Diagnóstico precoce e tratamento da síndrome de Gorlin-Goltz: acompanhamento de oito anos / Diagnóstico precoz y tratamiento del síndrome de Gorlin-Goltz: seguimiento de ocho años / Early diagnosis and treatment of Gorlin-Goltz syndrome: eight-year follow-up

RESUMO Introdução: A síndrome de Gorlin-Goltz, conhecida também como síndrome do Carcinoma Basocelular Nevóide, é um transtorno hereditário autossômico dominante de alta penetrância e expressividade variável. Foi primeiramente descrita por Jarisch em 1894 e, em 1960 Gorlin e Goltz relacionaram o conjunto de doença de casos anteriormente relatados na literatura, concluindo que se tratava de uma síndrome caracterizada por uma tríade (carcinomas basocelulares, queratocistos odontogênicos múltiplos e anomalias esqueléticas). Atualmente, sabe-se que um amplo espectro de outras manifestações sistêmicas pode estar presente como neurológicas, oftálmicas, genitais, cardiovasculares e endócrinas. Objetivo: O presente artigo tem como objetivo relatar um caso clínico de síndrome de Gorlin-Goltz com proservação de oito anos, bem como destacar a importância do Cirurgião-Dentista no diagnóstico precoce e tratamento da síndrome. Caso clínico: Paciente 10 anos, sexo masculino, compareceu em fevereiro de 2004 ao Serviço de Estomatologia e Cirurgia Bucomaxilofacial da Santa Casa de Misericórdia de São Felix, Bahia, Brasil, acompanhado de sua avó, que relatava a seguinte queixa: "Os dentes do meu neto estão tortos". Ao exame físico foi observado aumento do volume do lado direito da face, hipertelorismo, base nasal larga, bossa frontal, leve prognatismo mandibular e dedos dos pés encurtados. Ao exame físico intrabucal foram identificados dentes fora de posição e desvio de linha média. O paciente foi acompanhado por 8 anos e, durante este tempo, foram realizados exames imaginológicos observando grandes áreas de lesões radiolúcidas com recidiva. O diagnóstico conclusivo de Queratocisto Odontogênico foi então comprovado no exame histopatológico, a hipótese diagnóstica de síndrome de Gorlin-Goltz foi então confirmada. O paciente foi encaminhado para avaliação genética e atualmente encontra-se em proservação na Universidade Estadual de Feira de Santana, Bahia. Conclusão: É essencial o acompanhamento multidisciplinar e a longo prazo nos casos dessa síndrome, oferecendo melhor qualidade de vida a esses pacientes(AU)

RESUMEN Introducción: El síndrome de Gorlin-Goltz, conocido también como síndrome del carcinoma basocelular nevoide, es un trastorno hereditario autosómico dominante de alta penetración y expresividad variable. En 1960, Gorlin y Goltz relacionaron el conjunto de enfermedades de casos con anterioridad informados en la literatura, y concluyeron que se trataba de un síndrome caracterizado por una tríada (carcinomas basocelulares, queratocistos odontogénicos múltiples y anomalías esqueléticas). Actualmente, se conoce que un amplio espectro de otras manifestaciones sistémicas puede estar presente, como neurológicas, oftálmicas, genitales, cardiovasculares y endocrinas. Objetivo: describir un caso clínico de síndrome de Gorlin-Goltz con seguimiento de ocho años, así como destacar la importancia del dentista en el diagnóstico precoz y tratamiento del síndrome. Caso clínico: Paciente de 10 años, de sexo masculino, acudió en febrero de 2004 al Servicio de Estomatología y Cirugía Maxilofacial de la Santa Casa de Misericordia de São Félix, Bahia, Brasil, acompañado de su abuela, que refería: "Los dientes de mi nieto están torcidos". En el examen físico se observó aumento del volumen del lado derecho de la cara, hipertelorismo, base nasal ancha, bóveda frontal, leve prognatismo mandibular y dedos de los pies acortados. En el examen físico intrabucal se identificaron dientes fuera de posición y desviación de línea media. El paciente tuvo seguimiento por ocho años y durante este tiempo se realizaron exámenes imaginológicos en los que se observaron grandes áreas de lesiones radiolúcidas con recidiva. El diagnóstico conclusivo de queratocisto odontogénico fue comprobado en el examen histopatológico; la hipótesis diagnóstica del síndrome de Gorlin-Goltz fue entonces confirmada. El paciente fue dirigido para evaluación genética y actualmente se encuentra en seguimiento en la Universidad Estadual de Feira de Santana, Bahia. Conclusiones: Es esencial el seguimiento multidisciplinario y a largo plazo en los casos de este síndrome, a fin de ofrecer mejor calidad de vida a esos pacientes(AU)

ABSTRACT Introduction: Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome, is an autosomal dominant inherited disorder of high level penetrance and variable expressiveness. In 1960 Gorlin and Goltz listed the disease cases previously reported in the literature, concluding that it was a triad syndrome (basal cell carcinomas, multiple odontogenic keratocysts and skeletal anomalies). It is now known that a broad spectrum of other systemic manifestations may be present, such as neurological, ophthalmic, genital, cardiovascular and endocrine. Objective: Describe a clinical case of Gorlin-Goltz syndrome and its eight-year follow-up, and highlight the importance of the dentist in the early diagnosis and treatment of the syndrome. Case report: A 10-year-old male patient attended the Oral and Maxillofacial Surgery Service of Santa Casa de Misericordia Hospital in Sao Felix, Bahia, Brazil, in February 2004, accompanied by his grandmother, who reported that her grandson's teeth "were crooked". Physical examination revealed an increase in the volume of the right side of the face, hypertelorism, broad nasal base, frontal bossing, mild mandibular prognathism and shortened toes, whereas oral examination found ill-positioned teeth and midline deviation. The patient was followed up for eight years, and during this time imaging tests were performed which showed large areas of recurrent radiolucent lesions. Diagnosis of odontogenic keratocyst was verified by histopathological examination, confirming the diagnostic hypothesis of Gorlin-Goltz syndrome. The patient was referred for genetic evaluation and is currently being followed up at the State University of Feira de Santana, Bahia. Conclusions: Multidisciplinary long-term follow-up is essential in cases of this syndrome to improve the quality of life of patients(AU)

Albinism: epidemiology, genetics, cutaneous characterization, psychosocial factors

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.

Recurrence rate of basal cell carcinoma in patients submitted to skin flaps or grafts

Abstract: Background: Basal cell carcinoma is the most common type of skin cancer. Although the literature provides a great deal of information on the recurrences of basal cell carcinoma, studies about these indices addressing only the cases in which flaps and/or grafts have been performed for surgical reconstruction of the excision of this tumor are still lacking. Objectives: To evaluate rates of recurrence of basal cell carcinoma submitted to conventional surgery with pre-established margins and reconstruction by flaps or grafts. Methods: A retrospective and observational study was performed through the analysis of 109 patients, who met inclusion criteria with 116 basal cell carcinomas submitted to conventional surgery and pre-established safety margins, requiring reconstruction through a graft or cutaneous flap. This work was performed the small surgeries sector of Dermatology of the Specialty Outpatient Clinic of the University Hospital of the State University of Londrina, between January 1, 2011 and December 31, 2015. The following data were collected and inserted in an Excel worksheet: name, registration number of the hospital patient, sex, age, tumor location, histopathological type of BCC, procedure performed (type of flap and/or graft), follow-up time, recurrence. Results: Of the 116 procedures, there were recurrences in 3 cases (2.6%) that were located in the nasal region and related to sclerodermiform or micronodular histological types. Study limitations: Retrospective nature of the study. Conclusion: The present study of the dermatology department of this university hospital showed a low rate of recurrence of basal cell carcinoma in cases where flaps and/or grafts were used in the surgical reconstruction.

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.

Carcinoma basocelular. Un reto actual para el dermatólogo / Basal cell carcinoma. An actual challenge for the dermatologist

RESUMEN El carcinoma basocelular es un tumor maligno de origen epitelial, su crecimiento es lento y rara vez metastiza. Este puede producir destrucción local y comprometer extensas áreas de tejido, cartílago y hueso. Existen variantes clínicas e histológicas y constituye el cáncer más frecuente en humanos y su incidencia está en aumento. Se realizó una revisión para exponer los aspectos esenciales sobre factores predisponentes, formas clínicas y diagnóstico, así como las opciones terapéuticas en esta entidad. Se desarrolló una búsqueda en la Biblioteca Virtual de Infomed y Google. Fueron revisados veinticinco trabajos científicos sin limitación de año y país, de los cuales quince pertenecen a los últimos 5 años. El carcinoma basocelular se considera de origen multifactorial, el carcinógeno más importante es la luz ultravioleta. La forma clínica más frecuente es la variedad nodular y la distribución es en cara y cuello. La elección del tratamiento dependerá del tamaño de la lesión, la localización, la edad y estado general del paciente. A pesar de tener baja malignidad y mortalidad, puede ocasionar destrucción y deformidad y repercutir en la vida de los pacientes. El dominio de los factores de riesgo, los elementos para el diagnóstico precoz y las opciones terapéuticas son indispensable para elegir la conducta adecuada frente a la enfermedad y promover cambios en el estilo de vida, que favorezcan la prevención y disminuyan la morbilidad por esta causa (AU).

ABSTRACT Basal cell Carcinoma (BCC) is an epidermal malignant tumor, it has a slow growth and seldom metastases. It can produce local destruction and compromise big tissue areas, cartilage and bone. There are clinical and histological presentations. It is one of the most common cancer in humans and its incidence is increasing. This project’s goal is to expose the essential aspects about the predisposal factors, clinic presentations and diagnoses as well as this disorder’s therapeutic options.This study was made from different bibliographical revisions. The research was developed on Infomed Database and Google. Twenty five Scientific studies were researched without country and/or timeline limit, from whom fifteen belongs to the last 5 years. BCC is considered to have a multifactorial origin, whose most important carcinogen is the ultraviolet light. The most frequent clinical presentation is the nodular and the most common distribution is face and neck. The treatment choice depends on the tumor size, its distribution and the patient’s age and current state. Although it is a low malignancy and low-death rate neoplasia, it can cause tissue destruction and affect patient’s social life. The management of the risk factors, the elements for the early diagnosis and the therapeutic options are indispensable to choose the adequate behavior for the disorder and promote life style changes that favor the prevention and lower the morbidity rate (AU).

Study of factors affecting the incidence of skin cancer in patients after liver transplant

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.

Non-melanoma skin cancer in Portuguese kidney transplant recipients - incidence and risk factors

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.

Epidemiological profile of nonmelanoma skin cancer in renal transplant recipients: experience of a referral center

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 ...

Epitelioma basocelular multicéntrico gigante / Giant multicentric basal cell carcinoma

El Epitelioma Basocelular (EBC) es el tumor más frecuente de la piel representando aproximadamente el 75 % de los tumors no-melanoma. Existen múltiples formas de presentación clínica, que varían en agresividad, dentro de ellas la más frecuente es la variante Gigante, considerándose dentro de las mismas las lesiones mayores a 5 cm en su diámetro mayor. Se presenta el caso de un paciente con mencionada variedad. Analizamos incidencia, clínica y posibilidades terapéuticas para esta patología, así como también citamos actualizaciones en genética y comportamiento tumoral

Basocelular Epithelioma is the most frequent tumor of the skin, representing approximately 75 % of non-melanotic tumors. There are multiple clinical presentations, that vary in aggressiveness, among which there is the Gigantic form, for which are considered lesions greater than 5 cm in diameter. A case presentation is provided of such variant. Incidence, clinic and therapeutic possibilities for this desease are presented, as well as an update in genetics and tumoral behavior

Topografia do carcinoma basocelular e suas correlações com o gênero, a idade e o padrão histológico: um estudo retrospectivo de 1.042 lesões / Topography of basal cell carcinoma and their correlations with gender, age and histologic pattern: a retrospective study of 1042 lesions

FUNDAMENTOS: O carcinoma basocelular corresponde a 75 por cento dos tumores cutâneos. A exposição solar e a genética estão relacionadas à sua etiologia. Espera-se que diferenças comportamentais e biológicas proporcionem padrões diferenciados de acometimento entre os sexos. OBJETIVOS: Avaliar a topografia das lesões e suas correlações com gênero, idade e tipo histológico. MÉTODOS: Estudo retrospectivo de pacientes tratados por carcinoma basocelular entre 1999 e 2008 no ambulatório de câncer da pele da Santa Casa de Misericórdia de Curitiba. Avaliamos sexo, idade, localização, tipo histológico, situação das margens, histórico de fotoexposição e antecedentes familiares de câncer cutâneo. RESULTADOS: Contabilizamos 1.042 lesões em 545 pacientes (61 por cento mulheres), sendo mais numerosas nos homens (p < 0,01). As idades variaram entre 27 e 95 anos (mediana = 65). Os homens apresentavam mais fotoexposição (p < 0,01). As lesões extracefálicas foram mais frequentes recentemente (p < 0,01). O comprometimento de margens foi maior na cabeça (p < 0,01). o tipo superficial foi menos frequente na cabeça (p < 0,01) e se associou a idades menores nas mulheres (p < 0,01). a cabeça abrigou 74 por cento das lesões, e as pernas, 2 por cento. as mulheres apresentaram predileção para pernas, nariz e lábio superior e os homens para tronco, orelhas e couro cabeludo (p < 0,05). as cirurgias no epicanto medial e couro cabeludo ocorreram em idades menores (p < 0,01). CONCLUSÕES: identificamos associação significativa entre a topografia das lesões, o gênero, a idade e o tipo histológico, demonstrando a possível diversidade fisiopatológica e de atuação dos fatores de risco. no período estudado não verificamos tendência de aumento na proporção de jovens e mulheres entre os pacientes.

BACKGROUND: Basal cell carcinoma accounts for 75 percent of skin cancer. Sun exposure and genetics are related to its etiology. It's expected that biological and behavioral differences provide different patterns of involvement between sexes. OBJECTIVES: To evaluate the topography of lesions and their correlations with gender, age and histological type. METHODS: Retrospective study of basal cell carcinoma patients treated between 1999 and 2008 in the Skin Cancer Clinic of Santa Casa de Misericordia of Curitiba. We evaluated sex, age, location, histological type, margins commitment, sun exposure and family skin cancer history. RESULTS: We found 1042 lesions in 545 patients (61 percent women), being more numerous in men (p<0.01). Their ages ranged between 27 and 95 years (median=65). Men had more sun exposure (p<0.01). The lesions were more frequent extra-cephalic recently (p<0.01). The margin involvement was higher in the head (p<0.01). The superficial type was less frequent on the head (p<0.01) and was associated with younger ages in women (p<0.01). The head housed 74 percent of lesions and the legs 2 percent. Women had a predilection for the legs, nose and upper lip and men to trunk, ears and scalp (p <0.05). The surgeries in the medial epicanthus and scalp occurred at younger ages (p=0.01). CONCLUSIONS: We identified significant associations between the topography of lesions, gender, age and histological type, demonstrating the possible pathophysiological diversity and differential risk factors operation. In the period studied we found no trend of increase in the proportion of young or women among patients.

Epidemiologia do carcinoma basocelular / Epidemiology of basal cell carcinoma

O carcinoma basocelular é a neoplasia maligna mais comum em humanos e sua incidência vem aumentando nas últimas décadas. Sua grande frequência gera significativo ônus ao sistema de saúde, configurando problema de saúde pública. Apesar das baixas taxas de mortalidade e de rara ocorrência de metástases, o tumor pode apresentar comportamento invasivo local e recidivas após o tratamento, provocando importante morbidade. Exposição à radiação ultravioleta representa o principal fator de risco ambiental associado a sua gênese. Entretanto, descrevem-se outros elementos de risco: fotótipos claros, idade avançada, história familiar de carcinomas de pele, olhos e cabelos claros, sardas na infância e imunossupressão, além de aspectos comportamentais, como exercício profissional exposto ao sol, atividade rural e queimaduras solares na juventude. Entre 30 por cento e 75 por cento dos casos esporádicos estão associados à mutação do gene patched hedgehog, mas outras alterações genéticas são ainda descritas. A neoplasia é comumente encontrada concomitantemente com lesões cutâneas relacionadas à exposição solar crônica, tais como: queratoses actínicas, lentigos solares e telangiectasias faciais. A prevenção do carcinoma basocelular se baseia no conhecimento de fatores de risco, no diagnóstico e tratamento precoces e na adoção de medidas específicas, principalmente, nas populações susceptíveis. Os autores apresentam uma revisão da epidemiologia do carcinoma basocelular.

Basal cell carcinoma is the most common malignant neoplasm in humans and its incidence has increased over the last decades. Its high frequency significantly burdens the health system, making the disease a public health issue. Despite the low mortality rates and the rare occurrence of metastases, the tumor may be locally invasive and relapse after treatment, causing significant morbidity. Exposure to ultraviolet radiation is the main environmental risk factor associated with its cause. However, other elements of risk are described, such as light skin phototypes, advanced age, family history of skin carcinoma, light eyes and blond hair, freckles in childhood and immunosuppression. Behavioral aspects such as occupational sun exposure, rural labor and sunburns at a young age also play a role. Between 30 percent and 75 percent of the sporadic cases are associated with patched hedgehog gene mutation, but other genetic changes are also described. The tumor is commonly found in concomitance with skin lesions related to chronic sun exposure, such as actinic keratoses, solar lentigines and facial telangiectasia. The prevention of basal cell carcinoma is based on the knowledge of risk factors, early diagnosis and treatment, as well as on the adoption of specific measures, particularly in susceptible populations. The authors present a review of the epidemiology of basal cell carcinoma.

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.

giant polypoid basal cell carcinoma of the lower extremity

Less than 1% of basal cell carcinomas are giant basal cell carcinomas. Giant basal cell carcinomas are rare. They preferentially involve the trunk and are commonly associated with neglect. Giant basal cell carcinomas of 10 cm or greater are associated with a high rate of metastasis. We report a case of giant basal cell carcinoma of the leg which is not associated with neglect and no signs of metastasis, despite being more than 10 cm in diameter. The present paper includes a brief review of the literature

Análise e abordagem cirúrgica do carcinoma basocelular no serviço de cirurgia plástica do hospital São Lucas / Analysis and surgical boarding of basal cell carcinoma in the service of plastic surgery to Hospital São Lucas of PUCRS

Esse estudo realiza a análise de 67 pacientes que foram submetidos à excisão cirúrgica de carcinoma basocelular no Serviço de de Cirurgia Plástica do Hospital São Lucas da PUCRS em 2007. Os autores identificam a incidência, tipos histológicos, características, conduta cirúrgicae resultados, comparando-os com dados da literatura médica.

Cutaneous manifestations in renal failure patients: a case series.

Cutaneous involvement in renal disease is due to a host of factors ranging from metabolic disturbances to immunosuppressive drugs. Herein we report a series of six cases of renal failure with varied cutaneous manifestations ranging from infections to neoplasms due to prolonged immunosuppression. Our first case had cutaneous cryptococcosis where skin lesions gave a clue to the diagnosis of altered sensorium and underlying meningitis. The second case initially presented with florid warts and was treated successfully but later presented with an explosive recurrence of skin lesions due to malignant transformation. Our third case had basal cell carcinoma over the presternal region that was successfully treated with liquid nitrogen cryotherapy. Our fourth case had diabetic nephropathy that presented with septicemia and purpura fulminans. The last case had cutaneous manifestations of drug therapy because of heparin infusion. To conclude, cutaneous manifestations in patients with renal failure are varied and a high degree of suspicion is needed for early diagnosis and aggressive treatment to effectively combat mortality and morbidity.

Evaluation of relationship between cytomegalovirus infection and skin squamous cell carcinoma and basal cell carcinoma by using IHC technique

Skin squamous cell carcinoma [SCC] has high potency for aggression and metastasis; Basal cell carcinoma [BCC] is the most common form of skin cancers. These tumors are highly prevalent in middle-aged and old persons and have a high recurrence risk. Few studies showed the relationship between these tumors and cytomegalovirus [CMV]. The objective of this study was to assess the prevalence of CMV infection in these skin cancers. In this cross-sectional study, 60 paraffin embedded tissues including 30 SCC and 30 BCC blocks with non-involved margins were collected. Then slides were prepared by cytomegalovirus specified immunohistochemical staining. They were compared with positive control case under light microscope. From 30 SCC cases, 4 cases [13.3%] and 1 margin from non-involved cases were positive for CMV. From 30 BCC cases, 2 cases [6.7%], but no margin, were positive for CMV. There was no statistically significant difference in the prevalence of CMV infection according to histological grade, age, site of lesion or margins. The findings of this study do not support the association of CMV infection with SCC and BCC

Consideraciones sobre la capa de ozono y su relación con el cáncer de piel / The relationship between the ozone layer and skin cancer

In the recent decades, a sustained increase in the worldwide incidence of skin cancer has been observed and Chile is not the exception. The most important risk factor is the exaggerated and repeated exposure to ultraviolet radiation coming from the sun. The ozone layer restricts the transmission of type B and C ultraviolet light. Since 1980, a sustained depletion of stratospheric ozone levels is occurring, specially in middle latitudes (-30 to ¡60). Along with this depletion, the amount of ultraviolet light that reaches the earth surface is increasing. This article reviews some basic concepts about the ozone layer and the association between its depletion and skin cancer. The general population should be informed about the risks of inadequate and exaggerated exposure to sunlight.

Basal cell nevus syndrome presenting as a tender mass of the jaw: a case report

Basal cell nevus syndrome [Gorlin's syndrome] is a rare autosomal dominant tumor-predisposing syndrome which is classically consisted of multiple cutancous basal cell carcinomas, odontogenic keratocysts of the jaw, pits of the palms and soles, ectopic calcification of cranial membranes and various skeletal abnormalities. We report a typical case of Gorlin's syndrome in a 50-year-old man who presented with a tender mass of jaw