New imaging methods, such as optical coherence tomography, magnetic resonance and high frequency ultrasonography, have been developed for use in dermatology. Among the new methods, in vivo reflectance confocal microscopy, has presented the fastest growth in large cutaneous oncology centers and has generated the greatest number of articles in the literature recently, due to its resolution – similar to histological resolution. In vivo confocal microscopy has been particularly useful given the many limitations of the dermoscopic diagnosis of cutaneous neoplasias, especially of achromic or hypopigmented lesions, lesions in the face or in mucous membranes. Some studies have also suggested considerable utility in the assessment of surgical margins and in determining the best area of the body for carrying out excisional biopsies. This study briefly describes how the confocal laser reflectance microscope works and discusses some of the issues that arise in its use in the daily practice of dermatologic surgeons.

Keywords: MICROSCOPY, CONFOCAL, DETECTION OF CANCER, SKIN NEOPLASMS

INTRODUCTION: Cutaneous squamous cell carcinoma may originate from premalignant lesions, with actinic keratosis (AK) being the most frequent. The field cancerization is defined as an area of apparently healthy skin, but with important photodamage around the AK lesions. In this study, we compared imiquimod, an immunomodulator , to a medium-strength chemical peel, with Jessner’s solution combined with 35% trichloroacetic acid.
OBJECTIVE: To compare the efficacy/ acceptability of the two methods in treating the facial field cancerization.
METHODS: Ten patients who underwent the two forms of treatment were selected: in one hemiface, they used 5% imiquimod cream three times a week for 4 weeks; in the other, they applied the medium-strength chemical peel, with Jessner’s solution combined with 35% trichloroacetic acid. Patients were evaluated 30 days after the end of the treatment by counting the AKs and recording the degree of patient satisfaction and the adverse effects with both treatment modalities.
RESULTS: Treatment with imiquimod led to the resolution of 51.8% of the AKs and melanoses together and 72.8% when only the AKs were evaluated. Peeling treated 74.9% of AKs and melanoses and 79.1% of AKs. All patients felt satisfied at some level with both forms of treatment, with greater satisfaction with the chemical peel.
CONCLUSION: Both modalities were effective, but the chemical peel was more efficient and easier to apply, however, with more intense adverse effects

Keywords: Skin, cancer; Keratosis, actinic; Chemexfoliation

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