality.

Objetivo: A pesquisa visa determinar a evolução do estadiamento e do tratamento cirúrgico em pacientes com câncer de mama em uma clínica privada, nos últimos 40 anos. Métodos: Estudo observacional descritivo retrospectivo, por meio da análise estatística dos prontuários de 2105 pacientes atendidas em clínica privada em Curitiba, Paraná, entre 1977 e 2017. Resultados: Dados analisados de 2.105 pacientes diagnosticadas com câncer de mama revelaram que, ao longo do tempo, as cirurgias radicais predominaram quando comparadas às cirurgias conservadoras. No entanto, quando analisadas proporcionalmente ao longo dos anos, é possível constatar uma inversão das modalidades cirúrgicas. Demonstrou-se que de 1977 a 2017, houve aumento de 273% do número das cirurgias conservadoras e queda de 45,5% das mastectomias. Associado a esse dado, notou-se diminuição do número de esvaziamento axilar e consequentemente de linfonodos sentinela positivos. Além disso, os tumores diagnosticados em fase inicial (T1) aumentaram ao longo dos anos. Conclusão: As pacientes tiveram um diagnóstico em estadiamento mais precoce da doença, proporcionando tratamentos cirúrgicos menos invasivos e, consequentemente, menor morbidade.

Hidroacanthoma simplex: dermoscopy and cryosurgery treatment

Abstract: Hidroacanthoma simplex is a rare intraepidermal neoplasia that arises from the acrosyringial portion of the eccrine duct. Malignant transformation of hidroacanthoma simplex is reported in the literature and the treatment is performed with wide excision or Mohs micrographic surgery. We report the first case successfully treated with cryosurgery with a long-term follow up.

Frontal fibrosing alopecia in association with Sjögren's syndrome: more than a simple coincidence

Abstract Frontal fibrosing alopecia is a distinctive form of scarring alopecia considered to be a clinical variant of lichen planopilaris. It predominantly occurs in postmenopausal women and has a slowly progressive course. It was first described by Kossard in 1994. Since then the number of reported cases has increased significantly. Coexistence of frontal fibrosing alopecia and autoimmune disorders - such as discoid erythematosus lupus and Sjögren's syndrome - may suggest a common pathogenic background among the diseases.

Primary cutaneous aspergillosis and idiopathic bone marrow aplasia

Abstract: We describe the case of a 9-year-old boy with idiopathic bone marrow aplasia and severe neutropenia, who developed skin ulcers under cardiac monitoring electrodes. The diagnosis of primary cutaneous aspergillosis was made after the second biopsy and culture. Imaging investigation did not reveal internal fungal infection. The child was treated, but did not improve and died 3 months after admission. The report highlights and discusses the preventable risk of aspergillus skin infection in immunocompromised patients.