We describe a settlement in the Araras District in central Brazil that presents a high incidence of Xeroderma Pigmentosum.Twenty patients have had clinical diagnoses compatible with this condition so far. Reports from surviving relatives suggest an additional 20 deaths linked to typical Xeroderma Pigmentosum symptoms.This is possibly the first report of its kind in the literature, due to the extension of the family factor prevalence, the patients’ age range and different characteristics of the clinical manifestations.

Keywords: XERODERMA PIGMENTOSUM, SKIN NEOPLASMS, GENETICS, EPIDEMIOLOGY

Introduction: Cutaneous melanoma has significant relevance among malignant skin tumors, for despite its low incidence (3-4%) it is associated with the highest mortality. In Brazil, estimates for the year 2014 correspond to 10% of all cancers, establishing this as an important public health issue. Objectives: To present epidemiological data related to melanoma skin cancer in the midlands of the Brazilian State of São Paulo. Methods: Descriptive retrospective cross-sectional analysis of data from a tertiary hospital's medical records. The analysis was subject to measurement and information bias. A descriptive analysis with frequency and percentage was carried out. Results: There was a prevalence of cutaneous melanoma in women (71%), patients between 50 and 70 years of age (56%), Caucasians (78%), and individuals who identified their lesions through self-examination (42%), with predominant involvement of the trunk (35%). The most prevalent histological subtype was the superficial spreading (58%). Conclusions: Understanding the epidemiology of cutaneous melanoma in a given geographic region enables and facilitates medical actions, allowing for the better establishment of strategies for primary and secondary prevention.

Keywords: MELANOMA, EPIDEMIOLOGY, SKIN NEOPLASMS.

The present article discusses the importance of differential diagnosis with lesions located in the umbilicus. A case of verrucous nevus is described in this location, emphasizing the role of dermoscopy in the diagnosis.

Keywords: MELANOMA, EPIDEMIOLOGY, SKIN NEOPLASMS.

Introduction: Progressive macular hypomelanosis is characterized by the emergence of hypopigmentation, predominantly in the trunk region of young women of mixed racial origin. Although recent studies suggest that Propionibacterium acnes may have an important role in the pathogenesis, its etiology remains unclear. Objective: To evaluate the prevalence of the condition with regards to gender, age, skin phototype, affected areas and disease onset, and the relationship with ordinary acne and oily skin in the city of Niterói, Rio de Janeiro State, in the coastal region of Southeast Brazil. Methods: Retrospective epidemiological study that uses the analysis of medical records of 103 patients with diagnosis of progressive macular hypomelanosis, from 2001 to 2012. Results: Eighty-two percent of studied patients were women and 18% men, with a predominance of phototypes III (42.7%) and IV (42.7%). The average age of onset of the disease at diagnosis was 26 years. In 46.0% of patients the disease duration ranged from 1 to 4 years. When two areas were affected (50%), the dorsum was the most frequent (79.0%), followed by the abdomen (20.0%). In 98% of cases, patients had oily skin, and 71.8% had active acne. Conclusion: Progressive macular hypomelanosis is a chronic condition that primarily affects the skin of the dorsum and abdomen of young women with skin phototypes III and IV, who are also bearers of oily skin and acne. There are still many doubts regarding the true etiology and treatment of progressive macular hypomelanosis. The high percentage of association with skin oiliness and acne vulgaris suggests that these clinical conditions are possibly related.

Keywords: HYOPIGMENTATION; EPIDEMIOLOGY; ACNE VULGARIS

Eccrine spiradenoma is a rare benign adnexal epithelial neoplasm characterized by a bluish-pink, slow-growing solitary nodule, coursing with paroxysmal pain, mainly in young adults. It is most commonly located in the trunk and extremities. Bleeding and/or ulceration are common in the giant vascular variant, which is characterized by a size greater than 2 cm in diameter and a high degree of vascularization seen on histology. Its clinical characteristics are unspecific and require biopsy with histological analysis for diagnosis. Its histology presents one or more basophilic intradermal lobules enveloped in a fibrous capsule without connection to the epidermis. It presents two types of cells: small cells with dark nuclei in the periphery and large cells with light nuclei in the center. An accurate diagnosis is important due to the fact that it can develop into a potentially fatal malignancy - which is a rare phenomenon and occurs most often in the multiple variant. A rare case of eccrine spiradenoma in the abdomen with bleeding associated is described in the present paper, as well as a discussion on possible treatments.

Keywords: ECCRINE SPIROADENOMA, BENIGN EPITHELIAL NEOPLASIA, SEBACEOUS GLANDS

Introduction: The trends of malignant melanoma in Brazil are aligned with those worldwide: increasing incidence with reduced degree of severity at diagnosis. Objective: To use the prognostic criteria of the Grupo Multicêntrico e Multidisciplinar Brasileiro para Estudo do Melanoma (Brazilian Multicenter and Multidisciplinary Group for the Study of Melanoma) combined with clinical characteristics aimed at developing a clinical and histopathological profile of melanoma cases. Methods: A cross-sectional descriptive study was carried out, with the retrospective analysis of medical records of patients diagnosed with melanoma at a tertiary dermatology reference unit in the city of Bauru, in the Brazilian southeast State of São Paulo, between January 2007 and July 2014. Results: Female patients accounted for 56.2%, with ages ranging from 27 to 95 years (Mean = 61.4 years), with a lesion having been detected on physical examination in 36% of cases. The highest incidence of the disease was in the lower limbs (23.5%), with the superficial spreading subtype corresponding to 79.6% of biopsies. The average Breslow thickness was 2.9 mm, and in 28.1% of cases, the lesion was in situ. Conclusions: The following profile emerged: women, 61-years-old, with lesions in the lower limbs, superficial spreading subtype and with evidence of good prognostic. Studies like this are important due to the fact they provide subsidies for the design of strategies to treat the population.

Keywords: EPIDEMIOLOGY; MELANOMA; HISTOLOGY; PATHOLOGY, SURGICAL; SKIN NEOPLASMS

Introduction: Basal cell carcinoma is the most common skin cancer and corresponds to 70-80% of all malignant neoplasms of the skin. It is emerging as a global public health problem, with incidences of the condition increasing in all countries. Objective: To evaluate the epidemiological profile and characteristics of patients diagnosed with basal cell carcinoma in the previous four years in a reference hospital. Methods: A cross-sectional descriptive study was carried out at a dermatology reference center in the city of Bauru, São Paulo State, Brazil. Patients diagnosed with basal cell carcinoma, confirmed by histological examination from January 2010 to December 2013 were included in the study. The variables analyzed descriptively were: age at diagnosis, gender, city of origin, site of lesion, and race. Results: A higher incidence of basal cell carcinoma was observed in Caucasian women older than 60 years, with the malar and nasal regions arising as the usual locations. Conclusions: There is an increased incidence of basal cell carcinoma in young people, however the most affected population is still the elderly Caucasian population. The most common area for the cancer is the face, particularly the upper two thirds. The incidence of this cancer in younger populations is worrying, with the dermatologist having an important role in the prevention and early treatment.

Keywords: CARCINOMA, BASAL CELL; EPIDEMIOLOGY; SKIN NEOPLASMS; PATHOLOGY; DERMATOLOGY

Recurring nevus or pseudomelanoma is a benign melanocytic lesion that appears in the same location after an incomplete surgical removal of nevi. These pigmented melanocytic lesions can in some cases be a diagnostic challenge when examined through dermoscopy, especially if there is a clinical history of growth or recurrence of the lesion, as happens with the recurrent nevus phenomenon. Confocal reflectance microscopy is an in vivo non-invasive imaging technique with high histomorphological resolution of the skin that can be used to differentiate between benign and malignant lesions, increasing the in vivo diagnostic accuracy. Nonetheless, in some cases only the histological and immunohistochemical examinations of the complete lesion can clarify the diagnosis.

Keywords: CARCINOMA, BASAL CELL; EPIDEMIOLOGY; SKIN NEOPLASMS; PATHOLOGY; DERMATOLOGY

Introdução: Vitiligo is an acquired autoimmune form of hypopigmentation or depigmentation in which half of the cases begins in childhood. Objectives: To describe the clinical and epidemiological profile of childhood vitiligo in a referral center for dermatology. Methods: A cross-sectional, descriptive study was carried out based on the analysis of medical records of patients younger than 13 years diagnosed with vitiligo from 2004 to 2014. Results: Of the 113 cases identified, 54% were female and 46% male, the age ranged from 0 to 12 years, with most patients in the 4-8 years-old subgroup (54.8%). In 59% of the medical records there was no record of triggering factors of vitiligo; 31% of patients associated the onset of the illness to emotional stress, 3% to physical trauma and 7% did not associate it to any triggering factor. Conclusions: The discreet prevalence in women has also been reported in other studies. Vitiligo behavior in children is different from that observed in adults. The influence of psychological factors as triggers and potential lasting effects on self-esteem should be considered in the approach of the patient. Although studies on vitiligo in this age group are scarce in the literature, the results of the present study were similar to the reports already available in the literature.

Keywords: CHILD; EPIDEMIOLOGY; VITILIGO

INTRODUCTION: In Brazil, skin cancer is the most common type of cancer, and melanoma is the most lethal.
OBJECTIVES: To analyze the temporal trend of mortality due to melanoma in Brazil between 2000 and 2016.
METHODS: Ecological time-series study involving all deaths from melanoma in Brazil from 2000 to 2016. The crude death rate, adjusted for the Brazilian population and the world population, was analyzed. For the analysis, we used the regression model by inflection point with 5% significance.
RESULTS: In the period, 22,963 deaths from melanoma were recorded in Brazil, with an increasing trend in the crude death rate (2.6%), and in the adjusted rates for the Brazilian (0.6%) and the world population (0.5%). In the Southeast, we observed a steady trend in the crude death rate and the adjusted rate for the Brazilian population, as well as a decreasing trend in the world population rate. The crude death rate (77.77%; n=21); the Brazilian population (59.25%; n=16), and the world population adjusted rates (55.55%; n=15) presented an increasing trend. Only São Paulo and Rio de Janeiro showed a decreasing trend in the death rate adjusted for the Brazilian and the world population.
CONCLUSIONS: The study showed an increase in mortality from melanoma in Brazil. Policies should be implemented to favor early diagnosis and timely treatment.

Keywords: Melanoma; Time series studies; Epidemiology

INTRODUCTION AND OBJECTIVE: The Campanha Nacional de Prevenção ao Câncer de Pele (National Skin Cancer Prevention Campaign), promoted by SBD, is an annual event to inform about the early diagnosis and prevention of skin cancer. Considering the participants’ profile, composed mostly of older adults, and the campaign educational goals, it's opportune to identify the proportion of people with cognitive impairment to improve communication.
METHODS: We perform a cognitive screening of 2018 Campaign participants using a "10-point cognitive screener" score. The participants included were ≥ 60 years. We excluded those who were unable to communicate or denied consenting.
RESULTS: The study interviewed 66 participants. The median age was 68 years (p25-p75:63-73), and 42 (64%) were women. Twenty-four participants (36%) had some elementary school, and 13 (20%) had a neurological or psychiatric disease. The crude and adjusted by schooling 10-CS scores had a median of 8 (6-9). Twenty-five of the interviewed patients (38%) had adjusted score below eight, indicating cognitive impairment, and six (9%) had a probable impairment. The cognitive deficit was associated with a history of neurological disease and low schooling.
CONCLUSIONS: Despite covering all ages, the campaign prioritizes the risk population, including older adults. Therefore, campaign volunteers should adapt the communication to participants’ profile.

Keywords: Dermatology; Skin Neoplasms; Disease Prevention; Mild Cognitive Impairment; Epidemiology; Early Detection of Cancer

The increase in the incidence of basal cell carcinoma (BCC) affects all age groups, including young patients under twenty years old. Because it is poorly remembered in this group of patients, late diagnosis and treatment of this neoplasia may be more common. Like other age groups, excessive exposure to ultraviolet radiation is the main associated risk factor; however, genetic factors may also be involved in non-syndromic cases. We report a case of BCC on the face of an adolescent treated with Mohs micrographic surgery.

Keywords: Adolescent; Carcinoma, Basal Cell; Epidemiology; Mohs Surgery; Solar Radiation

INTRODUCTION: Basal cell carcinoma is the most common non-melanoma malignancy in humans. Its superficial variant has specificities that can represent a diagnostic and therapeutic challenge.
OBJECTIVE: To describe the epidemiological profile of patients with superficial basal cell carcinoma (SBCC) treated at a reference service and to correlate, statistically, clinical, dermoscopic, and anatomopathological characteristics.
METHODS: Observational, analytical, cross-sectional study conducted by collecting data from patients with suspected SBCC between November 2019 and October 2020.
RESULTS: In total, we confirmed 25 lesions as SBCC. They were more frequent in women, in the head and neck, and with a diameter of less than 1 cm. We also observed, in clinical characteristics, a predominance of individuals over 60 years old and with phototypes II and III. The anatomopathological examination observed some pigmentation in the lesions evaluated and a predominance of intra-epidermal keratinocytes in lesions with maple leaf-like areas in dermoscopy.
CONCLUSIONS: SBCC can present clinically as a pigmented lesion, affecting more the head and neck regions. Lighter skin phototypes are more likely to have SBCC with pigmented dermoscopic structures. Intra-epidermal keratinocytes possibly correlate with the formation of maple leaf structures.

Keywords: Basal cell carcinoma; Dermoscopy; Epidemiology; Skin Neoplasms; Pathology

O queratoacantoma (QA), apesar de frequente na prática diária, é um tumor que gera questionamentos. O aspecto mais intrigante associa-se à sua posição no limite entre malignidade e benignidade. A abordagem do tumor, bem como sua classificação, é controversa. Na definição da conduta, é importante levar em conta o potencial de transformação para carcinoma espinocelular. Desse modo, a excisão cirúrgica é a terapia de escolha, sempre que possível. Algumas situações merecem atenção adicional, como a imunossupressão associada. Neste artigo, relatamos um caso de QA gigante em um paciente com síndrome da imunodeficiência adquirida tratado com cirurgia micrográfica de Mohs.

Keywords: Ceratoacantoma; Retalhos Cirúrgicos; Neoplasias Nasais; Neoplasias Cutâneas; Cirurgia de Mohs; Síndrome de Imunodeficiência Adquirida; HIV; Imunossupressão

INTRODUCTION: Melanoma comprises 3% of all skin tumors and can produce metastasis with high mortality.
OBJECTIVE: To analyze the temporal behavior of mortality from skin melanoma in the capitals of Northeast Brazil from 2001 to 2017.
METHODS: We conducted an ecological time series study involving all deaths due to melanoma registered in the capitals of the Northeast region of Brazil from 2001 to 2017. Crude and standardized rates by the world and Brazilian populations were analyzed. We obtained the indicators from the National Cancer Institute (INCA). The regression model by inflection points was used in the statistical analysis, calculating the annual variation and the average annual variation percentages.
RESULTS: There were 954 deaths from melanoma. The three rates analyzed showed a linear growth trend over the time series: proportional mortality increased from 2.1% to 8.28% (AAPC 6.0%; p<0.02), the crude mortality grew from 0.22 to 0.64/100 thousand (AAPC 5.0%; p<0.01) and the mortality adjusted by the world population in the capitals of the Northeast rose from 0.28 to 0.61/100 thousand (AAPC 2.7%; p<0.01).
CONCLUSION: Mortality from melanoma grew in the Northeastern capitals, with inequality between the sexes and according to the capitals.

Keywords: Epidemiology; Melanoma; Mortality; Skin neoplasms.