Introduction: Incidence of skin cancer has increased signifi cantly in recent decades, corresponding to a public health problem in many countries. Skin is the organ most affected by the deleterious effects of ultraviolet radiation and the association between sun exposure and skin cancer is well-documented. Objective: To conduct a comprehensive review of the main photoprotection measures. Method: We conducted searches on MEDLINE from June 22 through August 18. Descriptive studies, review, and comparisons were analyzed together. Results: We selected 11 articles in with a review of photoprotection, effects of ultraviolet radiation on the skin, prevalence of the use of sunscreens, and behavioral measures between adults and adolescents were reported. Conclusions: The use of broad-spectrum sunscreens, besides simple behavioral measures, appears to have a major impact on prevention of skin cancer.

Keywords: ULTRAVIOLET RAYS, ULTRAVIOLET LIGHT, SUNLIGHT, ULTRAVIOLET FILTERS, CARCINOMA, SQUAMOUS CELL, SQUAMOUS CELL CARCINOMA, CARCINOMA, BASAL CELL, BASAL CELL CARCINOMA, MELANOMA, VITAMIN D, STABILITY OF COSMETICS

Introduction: Mohs Micrographic Surgery is a well-known and established method in the United States, and is currently considered the gold standard treatment in many cases involving cutaneous neoplasias. Since it was first described by Dr. Frederic E. Mohs, the micrographic surgery technique has been continuously changed and adapted to better suit the daily life needs of dermatologic surgeons. This article examines different and innovative Mohs Micrographic Surgery techniques.

Keywords: MOHS SURGERY, CARCINOMA, BASAL CELL, CARCINOMA, SQUAMOUS CELL

A case of pigmented basocellular carcinoma clinically mimicking a malignant lentigo melanoma in the temporal region of a black female patient is reported. Basal cell carcinoma rarely occurs in black patients. When present, however, it is the second most common malignant skin neoplasia, and is usually pigmented. When the face is affected in such patients, it is difficult to differentiate between malignant lentigo melanoma and basal cell carcinoma. Dermatoscopy is a very helpful diagnostic tool in these cases.

Keywords: CARCINOMA, BASAL CELL, MELANOMA, DERMOSCOPY

Introduction: The reconstruction of surgical defects resulting from the excision of tumors in the nose is a challenge for dermatologic surgeons due to its rigid structure and low mobility. The Mohs Micrographic Surgery technique allows the preservation of healthy tissue and leads to a smaller surgical wound. Objective: To demonstrate techniques for surgical correction of defects after removal of tumors of the nose through Mohs Micrographic Surgery, according to the anatomical location of the tumor. Methods: Descriptive study of patients operated on using Mohs Micrographic Surgery during the period 1996-2010. Patient images taken pre-, intra-, and post-operatively were analyzed with the aim of classifying the defect's anatomic location and the type of surgical reconstruction adopted. Results: 170 patients (totaling 203 lesions) were included in the study. The most common locations for tumors were (in descending order): nasal ala, dorsum, tip, and lateral wall. The advancement flap was the most common reconstruction type for lesions located in the lateral wall and in the nasal ala. Grafts were most often used in lesions located in the tip of the nose. Grafts and advancement flaps were more frequently used in the dorsum of the nose. Conclusions: The parameters that provide guidance on choosing the best reconstruction method must take into consideration the size and location of the surgical defect.

Keywords: MOHS SURGERY, CARCINOMA, BASAL CELL, CARCINOMA, SQUAMOUS CELL

Introduction: Mohs micrographic surgery is a treatment option that increases the cure rate in various types of skin cancer, offering greater tissue preservation and lower recurrence rates. Objective: To describe clinically and histologically the tumors operated on with Mohs micrographic surgery, and to draw correlations to the number of stages and the type of surgical reconstruction performed. The operations were performed at a private clinic in the municipality of Rio de Janeiro, Brazil that is a specialist center for this technique. Methods: Retrospective, observational, cross-sectional/transversal study was carried out based on the review of medical records. Results: A study was conducted of 93 tumors in 84 patients, operated on between April 2010 and August 2012, and followed up with until August 2013 (12 to 42 months). Findings: 47.61% of patients were men and 52.38% were women, the mean age was 62.89 years; predominant phototypes: II (44%) and III (43%); 6 cases (6.45%) of squamous cell carcinoma, 87 (93.54%) of basal cell carcinoma; 74.19% were primary tumors; the nose was the most frequent site (46.24%); a single surgical stage was performed in most cases, with flaps (44%) being the more frequently performed type of closure. There was recurrence in one patient, who required reoperation in October 2012 and followed without new recurrence. Conclusions: Mohs surgery has proven effective with high cure rates and a minimal recurrence rate, especially in lesions located in the face's H area of risk.

Keywords: MOHS SURGRY, CARCINOMA, BASAL CELL, CARCINOMA, SQUAMOUS CELL.

Introduction: UV light-induced photodamage is an acute precipitator of solar erythema, which is the phenomenon measured to assess the protection against the sun provided by a particular product. Objective: To investigate the ability of a dietary supplement containing antioxidants (carotenoids, trace elements/oligoelements, flaxseed oil, and vitamins E and C) to prevent photodamage, using as a parameter the minimum erythema dose level. Method: The minimum erythema dose level of 28 volunteers (Fitzpatrick skin types 2 and 3) was measured with a solar simulator, before and after 30 and 60 days of supplement use. Results: The daily use of the supplement was well tolerated. There was a significant increase in the minimum erythema dose level in the group evaluated (p = 0.017). Conclusion: The studied combination of antioxidants was demonstrated to increase the minimum erythema dose level with statistical significance, suggesting the presence of photoprotective activity.

Keywords: ULTRAVIOLET RAYS, ANTIOXIDANTS, CAROTENOIDS.

Introduction: In the Brazilian public health system, the current demand for dermatological procedures is greater than the offer, resulting in a waiting list of patients bearing dermatoses to be treated surgically. Aimed at reducing that waiting list, a collective effort of surgical procedures was carried out in the tertiary public health service. The corresponding data on the patients and lesions is disclosed in the present study. Objective: To assess the profile of the patients – and respective skin lesions – who are awaiting to undergo dermatological procedures. Methods: A simple descriptive profile analysis of the patients, treated dermatoses and procedures performed was carried out. Results: Thirty-one patients (aged between 21 and 95 years, mean = 63.7 years). Seventeen (54.83%) were women and 14 (45.17%) were men. Thirty-eight lesions were treated: 21 neoplastic (carcinomas and melanomas), 8 pre-neoplastic (actinic keratoses) and 9 non-neoplastic (nevi, keloid and neurofibroma). Conclusions: The present article is relevant due to the fact it identifies cases and patients awaiting dermatological surgical procedures in the public health system. Based on it, a better planning of public health strategies in the dermatological field should be possible. Also, it highlights the importance of the dermatologist physician’s action in the public health, diagnosing and treating pre-neoplastic and neoplastic lesions.

Keywords: DERMATOLOGY; AMBULATORY HEALTH SERVICES; HEALTH CENTERS; POPULATION STUDIES IN PUBLIC HEALTH; PUBLIC HEALTH; PUBLIC HEALTH ADMINISTRATION; NEOPLASMS; MELANOMA; CARCINOMA; CARCINOMA, BASAL CELL

Introduction: Photoprotectors are the active ingredients of sunscreens with the capability of protecting the skin against UV radiation. An increasing number of such photoprotection ingredients have been launched in the marketplace, causing sunscreens' formulas to become increasingly varied. Objective: To list the main active photoprotection ingredients contained in formulations commercially available in Brazil, as well as to document the presence of other ingredients contained in sunscreens. Methods: The authors inspected four drugstores in the city of Rio de Janeiro, Brazil, and analyzed the formulas of the SPF 30 sunscreens available. The active photoprotector substances found in all formulations were listed and the percentage of each of them was compared to those contained in all sunscreens evaluated. The presence of plant extracts and antioxidants was also documented. Results: Thirty commercially available SPF 30 sunscreens were found in different drugstores, having their formulas analyzed. Within this sample, there were 17 different active photoprotection principles, of which titanium dioxide was the most frequently found, followed by bis-ethylhexyloxyphenol methoxyphenyl triazine. Conclusion: The present study lists the profiles of photoprotection active principles found in the main sunscreens on sale in Brazil and provides data for further evaluation of changes in these profiles over time, as new sunscreens are launched in the marketplace.

Keywords: PHOTOPROTECTORS; SUNSCREENS; PHOTOPROTECTION; ULTRAVIOLET RAYS

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: Vitiligo is a pigmentation disorder characterized by white spots on the skin and mucous membranes. Wnt1 protein belongs to the Wnt signaling pathway. Wnt1 induction is linked with melanocyte stem cell differentiation in hair follicles on lentigo solaris, which is a hyperpigmentation skin disorder in sun-exposed area. This assumes the possibility of Wnt1 induction with NB-UVB therapy, which causes perifollicular repigmentation on vitiligo.
OBJECTIVES: To compare Wnt1 expressions in vitiligo repigmentation after NB-UVB treatment and to identify the relationship between Wnt1 expressions and vitiligo repigmentation area.
MATERIALS AND METHODS: The subjects of the study were 18 vitiligo patients. Immunohistochemical examination was conducted on vitiligo skin tissues pre- and post-phototherapy treatment twice a week for two months.
RESULTS: There were significant differences in the vitiligo lesion area between pre and post-therapy. Also, there were significant differences in Wnt1 expressions between pre and post-therapy. There was a correlation between the post-therapy Wnt1 expressions and the post-therapy vitiligo lesion area.
CONCLUSIONS: Wnt1 induction occurs in hair follicles post-NB-UVB therapy, causing pigmentation around hair follicles. Further studies are needed on the Wnt1 protein mechanism resulting in pigmentation around hair follicles.

Keywords: Hair Follicle; Melanocytes; Ultraviolet Therapy; Wnt1 Protein; Phototherapy; Vitiligo

Diagnosing basal cell carcinomas, both clinically and dermoscopically, is part of most dermatologists' daily routine. However, tumors of this lineage, when densely pigmented, can be a challenge for the physician and surgeon. Dermoscopic features typical of melanocytic lesions may be present in these carcinomas, and the similarity with melanoma results in a real dilemma. More in-depth knowledge on this topic can make a difference in the management of these cases.

Keywords: Carcinoma, Basal cell; Dermoscopia; Diagnosis; Melanoma

The cuniculatum carcinoma is a rare, slow-growth, local aggressive subtype of the squamous cell carcinoma, presented as a verrucous lesion with a low metastasis capacity. Its histopathology shows keratin-filled crypts, and its etiology is linked with HPV, especially 11 and 16 subtypes. The treatment of choice is surgical excision, followed by regular monitoring due to the high risk of local recurrence. We report a case of a woman with Cuniculatum carcinoma treated with surgery with perioperative frozen section procedure, graft, and good evolution.

Keywords: Carcinoma; Carcinoma, Squamous Cell; Foot

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

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

Sarcomas são neoplasias mesenquimais malignas, raras, que acometem, principalmente, crianças e adolescentes. O rabdomiossarcoma, subtipo oriundo da musculatura esquelética, é condição incomum em adultos, acometendo sítios de localização não habitual, crescimento rápido e de difícil tratamento. Apresenta-se caso de adulto jovem com nodulação em lóbulo auricular esquerdo, cuja análise histopatológica e imuno-histoquímica confirmou tratar-se de rabdomiossarcoma alveolar, o qual foi conduzido em conjunto com a Oncologia.

Keywords: Rabdomiossarcoma Alveolar; Miogenina; Desmina; Excisão de Linfonodo