Câncer na pele negra / The black skin cancer

JUSTIFICATIVA E OBJETIVOS: O câncer da pele é a neoplasia de maior incidência no Brasil. O câncer na pele negra é menos comum em relação à pele clara, mas está frequentemente associado com o aumento da morbidade e da mortalidade. O objetivo deste estudo foi observar o câncer na pele negra no Brasil. CONTEÚDO: Em indivíduos de pele escura o carcinoma espinocelular é a neoplasia mais comum, seguido do carcinoma basocelular e do melanoma. O carcinoma espinocelular e o melanoma geralmente ocorrem em locais não expostos ao sol e a radiação ultravioleta não é um fator etiológico importante,ao contrário do carcinoma basocelular que habitualmente localiza-se em regiões mais expostas. Os tumores nessa população tendem a se apresentar em estágios mais avançados e com pior prognóstico. Inúmeros fatores contribuem para isso, como a falta de experiência médica para diagnóstico e tratamento de doenças cutâneas de diferentes etnias, crença de que a pele negra é completamente protegida contra o câncer da pele, e menor acesso aos cuidados médicos e triagem preventiva por fatores socioeconômicos e culturais. No entanto, como no Brasil existe um grande número de negros, é necessário que os médicos se familiarizem com as diferentes nuanças que ocâncer da pele pode adquirir na pele mais pigmentada. CONCLUSÃO: Os cânceres da pele representam um risco significativo nas pessoas de pele escura, os médicos deveriam centrar-se sobre medidas preventivas nestes grupos, como exames de pele regular, autoexame, educação pública e programas de rastreio.

BACKGROUND AND OBJECTIVES: Skin cancer is the most frequent neoplasm in Brazil. The black skin cancer is less commonin relation to the skin, but is often associated with increased morbidity and mortality. This paper to study cancer in black skinin Brazil. CONTENTS: In individuals with dark skin squamous cell carcinomais the most common neoplasm, followed by basal cell carcinoma and melanoma. Squamous cell carcinoma and melanoma often occur in places not exposed to sunlight and ultraviolet radiationis not an important etiologic factor, unlike basal cell carcinoma usually located in regions most at risk. The tumors in this population tend to present in more advanced stages and bring a worse prognosis. Several factors contribute to this, the lack of medical expertise for diagnosis and treatment of skin diseases of different ethnicities, belief that black skin is fully protected against skin cancer, and less access to medical care and preventive screening for socioeconomic and cultural factors. However, as in Brazil there are a large number of blacks, it is necessary that health professionals become familiar with the different nuances that skin cancer can occurred the skin pigmentation. CONCLUSION: The skin cancers represent a significant risk in people with dark skin; doctors should focus on preventive measuresin these groups, such as regular skin examinations, self-examination, public education and screening programs.

Frecuencia de dermatosis en afrodescendientes Bolivianos / Frequeny of dermmatoses in afro Bolivian

La piel clásicamente denominada "negra" se caracteriza por la importancia de las reacciones discrómicas secundarias a la mayoría de las dermatosis, resultado de su hiperpigmentación genéticamente determinada y variable según la etnia, la edad, el sexo y la exposición solar. Bolivia es un país multicultural en el que conviven 37 grupos étnicos, entre los que destaca, por su idiosincrasia, el afroboliviano, compuesta por más de 30. 000 personas, donde el 70% habita en la región de los Yungas, al norte de La Paz. Las comunidades de Tocaña, Mururata y Chijchipa resultan ser las más representativas. Es un estudio descriptivo, prospectivo y de corte transversal, que tomó la totalidad de la población de las tres comunidades señaladas correspondientes a 391 afrodescendientes de ambos sexos, comprendidos entre 0 y 102 años y presentes en el momento del estudio. El objetivo principal fue identificar las dermatosis más frecuentes en este grupo étnico, además se observaron las características de la piel y anexos tratando de determinar el porcentaje de presentación de las características y dermatosis propias de la piel negra, considerando que los afrodescendientes bolivianos se desarrollan en un medio particular a más de 1500 msnm. Entre los resultados destacamos el alto porcentaje de piel seca (66%); color de la piel predominante: marrón medio (59,6%) y elasticidad conservada incluso en adultos mayores (59,1%). Los tipos de cabello predominantes fueron el rizado (54,2%) y lanoso (35,3%), probablemente producto del mestizaje de la población. Las tres dermatosis más frecuentes en orden de importancia fueron: Prúrigo simple, Melanosis residual pos inflamatoria y Pitiriasis capitis, es necesario recalcar que la Tiña capitis fue una de la patologías más frecuente en los niños. Pese a que la literatura señala un bajo porcentaje de fotodermatosis en la raza negra, en el presente estudio se observó hasta en un 11% de la población lesiones asocias a la exposición solar, incluso se encontró un caso de dermatitis actínica crónica. Entre las características propias de la raza negra se identificaron principalmente la pigmentación plantar, la pigmentación lineal de mucosas y uñas, y las líneas de Futcher, tal como se describe en la literatura. Dentro de las dermatosis de la raza negra se identificaron a la dermatosis papulosa negra, alopecia traumática, pseudofoliculitis de la barba, la celulitis desecante del cuero cabelludo y el acné queloidiano de la nuca. La semiología de la piel negra posee ciertas peculiaridades que deben ser reconocidas por el dermatólogo además deben considerase para el diagnostico datos epidemiológicos que resultan hasta el momento desconocidos en nuestro territorio.

The skin typically called "black" is characterized by the importance of secondary reactions dyschromicum most dermatosis, hyperpigmentation on the outcome of genetically determined and variable according to ethnicity, age, sex and sun exposure. Bolivia is a multicultural country where 37 ethnic groups coexist, among which stand out for its idiosyncrasies, the Afro Bolivian. The Afro-Bolivian community consists of 30,772 people, roughly, where 70% live in the Yungas region, north of La Paz. Tocaña communities, Chijchipa and Mururata are the most representative because families mantain almost intact cultural features. This is a descriptive, prospective and cross-sectional study, which took the entire population of the three signals corresponding to 391 communities ofAfrican descent of both sexes, ranging from 0 to 102 years present at the time of the study. The main objective was to identify the most common skin diseases in this ethnic group, however well observed characteristics of the skin and annexes trying to determine the percentage of presentation of the characteristics and dermatoses specific to black skin, whereas the Bolivian descent develop in a particular environment over 1500 meters over sea level. Among the main findings highlight the high percentage of dry skin (66%) in the population predominant skin color: medium brown (59.6%) and elasticity preserved even in older adults (59.1%) types of hair ripple was predominant (54.2%) and woolly (35.3%), probably the product of cultural mix of the population. The three most common dermatoses in order of importance were simple prurigo, residual post-inflammatory Melanosis Ptiriasis capitis is necessary to emphasize that the Tinea capitis was one of the most common diseases in children. Although the literature suggests a low rate in blacks photodermatosis in the present study found up to 11% of the lesions associated with sun exposure, even found a case of actinic chronic dermatitis. Among the characteristics of blacks identified themselves primarily plantar pigmentation, pigmentation of mucous membranes and nails linear, and Futcher lines, as described in the literature. Within the black dermatosis: it identified the dermatosis papulosa nigra, traumatic alopecia, the pseudofolliculitis barbae, cellulitis dessectting of the scalp, acne and acne Keloidalis nuchae the neck as skin diseases peculiar to blacks present in this population. The semiology of black skin has certain peculiarities that must be recognized by the dermatologist also be considered for diagnosis epidemiological data when you are unknow in our territory.