Study of skin neoplasms in a university hospital: integration of anatomopathological records and its interface with the literature

Abstract: Background: Skin cancer is a highly prevalent condition with a multifactorial etiology resulting from genetic alterations, environmental and lifestyle factors. In Brazil, among all malignant tumors, skin cancers have the highest incidences. Objective: To retrospectively evaluate the incidence, prevalence and profile of basal cell carcinoma, squamous cell carcinoma and cutaneous melanoma in Campos dos Goytacazes and region. Methods: In total, 2,207 histopathological reports of a local reference hospital were analyzed between January 2013 and December 2015, of which 306 corresponded to the neoplasms studied. Results: Of the 306 reports evaluated, 232 basal cell carcinomas (75.9%), 55 squamous cell carcinomas (18%) and 19 cutaneous melanomas (6.5%) were identified. The face was the most involved anatomical site (58.8%) and women (51%) were the most affected gender. The temporal analysis revealed a decrease in the overall incidence of 3.4% from 2013 to 2014 and 5.4% from 2014 to 2015. There was a 10.1% increase in basal cell carcinomas and 38% in melanomas in this period; however, there was a decrease in the number of squamous cell carcinomas of 14.8% during the studied years. Study limitations: Some samples of cutaneous fragments had no identification of the anatomical site of origin. Conclusion: Research that generates statistical data on cutaneous tumors produces epidemiological tools useful in the identification of risk groups and allows the adoption of more targeted and efficient future prevention measures.

Dermatite perioral granulomatosa com acometimento extrafacial na infância: boa resposta terapêutica com uso de azitromicina oral / Granulomatous perioral dermatitis with extra-facial involvement in childhood: good therapeutic response with oral azithromycin

RESUMO Objetivo: Apresentar um caso de dermatite perioral granulomatosa (DPG) com acometimento extrafacial e resposta terapêutica satisfatória ao uso de macrolídeo oral por curto período. Descrição do caso: Escolar de nove anos, sexo feminino, com quadro exuberante de DPG com acometimento extrafacial. Durante o período de evolução, submeteu-se a múltiplas terapêuticas ineficazes, apresentando melhora significativa das lesões após o uso de azitromicina por cinco dias. Comentários: A DPG é uma afecção dermatológica inflamatória representada por erupções papuloeritematosas em região perioral, nasal e periorbitária, mais comum em crianças e adolescentes. Raramente estende-se à região genital, ao tronco e às extremidades, caracterizando o comprometimento extrafacial. De etiologia ainda desconhecida, parece apresentar correlação com uso de corticosteroides tópicos e outros agentes.

ABSTRACT Objective: To present a case of granulomatous perioral dermatitis (GPD) with extra-facial involvement and good response to short-term treatment with oral macrolide. Case description: A 9-year-old girl presented with exuberant GPD with extra-facial involvement. During follow-up, she received multiple ineffective therapies, but showed significant improvement of the lesions after the use of azithromycin for five days. Comments: GPD is an inflammatory dermatological condition represented by papulo-erythematous eruptions on perioral, nasal and periorbital regions, more prevalent in children and adolescents. It rarely extends to the genital region, trunk, and extremities, which characterizes its extra-facial manifestation. Its etiology is unknown, but it seems to have a correlation with the use of topical corticosteroids and other agents.

Psoríase artropática eritrodérmica: rápida remissão com secuquinumabe / Erythrodermic psoriatic arthritis: quick remission with secukinumab

Entre 20% e 30% dos pacientes com psoríase vulgar têm formas exuberantes que requerem terapia sistêmica. A imunobiologia representa um ramo promissor da farmacologia moderna e configura um dos grandes avanços da medicina atual. O secuquinumabe é um anticorpo monoclonal de imunoglobulina humana totalmente recombinante, recentemente introduzido no mercado, que atua neutralizando seletivamente a interleucina17-A e promove excelentes resultados no tratamento de casos moderados a graves de psoríase. Apresentamos uma paciente de 66 anos internada por psoríase artropática eritrodérmica e tratada com secuquinumabe sob regime de monoterapia. Houve melhora importante das lesões cutâneas após 6 semanas e resolução completa do quadro, inclusive da artrite, após 10 semanas de tratamento. (AU)

Between 20% and 30% of patients with psoriasis have exuberante forms that require systemic therapy. Immunobiology represents a promising branch of modern pharmacology and is one of the great advances of current medicine. Secukinumab is a recently released recombinant human immunoglobulin monoclonal antibody that selectively neutralizes interleukin17A and promotes excelente results in the treatment of moderate to severe cases of psoriasis. We present a 66 year old patient hospitalized for erythrodermic arthropathic psoriasis and treated by a monotherapy regimen with secukinumab. There was significant mprovement of skin lesions after 6 weeks and complete resolution of the condition, including the arthritis, after 10 weeks of treatment. (AU)

Avaliação do tempo de dreno de sucção em pacientes submetidos à artrodese lombar: estudo prospectivo randomizado / Evaluation of the suction drain time in patients undergoing lumbar arthrodesis: prospective randomized study

Objetivo: Avaliar o tempo mais adequado para o uso do dreno de sucção no pós-operatório de artrodese lombar. Métodos: Estudo descritivo, comparativo, randomizado, com uma amostra de 40 pacientes, dos quais 20 utilizaram o dreno de sucção por três dias de pós-operatório e outros 20 utilizaram o dreno de sucção por cinco dias de pós-operatório. Foram avaliadas e comparadas as complicações surgidas no pós-operatório dos pacientes de ambos os grupos e a Escala Visual Analógica da dor. As complicações avaliadas foram seroma, infecção superficial e deiscência de sutura. Resultados: Entre os 40 pacientes avaliados, encontramos 10% de complicações da ferida operatória no pós-operatório, sendo as mais frequentes o seroma e a infecção superficial, não havendo necessidade de reintervenção cirúrgica. Conclusão: Apesar de a utilização do dreno de sucção por cinco dias ter levado a um menor número de complicações e a um menor índice de dor no pós-operatório, esta não foi estatisticamente significante quando comparada com o grupo em que o dreno foi retirado no terceiro dia de pós-operatório.

Objective: Evaluation of the most appropriate time to use suction drain in the postoperative period of lumbar arthrodesis. Methods: A descriptive, comparative and randomized study, with a sample of 40 patients, 20 used the suction drain during three days of the postoperative and 20 used the suction drain during five days of the postoperative. The complications and the Visual Analogue Pain Scale were evaluated and compared in postoperative patients of both groups. The complications included seroma, superficial infection and wound dehiscence. Results: Among the 40 patients, we found 10% of wound complications in the postoperative period, the most common being seroma and superficial infection, with no need for surgical intervention. Conclusion: Although the use of the suction drain for five days has led to fewer complications and a lower rate of postoperative pain, this was not statistically significant when compared with the group where the drain was removed on the third day of the postoperative.