Prevenção e detecção precoce do câncer de pele / Prevention and early detection of skin cancer

Introdução: O câncer de pele é o câncer mais comum no mundo todo. Ele se divide basicamente em melanoma e não melanoma. Este trabalho se propôs a promover o conhecimento e a conscientização sobre as estratégias de prevenção e detecção precoce de câncer de pele disponíveis na literatura. Métodos: Foram realizadas pesquisas na base de dados Pubmed para revisões sistemáticas sobre detecção precoce e prevenção de câncer de pele publicados nos últimos 5 anos. Dos artigos encontrados, foram selecionados aqueles que apresentavam as palavras-chave no título e que de fato consistiam em revisão sistemática. Resultados: Foram selecionados 11 artigos para leitura na íntegra. A principal estratégia de prevenção do câncer de pele é evitar exposição UV. Mudanças comportamentais como evitar exposição solar, queimadura solar, bronzeamento artificial, uso de filtro solar, chapéus, óculos ou roupa com proteção UV são medidas aconselhadas. As pessoas apresentam resistência em aderir a comportamentos de proteção solar. Estratégias de quimioprofilaxia, tanto primária quanto secundária, para o câncer de pele têm sido exploradas. A avaliação de lesão pela regra do ABCDE é indicada em pacientes de alto risco de câncer de pele para a sua detecção precoce. Estudos sobre o rastreamento do câncer de pele na população em geral não demonstraram redução na mortalidade. Conclusão: Mudanças comportamentais pró-proteção solar e quimioprofilaxia são estratégias de prevenção do câncer de pele. Os artigos apontam seus benefícios, mas carecem de maior nível de evidência.

Introduction: Skin cancer is the most prevalent, but also preventable. This work is conducive to a quick knowledge and awareness about prevention strategies and early selection available in the literature. Methods: The Pubmed database was searched for systematic reviews on the early detection and prevention of skin cancer published in the last 5 years. From the articles found, we selected those who presented the keywords in the title and that in fact consisted of a systematic review. Results: Eleven articles were selected for full reading. The main prevention strategy for skin cancer is to avoid UV exposure. Behavioral changes such as avoiding sun exposure, sunburn, tanning, using sunscreen, hats, glasses or clothing with UV protection are recommended measures. People have resistance in adhering to sun protection behaviors. Strategies for both primary and secondary chemoprophylaxis for skin cancer have been explored. Assessment of injury by ABCDE rule is indicated in high-risk patients of skin cancer for its early detection. Studies on the screening of skin cancer in the general population did not show a reduction in mortality Conclusion: Behavioral changes pro-sun protection and chemoprophylaxis are strategies for the prevention of skin cancer. The articles point to its benefits, but lack a greater level of evidence.

Validation of a Method for Estimation of Facial Age by Plastic Surgeons.

IMPORTANCE: Within cosmetic facial plastic surgery, there is considerable difficulty in producing high-quality scientific publications because of the lack of scientific tools that serve to transform sensations, such as more beautiful or rejuvenated, into numbers capable of being used in statistical analysis. OBJECTIVE: To validate an objective evaluation method that can be used to define the perception of facial age in scientific studies. DESIGN, SETTING, AND PARTICIPANTS: This is a cross-sectional, observational study of evaluation by plastic surgeons of 70 photographs of patients from a private care hospital performed from March 1, 2015, through April 30, 2016. When evaluating the photographs, 7 plastic surgeons wrote down the perceived age of each patient. The photographs of each patient were randomly presented twice to each evaluator (photograph 1 and photograph 2) and analyzed singly using a trimmed mean. Three evaluators were randomly chosen for further statistical analysis in an attempt to make the assessment technique more practical. EXPOSURES: Usual aging process. MAIN OUTCOMES AND MEASURES: Estimated mean age and chronological age. RESULTS: Photographs of 70 patients were evaluated (mean [SD] age, 41.5 [13.8] years; 48 women [68.6%]; and mean [SD] body mass index, 22.5 [2.7]). No significant differences were observed between photographs 1 and 2 for any of the evaluators. A significant difference in the mean ages was not observed when comparing evaluators. For photograph 1 (evaluated by only 3 evaluators), the difference was 0.16 years (P = .52). For photograph 2, the difference was 0.05 years (P = .86). The difference between the mean perceived age for the 3 evaluators and the chronological age was only 0.8 years (<10 months). CONCLUSIONS AND RELEVANCE: The intraevaluator and interevaluator agreement suggests that 3 plastic surgeons can estimate the age of a person with a margin of error of 10 months by analyzing a photograph. This article is important to facial plastic surgeons because it reveals how the results of rejuvenation procedures can be assessed. LEVEL OF EVIDENCE: NA.

Relationship between Vitamin D Status and Striae Distensae: A Case-Referent Study.

Vitamin D (VD) plays a role in the skin regulation. Striae Distensae (SD) are manifestations of epidermal atrophy that occurs after tissue tearing due to overstretching or rapid growth. The objective of this study was to investigate the relation between serum VD and occurrence of SD in women who had undergone mammaplasty with silicone implants. A case-referent study was conducted. The blood values of 25-hydroxyvitamin D (25OHD) were measured before the surgery. For each patient postoperatively diagnosed with SD, four other participants submitted to the same surgery, without the development of SD, were enrolled as the healthy controls. 67 women with SD after the surgery entered the study. 268 formed the control group. In the serum of healthy controls 25OHD mean was 27 ng/mL, and SD cases presented 20 ng/mL (P = 0.01). Scarce values of VD have been observed in 56.71% of the cases presenting SD and in 39.91% without SD (P = 0.002). Chance of having VD values lower than 20 ng/mL amongst cases with SD is 2.38 (P = 0.0001). Lower serum levels of VD are linked to a higher occurrence of SD.