Diagnostic index of cutaneous neoplasia in a campaign to fight skin cancer at a dermatologic service located in the Brazilian State of São Paulo’s midlands

Received on: 03/10/2017
Approved on: 28/12/2017
Financial support: None
Conflict of interests: None

Abstract

Introduction: Skin cancer is the most common type of cancer in the world. It is classified into melanoma (corresponding to 4% of cases) and non-melanoma types: basal cell carcinomas (70 to 80% of cases) and squamous cell carcinoma (25% of cases). The Brazilian Society of Dermatology conducts the National Campaign Against Skin Cancer on a yearly basis, aiming at diagnosing and providing early treatment to the neoplasia.
Objective: To demonstrate the incidence of lesions suspicious of skin cancer in selected patients originated from the 2016 National Campaign Against Skin Cancer, at the dermatologic clinic of a university hospital located in the Brazilian State of São Paulo’s midlands.
Methods: Two hundred and thirty patients were examined, of which 24 were selected with 22 undergoing biopsy of the suspected lesions.
Results: Sixteen basal cell carcinoma cases, one squamous cell carcinoma and one melanoma were confirmed through anatomopathology.
Conclusions: Notwithstanding the small sample, it was possible to conclude that the results found are compatible with those of the literature reviewed. It is of paramount importance to carry out the campaign as a way to streamline the population’s access to a dermatologist, which results in the early diagnosis and treatment of skin cancers.

Keywords: Melanoma; carcinoma, basal cell; skin neoplasms; neoplasms, squamous cell; health promotion

INTRODUCTION

Skin cancer is the most common malignancy in the world. In Brazil, it corresponds to 25% of all malignancies registered.¹ Excessive and unprotected sun exposure has great importance in its genesis. According to the Brazilian Society of Dermatology (SBD), the larger skin cancer registries are found in the South and Southeast regions, with the highest rates in Santa Catarina and Rio Grande do Sul.² These cancers are divided into melanoma and non-melanoma types, the latter known as basal cell carcinomas (BCC) and squamous cell carcinomas (SCC). Cure rates can reach 95% when detected and treated early.^1,3 The Brazilian Society of Dermatology (SBD) conducts an annual National Campaign Against Skin Cancer, focusing on education about prevention, skin examination and early diagnosis of the malignancy.³ We investigated the epidemiological profile of the patients seen in a campaign against skin cancer in a dermatological university center in a country town of São Paulo, reinforcing the importance of population education for the early diagnosis and treatment.

METHODS

A descriptive epidemiological study in which 230 patients who attended the station of the National Campaign for the Prevention of Skin Cancer were examined, with the consultation comprising a thorough clinical dermatological examination and dermoscopic analysis of suspicious lesions. Thirty-four patients were selected, of which 22 underwent biopsy of the suspicious lesions, two referred for body mapping and other 10 patients directed for the treatment of pre-malignant lesions in a specialized clinic of the service.

RESULTS

Of the patients who were biopsied, 12 were male and 10 female, with a mean age of 70.4 years. Incisional biopsies were performed in the majority of patients, with more than one sample submitted to histological analysis for some patients. After histopathological analysis, 14 cases of BCC, 2 cases of SCC, 2 cases of intradermal nevi,⁴ hypertrophic actinic keratoses and one melanoma were diagnosed (Table 1). Based on the results, we observed a higher incidence of malignancy in the age group of 71-80 years, with a prevalence of BCC, in accordance to the literature reviewed. SCC and melanoma cases were diagnosed in male patients. In our sample, most lesions were in areas exposed to the sun, such as malar region, dorsum of nose, and upper lip.

DISCUSSION AND CONCLUSION

Skin cancer is the most common malignancy in the world. Melanoma represent only 4% of skin malignancies, is highly aggressive because it has the potential to be invasive and metastatic. The nonmelanoma type has a high incidence but a low mortality, with high cure rates, particularly when diagnosed early. BCC is the most common skin tumor, representing between 70% and 80% of the diagnoses and occurring almost exclusively in areas exposed to solar radiation. SCC can occur in areas of the body exposed to solar radiation in an intermittent way, representing 25% of cases.^1,4,5 The campaigns against skin cancer conducted annually by the SBD in its accredited services has the objective of increasing the early diagnosis of the disease and therefore the chances of cure.² This study demonstrated that despite the small sample size, the results found are in accordance to the reviewed literature. We concluded that there is still a delayed demand of the population for diagnosis, demonstrated the great importance of conducting campaigns as a way of guaranteeing faster axis of the population to a dermatologist and, therefore, early diagnosis and treatment of skin cancers.

DECLARATION OF PARTICIPATION:

André Cesar Pessanha:

Research project, supervision and final review

Luciana Couto e Silva:

Elaboration, notes of the results and writing of the article

Daniela Terumi Saito:

Elaboration, notes of the results and writing of the article

Isabella Cardoso da Mota:

Elaboration, notes of the results and writing of the article

Denise Steiner:

Final review of the article

REFERENCES

1. Moraes CO, Beltrão ES, Fernandes AA, Castelo LN, Rocha DAP. Skin cancer prevention - self examination as strategy acessible to everybody. Rev Extendere. 2016; 4(1):63-75

2. Clavico LS, Trindade GS, Rodrigues O, Trindade RAR. Prevention Campaign Against Skin Cancer in Rio Grande, Brazil: An Epidemiological Profile. Saúde e Pesquisa. 2015; 8(1):113-23

3. Zink BS. Skin cancer: the importance of diagnosis, treatment and prevention. Revista HUPE, Rio de Janeiro, 2014;13(Supl. 1):76-83;

4. Iranzo CC, Rúbia-Orti JE, Castillo SS, Canhoto JF. Malignant and prema-lignant skin lesions: knowledge, habits and sun protection campaigns. Acta Paul Enferm. 2015; 28(1):1-6;

5. Chinem VP, Miot HA. Epidemiology of basal cell carcinoma. An Bras Dermatol. 2011;86(2):292-305.

This study was performed at the Universidade de Mogi das Cruzes (UMC) - Mogi das Cruzes (SP), Brasil.