Skin cancer incidence in rural workers at a reference hospital in western Paraná

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.

Uso de cámaras de bronceado y cáncer de piel / Indoor tanning and skin cancer

ResumenEl cáncer de piel es la neoplasia más frecuente en Costa Rica.La constante exposición a luz ultravioleta es un factor de riesgo ampliamente reconocido para este cáncer.Las cámaras de bronceado que emiten radiación UV fueron clasificadas por un grupo de investigadores, IARC “International Agency for Research on Cáncer” como Grupo 1 “Cancerígeno para humanos”.El riesgo de melanoma aumenta en un 75% cuando las cámaras de bronceado son utilizadas en edades tempranas.Las campañas de salud enfocadas en foto protección han tenido un importante impacto en la prevención del cáncer de piel. Sin embargo, aún es necesario dar a conocer a la población general sobre la relación directa que existe entre el uso de fuentes artificiales de radiación ultravioleta (como cámaras de bronceado) con la aparición de cáncer de piel melanoma y no melanoma.

AbstractSkin cancer is the most common malignancy in Costa Rica.Constant exposure to ultraviolet light is a widely recognized risk factor for this neoplasm. Indoor tanning chambers that emit UV radiation were classified as Group 1 "Carcinogenic for humans" by the “International Agency for Research on Cancer” (IARC).The risk of melanoma increases in a 75% when the tanning beds are used in early ages.Health campaigns focused photo protective measures have had an important impact on skin cancer prevention.However, it is still necessary to inform general population about the direct relationship between the use of artificial sources of ultraviolet radiation like in tanning beds, with the development of melanoma and non-melanoma cancer.

A prospective study of patients with large congenital melanocytic nevi and the risk of melanoma

Abstract: Background: Large congenital melanocytic nevus (LCMN) is considered a risk factor for melanoma, although the magnitude of this risk is controversial. Objective: To evaluate the risk of melanoma development in patients with LCMN seen at a dermatology referral center in Brazil during a twelve-year period. To the best of our knowledge, there are no published similar studies on large congenital melanocytic nevus in South America. Methods: Our prospective cohort included only patients with congenital nevi ≥20cm. The cumulative risk of developing melanoma and the standardized morbidity ratio were calculated for patients followed up prospectively for at least 1 month. Results: Sixty-three patients were enrolled in this study. One patient who developed melanoma prior to enrollment was excluded, and five were eliminated because of insufficient follow-up time. Mean follow-up for the remaining 57 patients was 5.5 years (median 5.2 years). Median age of entry into the study was 2.6 years. Most patients (75.4%) underwent only clinical observation. Melanomas occurred in 2 (3.5%) patients. Five-year cumulative risk for melanoma was 4.8% (95% CI: 1.9-11.5%). Standardized morbidity ratio was 1584 (95% CI: 266-5232, p<0.001). Study limitations: The small sample size reduces the accuracy of risk estimates. Conclusions: This study analyzed prospectively for the first time data from South America demonstrating that patients with LCMN have a higher risk of developing melanoma than the general population (p<0.001).

Occupational skin cancer: Systematic review / Câncer de pele ocupacional: revisão sistemática

SUMMARY Objective: To analyze the epidemiological profile, risk factors in the workplace environment and prevention methods for professionals at risk of skin cancer. Method: A systematic review of articles on occupational skin cancer, published in the Lilacs, Scielo, Medline and Cochrane Library from January 1st, 2008, to December 31st, 2013, was performed. The search included the following terms: “neoplasias cutâneas” (DeCS), “exposição ocupacional” (DeCS), “epidemiologia” (DeCS) as well as the keyword “prevenção”, and their equivalents in English. Results: After analyzing the titles and summaries of articles, the search strategy resulted in 83 references, of which 22 articles met the eligibility criteria. Discussion: We found that sun exposure is the main occupational risk factor for skin cancer, causing outdoor workers to be the most vulnerable to developing occupational skin cancer. Professionals with low levels of education and European descent are at increased risk of developing this cancer. Conclusion: Outdoor workers are more vulnerable to developing occupational skin cancer, estimating that professionals with low level of education and European descent are at increased risk of developing this cancer. Therefore, companies need to invest more in the health of workers by providing protective equipment and thus preventing occupational skin cancer.

RESUMO Objetivo: analisar o perfil epidemiológico, os fatores de risco no ambiente de trabalho e os métodos de prevenção dos profissionais de risco para câncer de pele. Método: foi realizada uma revisão sistemática de artigos sobre o câncer de pele ocupacional, publicados entre 1 de janeiro de 2008 e 31 de dezembro de 2013, nas bases de dados Lilacs, Scielo, Medline e Biblioteca Cochrane. A pesquisa baseou-se na intersecção dos seguintes termos: “neoplasias cutâneas” (DeCS), “exposição ocupacional” (DeCS), “epidemiologia” (DeCS) e a palavra-chave “prevenção” e seus equivalentes em inglês. Resultados: após a análise dos títulos e resumos dos artigos, a estratégia de busca resultou em 83 referências, das quais 22 artigos preencheram os critérios de elegibilidade. Discussão: a exposição solar é o principal fator de risco ocupacional para câncer de pele e os trabalhadores ao ar livre são os mais vulneráveis a desenvolvê-lo. Aqueles com baixo nível de escolaridade e ascendência europeia apresentam maior risco de desenvolver a neoplasia. Conclusão: os trabalhadores ao ar livre são mais vulneráveis a desenvolver câncer de pele ocupacional. Os profissionais com baixo nível de escolaridade e ascendência europeia apresentam maior risco de desenvolver a neoplasia. São necessários mais investimentos das empresas na saúde dos trabalhadores por meio de fornecimento de equipamentos de proteção, a fim de prevenir o câncer de pele ocupacional.

Brazilian guidelines for diagnosis, treatment and follow-up of primary cutaneous melanoma - Part II

Abstract The last Brazilian guidelines on melanoma were published in 2002. Development in diagnosis and treatment made updating necessary. The coordinators elaborated ten clinical questions, based on PICO system. A Medline search, according to specific MeSH terms for each of the 10 questions was performed and articles selected were classified from A to D according to level of scientific evidence. Based on the results, recommendations were defined and classified according to scientific strength. The present Guidelines were divided in two parts for editorial and publication reasons. In this second part, the following clinical questions were answered: 1) which patients with primary cutaneous melanoma benefit from sentinel lymph node biopsy? 2) Follow-up with body mapping is indicated for which patients? 3) Is preventive excision of acral nevi beneficious to patients? 4) Is preventive excision of giant congenital nevi beneficious to patients? 5) How should stages 0 and I primary cutaneous melanoma patients be followed?.

Perfil de casos de melanoma em um Hospital Universitário, 2003 a 2007 / Profile of Melanoma Cases in a University Hospital, 2003 to 2007 / Perfil de los Casos de Melanoma en un Hospital Universitario, 2003 y 2007

Introdução: A incidência do melanoma tem aumentado em todo o mundo, porém pouco se conhece sobre as características dos casos atendidos nos hospitais universitários do Brasil. Objetivo: Avaliar o perfil epidemiológico dos casos de melanoma registrados no Hospital de Clínicas da Universidade Federal do Paraná no período de 2003-2007. Método: Estudo descritivo com coleta de dados realizada de forma retrospectiva nos prontuários de casos confirmados de melanoma. As variáveis analisadas foram: sexo, idade, localização do tumor primário e tipo histológico segundo a base de dados do Registro Hospitalar de Câncer. Resultados: Foi identificado, na base de dados hospitalar no período estudado, um total de 71 casos com confirmação histológica. O perfil encontrado foi de pacientes brancos (98,2%),do sexo masculino (50,7%), na faixa etária de 40 anos ou mais (85,9%), mediana de 58 anos, apresentando lesão entre um a cinco anos de evolução (48,6%), nas regiões de cabeça e pescoço (25,4%) e tronco (29,6%), do tipo nodular (22%) e extensivo superficial (22%). A maioria das lesões de melanoma preencheu a regra ABCD (assimetria, bordo, cor e diâmetro alterado), sendo que 22,2% dos pacientes tiveram metástases. Conclusão: O melanoma predominouem pacientes brancos, na sexta década de vida, localização torácica com repercussão metastática ou linfonodal.

A melanoma risk score in a Brazilian population / Um escore de risco para melanoma em uma população brasileira

BACKGROUND: Important risk factors for cutaneous melanoma (CM) are recognized, but standardized scores for individual assessment must still be developed. OBJECTIVES: The objective of this study was to develop a risk score of CM for a Brazilian sample. METHODS: To verify the estimates of the main risk factors for melanoma, derived from a meta-analysis (Italian-based study), and externally validate them in a population in southern Brazil by means of a case-control study. A total of 117 individuals were evaluated. Different models were constructed combining the summary coefficients of different risk factors, derived from the meta-analysis, multiplied by the corresponding category of each variable for each participant according to a mathematical expression. RESULTS: the variable that best predicted the risk of CM in the studied population was hair color (AUC: 0.71; 95% CI: 0.62-0.79). Other important factors were freckles, sunburn episodes, and skin and eye color. Consideration of other variables such as common nevi, elastosis, family history, and premalignant lesions did not improve the predictive ability of the models. CONCLUSION: The discriminating capacity of the proposed model proved to be superior or comparable to that of previous risk models proposed for CM. .

FUNDAMENTOS: importantes fatores de risco para melanoma cutâneo são reconhecidos, mas escores padronizados para avaliação individual ainda precisam ser elaborados. OBJETIVOS: o objetivo deste estudo foi desenvolver um escore de risco de melanoma cutâneo para uma amostra brasileira. MÉTODOS: verificar as estimativas dos principais fatores de risco para melanoma, derivado de uma meta-análise (estudo de base italiano) e, externamente, validar em uma população do sul do Brasil por um estudo caso-controle. Um total de 117 indivíduos foram avaliados. RESULTADOS: a variável com maior poder preditivo para o risco de melanoma cutâneo na população estudada foi a cor do cabelo (AUC: 0,71, IC 95%: 0,62-0,79). Outros fatores importantes para o modelo foram: sardas, queimaduras solares, e cor de pele e cor dos olhos. Adicionando outras variáveis, como os nevos comuns, elastose, história familiar e lesões pré-malignas não houve melhora da capacidade preditiva. CONCLUSÃO: A capacidade discriminatória do modelo proposto mostrou-se superior ou comparável aos modelos de risco anteriores propostos para melanoma cutâneo. .

Cáncer de piel y radiación solar: experiencia peruana en la prevención y detección temprana del cáncer de piel y melanoma / Skin cancer and sun radiation: peruvian experience in the prevention and early detection of skin cancer and melanoma

La excesiva exposición a la radiación solar, específicamente la ultravioleta (RUV), ha sido causa de diferentes enfermedades, en especial de cáncer de piel. En 1995 el Círculo Dermatológico del Perú realizó la primera “Campaña de Educación, Prevención y Detección Temprana de Cáncer de Piel y Melanoma” denominada el “Día del Lunar”. Fue oficializada por el Ministerio de Salud, y cuenta con la participación del Seguro Social de Salud (EsSalud). Es una campaña gratuita que se realiza cada año a nivel nacional, en ella, desde 1995 al 2011 se atendieron a 118 092 personas, en 76 sedes distribuidas en 18 ciudades de todo el país, en el 2,8% de estas se pudo identificar alguna lesión cutánea sospechosa de malignidad, de las cuales el 64,9% correspondió a carcinoma basocelular, 26,7% a melanoma cutáneo y 8,4% a carcinoma espinocelular. Estas campañas destacan en importancia no solo por la práctica asistencial en ellas realizada, sino por las actividades educativas orientadas a fomentar una cultura de prevención en favor de las poblaciones más vulnerables. Finalmente, consideramos que es fundamental seguir educando a la población en la prevención del cáncer de piel, crear conciencia en las autoridades para que participen activamente en la realización de estas actividades, además de solicitar a todos los médicos que se sumen coordinadamente a este esfuerzo para seguir avanzando y mejorar lo logrado en beneficio de nuestro país.

The excessive exposure to sun radiation, especially to ultraviolet radiation (UV), has led to various diseases, in particular to skin cancer. In 1995, the Peruvian Dermatological Association conducted the first “Campaign for Education, Prevention and Early Detection of Skin Cancer and Melanoma” called “Mole’s Day”. The Ministry of Health has turned it into an official event, and the Health Social Security (EsSalud) also participates. This is a free campaign that takes place every year nationwide. 118,092 people attended from 1995 to 2011 in 76 sites distributed in 18 cities throughout the country. A cutaneous lesion were malignancy was suspected was identified in 2.8% of people attending, out of which 64.9% corresponded to basal cell carcinoma, 26.7% to cutaneous melanoma, and 8.4% to squamous cell carcinoma. These campaigns are highly important not only because of the assistance given, but also because of the educational activities aimed at promoting a prevention culture in favor of the most vulnerable populations. Finally, we believe it is important to continue educating the population on skin cancer prevention, to build awareness among the authorities so that they actively participate in the performance of these activities, and to ask all physicians to coordinately join this initiative, in order to continue growing, and to improve all that has been attained for the benefit of our country.

Fotoproteção tópica na infância e na adolescência / Topical photoprotection in childhood and adolescence

OBJETIVO: A exposição à luz solar na infância ocorre, frequentemente, de forma mais intensa do que em muitos adultos. Dados da literatura comprovam de maneira inequívoca a associação desse comportamento social com o risco de desenvolvimento do melanoma maligno e do câncer cutâneo não melanoma mesmo na vida adulta. Além disso, o fotoenvelhecimento cutâneo é semeado já na infância com a exposição solar inadequada. Esta revisão tem como objetivo orientar os pediatras nas medidas adequadas de fotoproteção tópica nas crianças e adolescentes, o que irá alterar de maneira positiva o futuro desses pacientes. FONTES DOS DADOS: Realizou-se uma revisão da literatura indexada na base de dados MEDLINE/PubMed entre os anos de 1999 e 2012 sobre fotoproteção na infância, selecionando-se como fonte os artigos de revisão mais relevantes, do ponto de vista de abrangência do tema fotoproteção em crianças e adolescentes, fotoproteção e vitamina D, fototerapia na neonatologia e impacto no câncer cutâneo, bronzeamento artificial e câncer cutâneo. SÍNTESE DOS DADOS: Crianças e adolescentes devem adotar medidas adequadas de fotoproteção para diminuir o risco de câncer cutâneo melanoma e não melanoma. CONCLUSÕES: Há dados na literatura que suportam a associação de hábitos de exposição solar segura e uso de fotoprotetores tópicos em crianças e adolescentes com a redução da ocorrência do câncer cutâneo.

OBJECTIVE: Exposure to sunlight in childhood is often more intense than in adults. Literature data unequivocally show the association between this social behavior and the risk for developing malignant melanoma and non-melanoma skin cancer, even in adulthood. Furthermore, skin photoaging begins already in childhood through inadequate sun exposure. This review aims to guide pediatricians on appropriate measures of topical photoprotection in children and adolescents, which will positively change the future of these patients. SOURCES: A review of the literature indexed in MEDLINE/PubMed between the years 1999 and 2012 on photoprotection in childhood was conducted. The most relevant review articles on photoprotection in children and adolescents, photoprotection and vitamin D in neonatal phototherapy and impact on skin cancer, artificial tanning and skin cancer were selected as sources. SUMMARY OF THE FINDINGS: Children and adolescents should adopt appropriate measures of photoprotection in order to decrease the risk of melanoma and non-melanoma skin cancer. CONCLUSIONS: There are published data that support the association between sun exposure habits and safe use of topical sunscreens in children and adolescents on the one hand and a reduced occurrence of skin cancer on the other.

Atypical mole syndrome and dysplastic nevi: identification of populations at risk for developing melanoma: review article

Atypical Mole Syndrome is the most important phenotypic risk factor for developing cutaneous melanoma, a malignancy that accounts for about 80 percent of deaths from skin cancer. Because the diagnosis of melanoma at an early stage is of great prognostic relevance, the identification of Atypical Mole Syndrome carriers is essential, as well as the creation of recommended preventative measures that must be taken by these patients.

Câncer de pele e sua associação com dano solar / Skin cancer and its association with solar damage

Estima-se que o câncer de pele vem crescendo muito a cada ano, tanto por falta de informação a respeito do assunto quanto pela falta de conscientização da população. Os tipos histológicos mais frequentes do câncer de pele são: carcinoma basocelular (CBC), o tumor maligno cutâneo com maior incidência em indivíduos de pele clara carcinoma espinocelular (CEC), o sexto tipo mais comum de câncer em todo mundo e o melanoma, que é comum em populações brancas, em especial nos trópicos. A principal causa de câncer de pele é exposição à radiação ultravioleta (UV). A elastose solar é um indicador histológico de comprometimento cutâneo pela radiação solar. Objetivo: A presente pesquisa visa relacionar os tipos histológicos mais frequentes de câncer de pele e ocorrência de elastose solar. Material e métodos: Foi realizado um estudo retrospectivo, no período de 2005 a 2008, com levantamento 738 casos de cânceres de pele com diagnóstico de CBC, CEC e melanoma. Resultados: 539 casos eram de CBC, 174 eram de CEC e 25 eram melanomas. Em 47% dos casos os pacientes eram do sexo masculino e 53% eram femininos 67% estavam na faixa etária entre 60 e 80 anos. O ano de 2005 foi o que apresentou o menor número de casos de câncer de pele (157 casos) e o ano de 2008 apresentou a maior incidência (212 casos). Elastose solar esteve associada a 32% dos casos de câncer de pele, sendo mais frequente nos casos de CBC. Conclusões: A maior parte dos casos de câncer de pele não apresentou elastose solar associada, mostrando que não só a radiação solar influencia na gênese desses cânceres.

UVB: suscetibilidade no melanoma maligno / UVB: susceptibility in malignant melanoma

FUNDAMENTOS: Está bem definido que a radiação ultravioleta provoca depleção imunológica na pele, permitindo o desenvolvimento de tumores cutâneos malignos. A maioria dos pacientes de cânceres da pele não melanomas são considerados UVB-suscetíveis. OBJETIVOS: Estudar a UVB-suscetibilidade nos pacientes com melanoma maligno e se este é um fator de risco para o desenvolvimento desse câncer. MÉTODOS: Foram selecionados 88 voluntários divididos em dois grupos: grupo-controle saudável (n=61) e grupo de portadores de melanoma (n=27), todos identificados de acordo com os critérios: tipo histológico, nível de invasão, fotótipos de pele, sexo e idade. A suscetibilidade à radiação ultravioleta B (UVB) foi medida pela reação de hipersensibilidade ao contato com o difenciprone nos voluntários sensibilizados em áreas previamente irradiadas. RESULTADOS: A suscetibilidade à radiação UVB foi de 81,5 por cento nos pacientes com melanoma maligno e de 31,2 por cento no grupo-controle. O risco de um indivíduo desenvolver o melanoma maligno foi 9,7 vezes maior do que nos indivíduos UVB-resistentes. CONCLUSÕES: A UVB-suscetibilidade pode ser considerada um fator de risco importante para o desenvolvimento do melanoma maligno.

BACKGROUND: It is well established that UV radiation provokes an immunological depletion in the skin, enabling the development of malignant cutaneous tumors. Most nonmelanoma skin cancer patients are considered to be UVB-susceptible. OBJECTIVE: To study the behavior of UVB- susceptibility in malignant melanoma (MM) patients and whether this is a risk factor to the development of MM. METHODS: Eighty-eight volunteers were selected and divided into two groups: healthy control group (n = 61) and MM group (n = 27), which were identified according to the following clinical criteria: histopathological type, level of invasion, skin phototype, sex and age. Susceptibility to ultraviolet B (UVB) radiation was measured by the onset of a contact hypersensitivity reaction to diphenylcyclopropenone among individuals sensitized in previously irradiated areas. RESULTS: Susceptibility to UVB radiation was 81.5 in the MM group and 31.2 percent in the control group. The risk of an UVB-susceptible individual to develop MM was 9.7 times higher than when UVB resistant. CONCLUSION: UVB susceptibility should be considered an important risk factor to the development of this type of cancer.

Presentación de un estudio en aplicación en Chile: factores genéticos y medioambientales de riesgo para el desarrollo de melanoma maligno / Genetic and environmental risk factors of cutaneous malignant melanoma

Introducción: El MM es el tumor cutáneo (MMC) que comparte una mayor mortalidad. En los próximos años se calcula que una de cada 27-90 personas de raza caucásica será diagnosticada MM en algún momento de su vida. Objetivo principal: Dar a conocer aspectos metodológicos de un estudio multicéntrico internacional sobre melanoma, su genética y factores medioambientales, en desarrollo en Chile con base en dos hospitales públicos metropolitanos y GenoMel (consorcio en genética del melanoma). La finalidad es investigar la interacción genotipo/fenotipo, gen/gen y gen/medio ambiente de los genes conocidos de susceptibilidad a melanoma (CDKN2A/p I 4ARF CDK4. MC IR) en casos de melanoma familiar y múltiples en Chile. Con esta presentación queremos invitar a las clínicas a incorporar a sus pacientes para ampliar la base del estudio y conocer el perfil epidemiológico genético local de los diversos servicios de salud del país que se involucren.

Introduction: Malignant Melanoma (MM) is the cutaneous tumour with the highest mortality rate. In the upcoming years, one out of 27-90 caucasians will be diagnosed with MM at some point in their life. The aim of this study is to show the methadological approach of o multicentric international study on melanoma. Its genetics and environmental factors. This study is being carried out in Chile in two public hospitals and at GenoMel. The objective is to investigate genotype/phenotype. gene/gene and gene/environment interaction of melanoma susceptibility gene (CDKN2A/ p 14ARF CDK 4. MC / R) in cases of familial melanoma and multiple melanoma in Chile. With this study we invite our colleagues to refer patients in order to enlarge the study group and learn about the epidemiological and genetic profile of the health system involved in our country.

Melanoma maligno: revisión bibliográfica / Harmful melanoma: bibliografical review

El melanoma es una neoplasia maligna que resulta de la transformación de los malanocitos usualmente localizados en la epidermis, que en el 95 por ciento de los casos se origina en la piel. Tiene una muy alta agresividad, con una gran tendencia a la producción de metástasis, es un tumor que ha cobrado notoriedad en los últimos decenios en virtud del significativo aumento de su incidencia y por el hecho de ser un cáncer que en su patogenia juega un papel fundamental el medio ambiente por la acción de los rayos ultravioletas, tiene una relación directa con la exposición al sol, especialmente durante la niñez; demás, se estima que aproximadamente 10 por ciento de los casos de melanoma ocurre en el contexto de una predisposición genética debida a la transmisión autosómica dominante con penetrancia incompleta de un gen de susceptibilidad.

The melanoma is a harmful neoplasia that results from the transformation of the malanocytes usually located in the epidermis, that in the 95 percent of the cases is originated in the skin. It has a very high aggressiveness, with a great tendency to the production of metastasis, is a tumor that has gotten notoriety in the last decades by virtue of the significant increasement of its incidence and because in its patogenia plays a fundamental role the environment, by the action of the ultraviolet rays having a direct relation with the exposition to sun especially in Childhood, besides it is estimated that approximately 10 percent of the cases of melanoma occurs in the context of a genetic predisposition due to the autosomic dominant transmission with incomplete penetrance of a susceptivility gene.

Epidemiología del melanoma cutáneo / Epidemiology of cutaneous melanoma

Durante las últimas décadas hubo un aumento de la incidencia del melanoma cutáneo en la población caucásica del mundo, aunque este tumor puede afectar a cualquier grupo étnico. En la actualidad se considera a la exposición solar intermitente como un factor de riesgo cierto, en el desarrollo del melanoma cutáneo. La incidencia del melanoma cutáneo en Auckland, Nueva Zelanda, es la mayor del mundo. En Europa, la incidencia y la mortalidad fue creciente hasta que en la década de los 80 se estabilizó. En EEUU también se observó una estabilización de la incidencia. Con respecto a la edad, según la bibliografía consultada la incidencia aumenta a partir de los 20 años; en algunos pacientes con más de 200 nevos y sin pautas de protección solar antes de los 5 años de vida. También se observa aumento de la incidencia en los adultos mayores de 60 años de edad. Con respecto al sexo, en los EEUU y la Argentina es más frecuente en los hombres y en Europa en el sexo femenino.

During the last decades there was an increase of incidence of cutaneous melanoma in Caucasian population worldwide, but this tumor can affect any ethnic group. Nowadays, the intermittent solar exposition is a well known predisposing factor. The incidence in Auckland, New Zealand, is the highest in the world. In Europe and in the USA, the incidence and mortality rates decreased until the 80's when it stabilized. Regarding the age of appearance, the incidence increases starting at 20 years of age in patients with more than 200 nevi and without history of sun protection in childhood. There was also an increase in the incidence in adults (>60 y-o). The distribution by sex in USA and Argentina is more frequent in males and in Europe in females.

Factores de riesgo para melanoma cutáneo: estudio de casos y controles en Córdoba, Argentina / Risk factors for cutaneous melanoma: case-control study in Córdoba, Argentina

Over the past years, considerable effort has been directed toward the identification of risk factors associated with the increasing incidence of cutaneous melanoma in white populations worldwide. Limited data are available from Argentine populations concerning risk factors for malignant melanoma. A case-control study was performed in Cordoba to estimate the risk factors for cutaneous malignant melanoma. The study group comprised 65 patients and 195 controls, matched by age and sex. The following risk factors were significant in the univariate analysis: European grandparents, blonde and brown hair, fair skin tone, light colored and brown eyes, presence of freckles and melanocytic nevi, severe sunburns before the age of 18 years, recreational sun exposure, family history of malignant melanoma. In the multivariate analysis, European grandparents (OR 2.27, IC95% 1.08 to 3.46), fair skin (OR 4.99, IC95% 2.72 to 7.28), severe sunburns before the age of 18 (OR 6.47, IC95% 5.29 to 7.65), and family history of malignant melanoma (OR 1525, IC95% 1467 to 1584), remain as independent risk factors for malignant melanoma. The results of the current study are similar to those obtained in other populations.

En los últimos años se han realizado considerables esfuerzos para identificar factores de riesgo asociados al incremento en la incidencia de melanoma maligno en la población blanca mundial. En Argentina los datos concernientes a factores de riesgo para melanoma maligno son limitados. Realizamos en el Hospital Privado de Córdoba un estudio de casos-controles con el objetivo de determinar factores de riesgo para melanoma maligno. El grupo de estudio fue de 65 pacientes con melanoma maligno y 195 controlespareados por sexo y edad. Los siguientes factores de riesgo fueron significativos en el análisis estadísticounivariado: abuelos nacidos en Italia o España y en otros países europeos, color de pelo castaño y claro, colorde piel claro, color de ojos marrón y claros, efélides, presencia de nevos melanocíticos, quemaduras solaresgraves antes de los 18 años de edad, exposición solar tanto laboral como recreativa y antecedente familiar demelanoma maligno, de éstos se mantienen como factores de riesgo independientes en el análisis multivariado abuelos nacidos en países europeos (OR 2.27, IC95% 1.08 a 3.46), piel clara (OR 4.99, IC95% 2.72 a 7.28) quemadura solar grave en más de 3 episodios antes de los 18 años (OR 6.47, IC95% 5.29 a 7.65) y antecedentes familiares de melanoma (OR 1525, IC95% 1467 a 1584). La mayoría de los datos que obtuvimos guardan semejanza con los descriptos en otras poblaciones.