Carcinoma basocelular. Un reto actual para el dermatólogo / Basal cell carcinoma. An actual challenge for the dermatologist

RESUMEN El carcinoma basocelular es un tumor maligno de origen epitelial, su crecimiento es lento y rara vez metastiza. Este puede producir destrucción local y comprometer extensas áreas de tejido, cartílago y hueso. Existen variantes clínicas e histológicas y constituye el cáncer más frecuente en humanos y su incidencia está en aumento. Se realizó una revisión para exponer los aspectos esenciales sobre factores predisponentes, formas clínicas y diagnóstico, así como las opciones terapéuticas en esta entidad. Se desarrolló una búsqueda en la Biblioteca Virtual de Infomed y Google. Fueron revisados veinticinco trabajos científicos sin limitación de año y país, de los cuales quince pertenecen a los últimos 5 años. El carcinoma basocelular se considera de origen multifactorial, el carcinógeno más importante es la luz ultravioleta. La forma clínica más frecuente es la variedad nodular y la distribución es en cara y cuello. La elección del tratamiento dependerá del tamaño de la lesión, la localización, la edad y estado general del paciente. A pesar de tener baja malignidad y mortalidad, puede ocasionar destrucción y deformidad y repercutir en la vida de los pacientes. El dominio de los factores de riesgo, los elementos para el diagnóstico precoz y las opciones terapéuticas son indispensable para elegir la conducta adecuada frente a la enfermedad y promover cambios en el estilo de vida, que favorezcan la prevención y disminuyan la morbilidad por esta causa (AU).

ABSTRACT Basal cell Carcinoma (BCC) is an epidermal malignant tumor, it has a slow growth and seldom metastases. It can produce local destruction and compromise big tissue areas, cartilage and bone. There are clinical and histological presentations. It is one of the most common cancer in humans and its incidence is increasing. This project's goal is to expose the essential aspects about the predisposal factors, clinic presentations and diagnoses as well as this disorder's therapeutic options.This study was made from different bibliographical revisions. The research was developed on Infomed Database and Google. Twenty five Scientific studies were researched without country and/or timeline limit, from whom fifteen belongs to the last 5 years. BCC is considered to have a multifactorial origin, whose most important carcinogen is the ultraviolet light. The most frequent clinical presentation is the nodular and the most common distribution is face and neck. The treatment choice depends on the tumor size, its distribution and the patient's age and current state. Although it is a low malignancy and low-death rate neoplasia, it can cause tissue destruction and affect patient's social life. The management of the risk factors, the elements for the early diagnosis and the therapeutic options are indispensable to choose the adequate behavior for the disorder and promote life style changes that favor the prevention and lower the morbidity rate (AU).

Initial basal cell carcinomas diagnosed in the National Campaign for Skin Cancer Prevention are smaller than those identified by the conventional medical referral system

Abstract: BACKGROUND: Basal cell carcinoma is the malignant tumor most often diagnosed in the National Campaign for Skin Cancer Prevention (NCSCP). Little is known about the profile of these lesions compared to the profile of lesions diagnosed by conventional routes of public dermatological care. OBJECTIVE: To identify if basal cell carcinomas identified in prevention campaigns and referred to surgery are smaller than those routinely removed in a same medical institution. METHODS: Cross-sectional study including tumors routed from 2011-2014 campaigns and 84 anatomopathological reports of outpatients. RESULTS: The campaigns identified 223 individuals with suspicious lesions among 2,531 examinations (9%), with 116 basal cell carcinomas removed. Anatomopathological examinations revealed that the primary lesions identified in the national campaigns were smaller than those referred to surgery by the conventional routes of public health care (28 [13-50] x 38 [20-113] mm2, p <0.01). On the other hand, after a mean follow-up of 15.6 ± 10.3 months, 31% of cases identified in campaigns showed new basal cell carcinoma lesions. STUDY LIMITATIONS: Retrospective study and inaccuracies in the measurements of the lesions. CONCLUSIONS: The NCSCP promotes an earlier treatment of basal cell carcinomas compared to patients referred to surgery by the conventional routes of public health care, which can result in lower morbidity rates and better prognosis.

Lupus palpebral: a propósito de dos casos / Palpebral lupus: apropos of two cases

El lupus eritematoso es una dermatosis inflamatoria, crónica, aguda o subaguda que evoluciona por brotes. Puede afectar a todos los órganos pero más frecuentemente a la piel. Presentamos a dos pacientes con lesión en forma de placa, localizada en zona interna y media del borde libre palpebral inferior, de bordes elevados, depresión central con fondo costroso y pérdida de las pestañas a ese nivel. Se decide -por la localización, extensión de la lesión, los antecedentes personales y la aplicación de tratamientos previos sin mejoría del cuadro clínico- realizar biopsia incisional para un mejor estudio. Los resultados anatomopatológicos revelaron el diagnóstico de lupus discoide palpebral. La evolución posterior al tratamiento médico fue satisfactoria, sin recidiva de la lesión durante el primer año de seguimiento.

Erythematosus lupus is an inflammatory dermatosis of chronic, acute or subacute nature that occurs in outbreaks. It can affect all the body organs, but mainly the skin. Here are two patients with plaque-form lesions located in the internal middle area of the free inferior palpebral border, thick contours, central depression with scabby bottom and loss of eyelash. Taking into account the location, the extension of the lesion, personal histories and application of previous treatment without improved clinical picture, it was decided to perform incisional biopsy for better examination. The anatomopathological results showed the diagnosis of palpebral discoid lupus. The recovery of the patient was satisfactory after the medical treatment, with no relapse during the first follow-up year.

Fístula cutánea odontogénica: reporte de un caso que simula un carcinoma basocelular / Cutaneous sinus tract: report of a case simulating a basal cell carcinoma

La fistula cutánea odontogénica (FCO) es una entidad conocida, aunque no frecuente, que afecta mayormente áreas faciales cercanas a la región maxilar o mandibular, y es producida casi siempre por abscesos dentarios periapicales. Tiene mayor prevalencia en los adultos y en ocasiones es posible identificar la causa que lo originó. Se presenta el caso de una paciente mayor, con una lesión nodular de evolución crónica y progresiva en región nasogeniana, con apariencia clínica inicial de carcinoma basocelular, que luego de ser descartado con una biopsia cutánea, obliga a ampliar el estudio, llegándose finalmente al diagnóstico de FCO, con resolución total de la lesión. La FCO resulta muchas veces mal diagnosticada debido a que puede tomar la apariencia clínica de otras entidades más frecuentes; su presentación es variada y no siempre se presenta en áreas muy cercanas al sitio de origen, resulta importante tenerla en cuenta para un adecuado y pronto tratamiento.

Cutaneous sinus tract odontogenic is a known entity, but not frequent, mostly affecting facial areas near the maxillary or mandibular region, and is almost always caused by periapical dental abscesses. lt's more prevalent in adults and sometimes is possible to identify the cause that originated ir. We report the case of an older patient with a nodular chronic and progressive lesion in nasogenian region, with initial clinical appearance of basal cell carcinoma, which was then ruled by a skin biopsy, requiring expansion of the study, eventually reaching the diagnosis of cutaneous sinus tract with total resolution of the lesion. This condition is often misdiagnosed because it may take the clinical appearance of other more common entities; its presentation is varied and not always occurs in areas very close to the site of origin, is important to take into account for a proper and prompt treatment.

Carcinoma basocelular de localização inguinoescrotal: relato de caso

Carcinoma basocelular é neoplasia cutânea de alta incidência no Brasil.Caracteriza-se por sua associação com pacientes de pele clara, exposição solar crônica e a localização das lesões em áreas fotoexposta.A incidência de metástases é excepicional,ocorrendo a cada 10.000 e 35.000 casos.Localização na região perineal é rara e,quando presente,a hipótese de carcinoma basocelular é raramente aventada e o diagnóstico final,postergado.Há referência de que a possibilidade de metástases cresce quando o carcinoma basocelular é de localização perineal.