Epidemiology of cutaneous melanoma in Blumenau, Santa Catarina state, Brazil from 1980 to 2019.

BACKGROUND: The incidence and mortality of melanoma have increased in the last years in the Caucasian population. This 40-year study of melanoma incidence in Blumenau-SC shows the impact of primary prevention on the decrease of mortality. OBJECTIVES: To classify cutaneous melanomas and evaluate their incidence in Blumenau from 1980 to 2019. METHODOLOGY: This retrospective, descriptive and cross-sectional study collected 2,336 histopathological examinations of individuals living in the city, considering sex, age, primary location, histopathological type, invasion level (Clark), and tumor thickness (Breslow). The crude coefficients of annual incidence rates were calculated using the number of melanomas and the population estimated by the Brazilian Institute of Geography and Statistics between 1980 and 2019. RESULTS: Melanoma incidence rates reached 44.26 cases/100,000 inhabitants/year and the rates by sex reached 52.87 in men and 46.73 cases in women per 100,000 inhabitants. The most affected age group was 70 years old and over, with 421 cases in men and 301 cases/100,000 inhabitants in women. Superficial spreading melanoma occurred in 64.5% of the cases, followed by nodular melanoma in 22.8%. Early diagnoses reached 1900% with Breslow < 0.5 mm. STUDY LIMITATIONS: This study only covers histopathological reports with definitive diagnoses of cutaneous melanoma; therefore, the data are underestimated, consequently resulting in lower rates than in reality. CONCLUSIONS: The incidence of cutaneous melanoma has increased fivefold between 1980 and 2009 and early diagnosis increased as a result of health education and primary prevention.

Epidemiology of cutaneous melanoma in Blumenau, Santa Catarina state, Brazil from 1980 to 2019

Abstract Background The incidence and mortality of melanoma have increased in the last years in the Caucasian population. This 40-year study of melanoma incidence in Blumenau-SC shows the impact of primary prevention on the decrease of mortality. Objectives To classify cutaneous melanomas and evaluate their incidence in Blumenau from 1980 to 2019. Methodology This retrospective, descriptive and cross-sectional study collected 2,336 histopathological examinations of individuals living in the city, considering sex, age, primary location, histopathological type, invasion level (Clark), and tumor thickness (Breslow). The crude coefficients of annual incidence rates were calculated using the number of melanomas and the population estimated by the Brazilian Institute of Geography and Statistics between 1980 and 2019. Results Melanoma incidence rates reached 44.26 cases/100,000 inhabitants/year and the rates by sex reached 52.87 in men and 46.73 cases in women per 100,000 inhabitants. The most affected age group was 70 years old and over, with 421 cases in men and 301 cases/100,000 inhabitants in women. Superficial spreading melanoma occurred in 64.5% of the cases, followed by nodular melanoma in 22.8%. Early diagnoses reached 1900% with Breslow < 0.5 mm. Study limitations This study only covers histopathological reports with definitive diagnoses of cutaneous melanoma; therefore, the data are underestimated, consequently resulting in lower rates than in reality. Conclusions The incidence of cutaneous melanoma has increased fivefold between 1980 and 2009 and early diagnosis increased as a result of health education and primary prevention.

Perfil epidemiológico da Leishmaniose Tegumentar Americana no município de Blumenau-SC / Profile of epidemiological American Cutaneous Leishmaniasis in munnicipality of Blumenau-SC

A Leishmaniose Tegumentar Americana (LTA) é uma doença infecciosa, não contagiosa, de transmissão vetorial cujo agente etiológico são protozoários do gênero Leishmania. Ela é considerada uma das doenças infecciosas mais negligenciadas em todo o mundo e constitui problema de saúde pública vários países. O Município de Blumenau-SC estava isento de casos de LTA até o ano de 2005, quando se registrou surto da doença. O presente estudo estimou a incidência da LTA naquele Município entre os períodos de 2007 a 2013, e traçou o perfil epidemiológico no tocante à idade, sexo, distribuição dos casos entre os bairros e prováveis vetores da doença envolvidos, a fim de se verificar a ocorrência de novos surtos e possíveis alterações no perfil epidemiológico. Os dados foram coletados através da Vigilância Epidemiológica da Secretaria de Saúde do Município de BlumenauSC. Foram consideradas para a pesquisa apenas as notificações de casos autóctones do Município, não incluindo os casos importados e os indeterminados. Ao todo foram encontrados 77 casos autóctones, com coeficiente geral de detecção em 2007 e 2008 de 6,4 e 13,8 casos de LTA por 100.000 habitantes, respectivamente. Predominou o sexo masculino (50,64%), com idades variando de 10 a 60 anos. O flebotomíneo predominante foi o Ny. Neivai (42,91%), e o bairro mais acometido foi o Progresso seguido da Itoupava Central. Houve diminuição do número de notificações nos anos subsequentes ao surto de 2005/2006, porém a situação de surto se estendeu até o ano de 2008.

American Cutaneous Leishmaniasis is an infectious disease, not contagious, vector transmitted whose etiologic agent is Leishmania protozoa. The ACL is considered one of the most neglected infectious diseases worldwide and a public health problem in many countries. The city of Blumenau-SC was exempt from cases of LTA until 2005, when it registered an outbreak of the disease. This study aimed to estimate the incidence of LTA on that Municipality between the periods of 2007 to 2013, and trace the epidemiological profile with respect to age, sex, distribution of cases between the neighborhoods and check probable vectors of the disease in order to verify the occurrence of new outbreaks and possible changes in the epidemiological profile. Data were collected from the Epidemiological Surveillance of the Health Department of the Municipality of Blumenau-SC. Were considered for the survey only reports of autochthonous cases of the Municipality, not including imported or indeterminate cases. Altogether were found 77 autochthonous cases, with overall detection rate in 2007 and 2008 of 6.4 and 13.8 cases of LTA per 100,000 inhabitants, respectively. Male were more prevalent (50.64%), with ages ranging from 10 to 60 years. The predominant sandfly was the Ny. Neivai (42.91%), and the most affected district was the Progresso followed by Itoupava Central. There was a decrease in the number of notifications in the years following the 2005/2006 outbreak, but the outbreak situation lasted until 2008.

Squamous cell cancer--31-year epidemiological study in a city of south Brazil.

BACKGROUND: The incidence and morbidity of squamous cell cancers are increasing worldwide. Epidemiological studies with morbidity coefficients about this type of cancer are scarce in Brazil. OBJECTIVES: To determine morbidity coefficients, analyze and classify the squamous cell cancers diagnosed in the city of Blumenau - SC from 1980 to 2011, according to clinical and histological features. METHODS: The authors revised 4000 histopathological exams with respect to sex, age, anatomic site and histological type. The morbidity coefficients were calculated using the number of squamous cell cancers found and the annual population estimated by the Brazilian Institute of Geography and Statistics between 1980 and 2011. RESULTS: A total of 4000 tumors were identified, 2249 (56.2%) in male and 1751 (43.8%) in female patients. The standard incidence rates varied from 40 cases in 1980 to 120 cases/100,000 inhabitants in 2011. The morbidity above 70 years of age reached 1484 cases/100,000 inhabitants in male and 975 in female patients. As to primary anatomic site, we found more tumors on the lips and ears in male and on the face and legs in female patients. As to the degree of involvement, the more frequent were Well Differentiated Squamous cell carcinomas (70%) and Moderate Squamous cell carcinomas (19,1%). The Low Differentiated Squamous cell carcinomas, which represented those with the worst prognosis, were found in 4.5% of the tumors. CONCLUSION: Squamous cell cancers in Blumenau - SC have similar patterns of distribution regarding age, primary anatomic site and histological types as found in the international literature. The morbidity increased by 300% in the last 31 years, which indicates that we need to dedicate special attention to the older population.

Squamous cell cancer – 31-year epidemiological study in a city of south Brazil

BACKGROUND: The incidence and morbidity of squamous cell cancers are increasing worldwide. Epidemiological studies with morbidity coefficients about this type of cancer are scarce in Brazil. OBJECTIVES: To determine morbidity coefficients, analyze and classify the squamous cell cancers diagnosed in the city of Blumenau - SC from 1980 to 2011, according to clinical and histological features. METHODS: The authors revised 4000 histopathological exams with respect to sex, age, anatomic site and histological type. The morbidity coefficients were calculated using the number of squamous cell cancers found and the annual population estimated by the Brazilian Institute of Geography and Statistics between 1980 and 2011. RESULTS: A total of 4000 tumors were identified, 2249 (56.2%) in male and 1751 (43.8%) in female patients. The standard incidence rates varied from 40 cases in 1980 to 120 cases/100,000 inhabitants in 2011. The morbidity above 70 years of age reached 1484 cases/100,000 inhabitants in male and 975 in female patients. As to primary anatomic site, we found more tumors on the lips and ears in male and on the face and legs in female patients. As to the degree of involvement, the more frequent were Well Differentiated Squamous cell carcinomas (70%) and Moderate Squamous cell carcinomas (19,1%). The Low Differentiated Squamous cell carcinomas, which represented those with the worst prognosis, were found in 4.5% of the tumors. CONCLUSION: Squamous cell cancers in Blumenau - SC have similar patterns of distribution regarding age, primary anatomic site and histological types as found in the international literature. The morbidity increased by 300% in the last 31 years, which indicates that we need to dedicate special attention to the older population. .

Brazilian Consensus on Photoprotection

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.

Brazilian consensus on photoprotection.

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.

Incidência de dermatoses em transplantados hepáticos / Incidence of dermatoses in liver transplantation

Fundamentos: os transplantes trouxeram doenças específicas de organismos imunossuprimidos iatrogenicamente como patologias cutâneas. Objetivos: determinar a incidência de dermatoses em transplantados hepáticos. Métodos: estudo transversal em transplantados hepáticos do Hospital Santa Isabel de Blumenau-SC, entre agosto de 2002 e março de 2009. Obteve-se amostra de conveniência de 157 indivíduos. Variáveis: Tipos de dermatoses, regime de imunossupressão, tempo de desenvolvimento de dermatoses. Resultados: dos 157 prontuários analisados, encontrou-se 61 dermatoses, sendo 19 infecções fúngicas, 14 virais e 9 bacterianas, 8 neoplasias e 11 dermatoses não atribuídas aos imunossupressores. O regime mais utilizado foi associação de micofenolato mofetil e tacrolimo (n = 69) com 24 dermatoses, seguido de rapamicina e tacrolimo (n =16) com 5 lesões. A monoterapia com tacrolimo (n = 66) apresentou 17 lesões, e a rapamicina e micofenolato mofetil (n = 2), 1 caso. A incidência de dermatoses foi de 58,3% (n = 28) no primeiro ano pós-transplante, entre o primeiro e o segundo ano 27,08%, e a partir do segundo ano, ocorreram 14,58% de dermatoses (p < 0,01). Conclusão: a terapia imunossupressora é fator de risco para dermatoses. Em vista de nossos resultados, recomendamos o acompanhamento dermatológico destes pacientes transplantados hepáticos, visando a prevenção e o tratamento precoce das dermatoses.

Background: the transplants have brought specific diseases caused by iatrogenically immunosuppressed organisms as skin diseases. Objectives: to determine the incidence of dermatosis in liver transplants. Material and methods: transversal study in liver transplant patients at the Santa Isabel Hospital-Brazil, from August 2002 to March 2009. It was obtained a convenience sample of 157 individuals. Variables: types of dermatosis, immunosuppressive regimen, development time of dermatosis. Results: from the 157 records analyzed, 61 cases had dermatosis, which were caused by: 19 fungal, 14 viral, 9 bacterial, 8 neoplasms and 11 were not related to immunosuppression. The medication regime most used was the association of mycophenolate mofetil and tacrolimus (n = 69) with 24 dermatosis, followed by rapamycin and tacrolimus (n = 16) had 5 lesions. The monotherapy with tacrolimus (n = 66) had 17 lesions, and rapamycin mycophenolate mofetil (n = 2) had a single case. The incidence of dermatosis appeared in 58.3% (n = 28) from total in the first year after the transplant, 27.08% between the first and second year, and 14.58% (p < 0.01) from the second year onwards. Conclusions: immunosuppressive therapy is risk factor for dermatosis. In view of our results, we recommend monitoring dermatological these liver transplanted patients, leading to prevention and early treatment of dermatosis.

Poroceratose de Mibelli com lesões gigantes: relato de caso / Porokeratosis of Mibelli with huge injuries: case report

Poroceratose de Mibelli é uma genodermatose disceratósicade forma crônica, progressiva e rara, comrisco de evolução para malignidade. É de transmissãoautossômica dominante e a patogenia é ainda desconhecida.O caso clínico mostra um paciente com 78anos de idade, com 75 anos de evolução de Poroceratosede Mibelli com lesões gigantes, exuberantes ehistória médica familiar da genodermatose. As lesõesda poroceratose de Mibelli são assintomáticas e maiscomumente encontradas nas extremidades, preferencialmentedorso das mãos e pés. Pode apresentar progressãoe regressão espontânea e ocasionar cicatrizeslevemente atróficas. O diagnóstico é clínico-histológico,apresentando a lamela coróide no histológico. A policeratosede Mibelli deve ser tratada para evitar a transformaçãoem células escamosas, doença de Bowen oucarcinoma basocelular.

Porokeratosis of Mibelli is a chronic, progressiveand rare genodermatosis disceratosica, that has therisk to become a malignant tumor. Its transmissionis mainly autosomal and the pathogenesis is stillunknown. The clinic case shows a patient with 78years, 75 years of those with evolving Porokeratosisof Mibelli, huge injuries, and familiar historic ofgenodermatosis. The injuries from the Porokeratosisof Mibelli are asymptomatic and generally found inthe ends of the body, preferably in the back of thehand or feet. The injuries can increase or diminishspontaneously and lead to scars a little atrophic.The diagnosis is clinical-histological, and it is representedby a choroid lamella in the histological. ThePorokeratosis of Mibelli may be treated to avoid thetransformation into squamous cells, Bowen diseaseor basal cell carcinoma.

Incontinência pigmentar: relato de caso / Incontinentia pigmenti: case report

A incontinência pigmentar é uma afecção hereditáriarara, dominante ligada ao cromossomo X. A condiçãoacomete o neonato afetando a pele, cabelos esistema nervoso central, tem maior incidência no sexofeminino, sendo letal, na maioria das vezes, quandoafeta o sexo masculino. A doença se caracteriza pormanifestações cutâneas e extra cutâneas, sendo a primeiramais prevalente. As lesões cutâneas são progressivasevoluindo em quatro estágios de acordo comcada fase evolutiva da doença. O diagnóstico baseia--se no quadro clínico e na apresentação histológica.A boa resposta ao tratamento clínico no relato de umcaso de incontinência pigmentar estimulou os autoresa discutir os aspectos etiológicos, diagnósticos e terapêuticosda enfermidade.

Incontinent pigment is a rare inherited disorder, Xchromosome-linked dominant The condition affectsthe newborn affecting the skin, hair and centralnervous system, has a higher incidence in females,being lethal in most cases, when it affects males.The disease is characterized by cutaneous and extraskin, the former being more prevalent. The skin lesionsare progressive evolving in four stages accordingto each phase of the disease diagnosis basedon clinical and histological presentation. The goodresponse to treatment in clinical report of a case ofpigmentary incontinence motivated the authors todiscuss the etiological aspects, diagnosis and treatmentof disease.

Treatment of common warts with the immune stimulant Propionium bacterium parvum.

BACKGROUND: Warts are epithelial proliferations in the skin and mucous membrane caused by various types of HPV. They can decrease spontaneously or increase in size and number according to the patient's immune status. The Propionium bacterium parvum is a strong immune stimulant and immune modulator and has important effects in the immune system and it is able to produce antibodies in the skin. OBJECTIVE: To show the efficacy of the Propionium bacterium parvum in saline solution in the treatment of skin warts. METHODS: A randomized double-blind study. Twenty patients with multiple warts were divided into two groups: one received 0,1 ml intradermal injection of placebo solution in just one of the warts and the other received 0,1 ml of saline solution of Propionium bacterium parvum, one dose a month, for 3 to 5 months. RESULTS: Among the 20 patients who participated in the study, ten received the placebo and ten received the saline solution with Propionium bacterium parvum. In 9 patients treated with the Propionium bacterium parvum solution the warts disappeared without scars and in 1 patient it decreased in size. In 9 patients who received the placebo no change to the warts was observed and in 1 it decreased in size. CONCLUSIONS: The immune modulator and immune stimulant Propionium bacterium parvum produced antibodies in the skin which destroyed the warts without scars, with statistically significant results (P<0,001), and cured 90 % of the patients. We suggest the use of the immune stimulant in the treatment of warts.

Treatment of common warts with the immune stimulant Propionium bacterium parvum / Tratamento das verrugas vulgares com o imunoestimulante Propionium bacterium parvum

BACKGROUND: Warts are epithelial proliferations in the skin and mucous membrane caused by various types of HPV. They can decrease spontaneously or increase in size and number according to the patient's immune status. The Propionium bacterium parvum is a strong immune stimulant and immune modulator and has important effects in the immune system and it is able to produce antibodies in the skin. OBJECTIVE: To show the efficacy of the Propionium bacterium parvum in saline solution in the treatment of skin warts. METHODS: A randomized double-blind study. Twenty patients with multiple warts were divided into two groups: one received 0,1ml intradermal injection of placebo solution in just one of the warts and the other received 0,1 ml of saline solution of Propionium bacterium parvum, one dose a month, for 3 to 5 months. RESULTS: Among the 20 patients who participated in the study, ten received the placebo and ten received the saline solution with Propionium bacterium parvum. In 9 patients treated with the Propionium bacterium parvum solution the warts disappeared without scars and in 1 patient it decreased in size. In 9 patients who received the placebo no change to the warts was observed and in 1 it decreased in size. CONCLUSIONS: The immune modulator and immune stimulant Propionium bacterium parvum produced antibodies in the skin which destroyed the warts without scars, with statistically significant results (P<0,001), and cured 90 % of the patients. We suggest the use of the immune stimulant in the treatment of warts.

FUNDAMENTOS: Verrugas são proliferações epiteliais na pele e mucosas causadas por diversos tipos de HPV. Elas podem involuir espontaneameme ou aumentar em número e tamanho de acordo com estado imunitário do paciente. O Propionium bacterium parvum é urn potente imunoestimulador e imunomodulador e tem efeitos importantes no sistema imune e é capaz de produzir anticorpos na pele. OBJETIVO: Mostrar a eficácia do Propionium bacterium parvum diluído em solução salina no tratamento de verrugas cutâneas. MÊTODOS: Estudo duplo-cego randomizado. Vinte pacientes com verrugas múltiplas foram divididos em dois grupos, um recebeu aplicação intradérmica do placebo em uma (1) única verruga e o outro da solução salina com Propionium bacterium parvum, uma dose por mês por 3 a 5 meses. RESULTADOS: Dos 20 pacientes do estudo, dez receberam placebo e 10 de solução salina com Propionium bacterium parvum. Dos pacientes tratados com Propionium bacterium parvum nove (9) foram curados e um teve diminuição das lesões. Do grupo do placebo nove (9) não apresentaram alterações e 1 (um) apresentou diminuição das lesões. CONCLUSÔES: O imunomodulador e imunoestimulador Propionium bacterium parvum produz anticorpos na pele que destroem as verrugas sem cicatrizes e mostrou uma significância de P<0,001, com cura de 90% dos pacientes submetidos à terapia. Sugerimos a utilização de imunoestimulante para o tratamento de verruga vulgar.

Giant basal cell carcinoma.

The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm(2) on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no signs of dissemination or local recurrence have been detected after follow up of five years.

Giant basal cell carcinoma / Carcinoma basocelular gigante

The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no signs of dissemination or local recurrence have been detected after follow up of five years.

O carcinoma basocelular é o tipo mais comum de câncer de pele, mas o carcinoma basocelular gigante vegetante não atinge 0,5% de todos os tipos de carcinomas basocelulares. O Carcinoma Basocelular Gigante, definido como lesão maior que 5 cm no maior diâmetro, é uma forma rara de carcinoma basocelular e comumente ocorre no tronco. Este paciente apresenta um Carcinoma Basocelular Gigante com 180cm² no ombro direito e foi negligente em procurar tratamento. Foi realizado tratamento cirúrgico e nenhum sinal de disseminação ou recorrência local foi detectada após 5 anos.

Linfocitoma cútis na região fronto- parietal: relato de caso / Front-parietal region lymphocytoma cutis: case report

O linfocitoma cútis é uma doença rara, pode simularum linfoma de células B tanto histológica como clinicamentee ocorre de forma idiopática na maioria dos casos.É necessário diagnóstico preciso das lesões para umaorientação terapêutica e prognóstica corretas. Mesmotratando-se de uma doença benigna, seu curso é crônicoe é necessário o acompanhamento destes pacientes alongo prazo, a fim de diagnosticar e tratar precocementeos raros casos necessários. Descreve-se um caso de linfocitomacútis na região fronto-parietal direita responsivaao tratamento clínico. Os autores abordam em seguidaos fatores etiológicos, o diagnóstico e a terapêutica.

The lynphocytoma cutis is a rare disease, it can simulatea B-cell lymphoma, both, clinically and histologically,and it is idiopathic in most cases. Is necessary accuratelesions diagnosis to a correct therapeutics and prognostics.Even being a benign disease, its course is chronicand it is necessary a long term follow up of these patients,in order to an early diagnose and treatment whenit is necessary due to its rare cases. A right front-parietallymphocytoma cutis responsive to medical treatmentcase is described. The authors then discuss the etiologicfactors, the diagnosis and the therapeutics.

Criptococcose cutânea primária em paciente imunocompetente / Primay cutaneous cryptococcosis in an immunocompetent patient

Os autores relatam caso de Criptococcose cutânea primária, causada pelo Cryptococcus neoformans, em paciente imunocompetente, fazendeiro que desenvolveu extensivas lesões, no antebraço, após injúria provocada por galináceo, quando fazia limpeza de seu celeiro. Tratamento oral com fluconazol resultou em cura total. A literatura relata raridade de criptococcose cutânea primária em imunocompetentes e sua relativa frequência em imunodeprimidos.

The authors report a primary cutaneous cryptococcosis, caused by Cryptococcus neoformans in immunocompetent patient, a farmer who developed extensive lesions at the site of an injury caused by one of the chickens on his right forearm, while he was cleaning out his barn. Oral treatment with fluconazole was totally successful. A review of the literature showed the rarity of cutaneous cryptococcosis in immunocompetent patients and in contrast, that skin lesions frequently occur in immunocompromised patients.

Primay cutaneous cryptococcosis in an immunocompetent patient.

The authors report a primary cutaneous cryptococcosis, caused by Cryptococcus neoformans in immunocompetent patient, a farmer who developed extensive lesions at the site of an injury caused by one of the chickens on his right forearm, while he was cleaning out his barn. Oral treatment with fluconazole was totally successful. A review of the literature showed the rarity of cutaneous cryptococcosis in immunocompetent patients and in contrast, that skin lesions frequently occur in immunocompromised patients.

UVB: suscetibilidade no melanoma maligno / UVB: susceptibility in malignant melanoma

FUNDAMENTOS: Está bem definido que a radiação ultravioleta provoca depleção imunológica na pele, permitindo o desenvolvimento de tumores cutâneos malignos. A maioria dos pacientes de cânceres da pele não melanomas são considerados UVB-suscetíveis. OBJETIVOS: Estudar a UVB-suscetibilidade nos pacientes com melanoma maligno e se este é um fator de risco para o desenvolvimento desse câncer. MÉTODOS: Foram selecionados 88 voluntários divididos em dois grupos: grupo-controle saudável (n=61) e grupo de portadores de melanoma (n=27), todos identificados de acordo com os critérios: tipo histológico, nível de invasão, fotótipos de pele, sexo e idade. A suscetibilidade à radiação ultravioleta B (UVB) foi medida pela reação de hipersensibilidade ao contato com o difenciprone nos voluntários sensibilizados em áreas previamente irradiadas. RESULTADOS: A suscetibilidade à radiação UVB foi de 81,5 por cento nos pacientes com melanoma maligno e de 31,2 por cento no grupo-controle. O risco de um indivíduo desenvolver o melanoma maligno foi 9,7 vezes maior do que nos indivíduos UVB-resistentes. CONCLUSÕES: A UVB-suscetibilidade pode ser considerada um fator de risco importante para o desenvolvimento do melanoma maligno.

BACKGROUND: It is well established that UV radiation provokes an immunological depletion in the skin, enabling the development of malignant cutaneous tumors. Most nonmelanoma skin cancer patients are considered to be UVB-susceptible. OBJECTIVE: To study the behavior of UVB- susceptibility in malignant melanoma (MM) patients and whether this is a risk factor to the development of MM. METHODS: Eighty-eight volunteers were selected and divided into two groups: healthy control group (n = 61) and MM group (n = 27), which were identified according to the following clinical criteria: histopathological type, level of invasion, skin phototype, sex and age. Susceptibility to ultraviolet B (UVB) radiation was measured by the onset of a contact hypersensitivity reaction to diphenylcyclopropenone among individuals sensitized in previously irradiated areas. RESULTS: Susceptibility to UVB radiation was 81.5 in the MM group and 31.2 percent in the control group. The risk of an UVB-susceptible individual to develop MM was 9.7 times higher than when UVB resistant. CONCLUSION: UVB susceptibility should be considered an important risk factor to the development of this type of cancer.

UVB: susceptibility in malignant melanoma.

BACKGROUND: It is well established that UV radiation provokes an immunological depletion in the skin, enabling the development of malignant cutaneous tumors. Most nonmelanoma skin cancer patients are considered to be UVB-susceptible. OBJECTIVE: To study the behavior of UVB- susceptibility in malignant melanoma (MM) patients and whether this is a risk factor to the development of MM. METHODS: Eighty-eight volunteers were selected and divided into two groups: healthy control group (n = 61) and MM group (n = 27), which were identified according to the following clinical criteria: histopathological type, level of invasion, skin phototype, sex and age. Susceptibility to ultraviolet B (UVB) radiation was measured by the onset of a contact hypersensitivity reaction to diphenylcyclopropenone among individuals sensitized in previously irradiated areas. RESULTS: Susceptibility to UVB radiation was 81.5 in the MM group and 31.2% in the control group. The risk of an UVB-susceptible individual to develop MM was 9.7 times higher than when UVB resistant. CONCLUSION: UVB susceptibility should be considered an important risk factor to the development of this type of cancer.