Sun protection in children: a behavioural study.

BACKGROUND: Incidence of skin cancer is increasing worldwide and UV exposure at a young age is an important risk factor. OBJECTIVES: To compare sun exposure-related knowledge and behaviour among children during school and holiday periods. MATERIAL & METHODS: A cross-sectional study was undertaken at 12 Oporto public primary schools. Educational sessions for educators were head by dermatologists every spring from 2004 to 2012. An educational activity book, Play and Learn with Jo Spots, was distributed to all primary school children and was explained by the educators every year. A questionnaire about sun exposure and behaviour was given to students in 2004 and 2012. RESULTS: In total, 2,114 students answered the questionnaire (1,233 in 2004 and 881 in 2012). Children practiced more outdoor sports in 2012 than in 2004 (86% vs 56%; p<0.001), but spent less time outside when the sun's rays were most dangerous. The use of hats (64% vs 59%; p = 0.028) and sunscreen (35% vs 15%; p<0.001) at school and the application of sunscreen before going to the beach improved over time (51% vs 26% in 2004; p<0.001). However, there was an increase in sunburn rate (43% vs 37%; p = 0.005). CONCLUSION: Sun exposure-related behaviour among primary school students in Oporto is improving but is still far from optimal. School would appear to be an adequate setting for effective and long-lasting sun protection interventions, and the introduction of educational books at schools, such as Play and Learn with Jo Spots, might be effective in bringing about positive behavioural changes.

Sun protection behaviour and skin cancer literacy among outdoor runners.

Outdoor runners have an increased risk of melanoma and non-melanoma skin cancer. The purpose of this study was to assess skin cancer literacy and sun exposure and protection behaviour among outdoor runners during training. A cross-sectional survey-based study was conducted. All athletes registered for four consecutive running events in Porto: the Porto Marathon (November 2014), the Fathers' Day 10-km race (March 2015), the Saint John's Day 15-km race (June 2015), and the Porto half-marathon (September 2015). Athletes were invited to answer an online survey with 23 questions on the following items: sociodemographic and constitutional factors, skin cancer literacy, and sun exposure and protection behaviour. A scoring system was devised to analyse behaviour. Multivariate analysis was performed. The survey was completed by 2,445 runners, 2,159 of whom trained outdoors. Only 23.5% had adequate sun exposure and protection behaviour. A higher proportion of women than men had adequate behaviour (33% versus 17%; P < 0.001). Athletes with a university, or higher degree were more knowledgeable about skin cancer than those with a lower level of education, however, their behaviour in relation to sun exposure and protection was the same. Based on multivariate analysis, gender, skin type, marital status, and average number of hours spent training significantly affected attitude score. Investment in more targeted campaigns, aimed particularly at high-risk groups such as outdoor athletes, is essential to modify attitudes and behaviour regarding sun exposure and protection. Outdoor sports event organisers and sport associations also need to engage.

Cirugía de Mohs / Mohs surgery

La cirugía de Mohs es una técnica quirúrgica que permite la extirpación en capas de tumores cutáneos seleccionados con los más elevados porcentajes de curación. Al mismo tiempo permite el máximo ahorro de tejido sano. Todo ello es posible gracias a la supervisión microscópica, que posibilita analizar el 100% de los bordes tumorales de cada una de las capas y así poder guiar al cirujano en las sucesivas persistencias tumorales hasta la completa extirpación del tumor. Esta técnica tiene una gran aceptación en Estados Unidos, donde cerca del 30% de todos los epiteliomas son intervenidos con cirugía de Mohs, y poco a poco va adquiriendo protagonismo en Europa. Se revisan todos los aspectos de la técnica, el abordaje tumoral, las alternativas de tratamiento, las variantes de la técnica y las innovaciones más importantes. Se hace especial hincapié en las indicaciones, algunas ya consolidadas y otras no tanto, que cada día van aumentando en número debido a las ventajas de la técnica (AU)

Recidivas tardías de carcinoma basocelular después de cirugía de Mohs / Late recurrences of basalcell carcinoma afther Mohs surgery

Objetivo: Comprobar el porcentaje de recidivas a los 5 años o más de operados del carcinoma basocelular con Cirugía de Mohs.Material y Método: Se operaron 1.987 pacientes con 2162 carcinomas basocelulares Resultados: 30 (1,38 por ciento) tumores recidivaron: 3 (0,13 por ciento) en los primeros 3 años, 14 (0,64 por ciento) de 3 o menos de 5 años y 13 (0,57 por ciento) de 5 años o más del postoperatorio.Conclusión: La cirugía de Mohs es el método quirúrgico con mejores resultados terapéuticos para el carcinoma basocelular. La recidiva de este tumor puede presentarse después de 5 años de operado. El seguimiento postoperatorio sugerimos sea permanente.Conclusión: La cirugía de Mohs es el método quirúrgico con mejores resultados terapéuticos para el carcinoma basocelular. La recidiva de este tumor puede presentarse después de 5 años de operado. El seguimiento postoperatorio sugerimos sea permanente. (AU)