Skin disorders in renal transplant recipients: a retrospective study

Abstract: Background: Immunosuppressive therapy, which is necessary to avoid graft rejection in renal transplant recipients, presents an increased risk of several pathologies, namely infectious and neoplastic. Objectives: To identify the most frequent skin diseases and their clinical and demographical risk factors within a population of renal transplant recipients. Methods: A retrospective study of renal transplant recipients referred to dermatology visit and observed for the first time from January 2008 to December 2014. Results: The study included 197 patients, 120 men (60,9%). Mean age was 50,7 years (±13,4). 12 patients (6,1%) had previous skin cancer. Infections were the most frequent reason of referral (93/197; 44%). From the total referred, 18,3% (36/197) presented pre-cancerous lesions. Malignancy was diagnosed in 36 patients (18,3%), with 29 non-melanoma skin cancers (14,7%) and 7 Kaposi sarcomas (3,6%). Ratio of basal cell carcinoma to squamous cell carcinoma was 1,1:1. Non-melanoma skin cancer was significantly associated with older age (p = 0,002), male gender (p = 0,028), history of previous skin cancer (p = 0,002) and higher duration of immunosuppressive therapy (p<0,001). Study limitations: Retrospective study, with data from the first visit in dermatology. We didn't made classification on skin-types. Conclusions: The great incidence of cutaneous infections and skin cancer is responsible for a significant morbidity. It is important to assure the regular dermatological follow-up of renal transplant recipients, which will promote the prevention, an early diagnosis and an efficient treatment.

Non-melanoma skin cancer in Portuguese kidney transplant recipients - incidence and risk factors

Abstract: Background: Cancer is currently among the three leading causes of death after solid organ transplantation and its incidence is increasing. Non-melanoma skin cancer - squamous cell carcinoma and basal cell carcinoma - is the most common malignancy found in kidney transplant recipients (KTRs). The incidence of non-melanoma skin cancer in KTRs has not been extensively studied in Portugal. Objectives: To determine the incidence of non-melanoma skin cancer in KTRs from the largest Portuguese kidney transplant unit; and to study risk factors for non-melanoma skin cancer. Methods: Retrospective analysis of clinical records of KTRs referred for the first time for a dermatology consultation between 2004 and 2013. A case-control study was performed on KTRs with and without non-melanoma skin cancer. Results: We included 288 KTRs with a median age at transplantation of 47 years, a male gender predominance (66%) and a median transplant duration of 3.67 years. One fourth (n=71) of KTRs developed 131 non-melanoma skin cancers, including 69 (53%) squamous cell carcinomas and 62 (47%) basal cell carcinomas (ratio squamous cell carcinoma: basal cell carcinoma 1.11), with a mean of 1.85 neoplasms per patient. Forty percent of invasive squamous cell carcinomas involved at least two clinical or histological high-risk features. The following factors were associated with a higher risk of non-melanoma skin cancer: an older age at transplantation and at the first consultation, a longer transplant duration and the presence of actinic keratosis. KTRs treated with azathioprine were 2.85 times more likely to develop non-melanoma skin cancer (p=0.01). Conclusion: Non-melanoma skin cancer was a common reason for dermatology consultation in Portuguese KTRs. It is imperative for KTRs to have access to specialized dermatology consultation for early referral and treatment of skin malignancies.

Occupational skin cancer: Systematic review / Câncer de pele ocupacional: revisão sistemática

SUMMARY Objective: To analyze the epidemiological profile, risk factors in the workplace environment and prevention methods for professionals at risk of skin cancer. Method: A systematic review of articles on occupational skin cancer, published in the Lilacs, Scielo, Medline and Cochrane Library from January 1st, 2008, to December 31st, 2013, was performed. The search included the following terms: “neoplasias cutâneas” (DeCS), “exposição ocupacional” (DeCS), “epidemiologia” (DeCS) as well as the keyword “prevenção”, and their equivalents in English. Results: After analyzing the titles and summaries of articles, the search strategy resulted in 83 references, of which 22 articles met the eligibility criteria. Discussion: We found that sun exposure is the main occupational risk factor for skin cancer, causing outdoor workers to be the most vulnerable to developing occupational skin cancer. Professionals with low levels of education and European descent are at increased risk of developing this cancer. Conclusion: Outdoor workers are more vulnerable to developing occupational skin cancer, estimating that professionals with low level of education and European descent are at increased risk of developing this cancer. Therefore, companies need to invest more in the health of workers by providing protective equipment and thus preventing occupational skin cancer.

RESUMO Objetivo: analisar o perfil epidemiológico, os fatores de risco no ambiente de trabalho e os métodos de prevenção dos profissionais de risco para câncer de pele. Método: foi realizada uma revisão sistemática de artigos sobre o câncer de pele ocupacional, publicados entre 1 de janeiro de 2008 e 31 de dezembro de 2013, nas bases de dados Lilacs, Scielo, Medline e Biblioteca Cochrane. A pesquisa baseou-se na intersecção dos seguintes termos: “neoplasias cutâneas” (DeCS), “exposição ocupacional” (DeCS), “epidemiologia” (DeCS) e a palavra-chave “prevenção” e seus equivalentes em inglês. Resultados: após a análise dos títulos e resumos dos artigos, a estratégia de busca resultou em 83 referências, das quais 22 artigos preencheram os critérios de elegibilidade. Discussão: a exposição solar é o principal fator de risco ocupacional para câncer de pele e os trabalhadores ao ar livre são os mais vulneráveis a desenvolvê-lo. Aqueles com baixo nível de escolaridade e ascendência europeia apresentam maior risco de desenvolver a neoplasia. Conclusão: os trabalhadores ao ar livre são mais vulneráveis a desenvolver câncer de pele ocupacional. Os profissionais com baixo nível de escolaridade e ascendência europeia apresentam maior risco de desenvolver a neoplasia. São necessários mais investimentos das empresas na saúde dos trabalhadores por meio de fornecimento de equipamentos de proteção, a fim de prevenir o câncer de pele ocupacional.

Skin cancer in rural workers: nursing knowledge and intervention / Cáncer de piel en trabajadores rurales: conocimiento e intervención de enfermería / Câncer de pele em trabalhadores rurais: conhecimento e intervenção de enfermagem

OBJECTIVETo identify the exposure of rural workers to the sun's ultraviolet radiation and pesticides; to identify previous cases of skin cancer; and to implement clinical and communicative nursing actions among rural workers with a previous diagnosis of skin cancer.METHODObservational-exploratory study conducted with rural workers exposed to ultraviolet radiation and pesticides in a rural area in the extreme south of Brazil. A clinical judgment and risk communication model properly adapted was used to develop interventions among workers with a previous history of skin cancer.RESULTSA total of 123 (97.7%) workers were identified under conditions of exposure to the sun's ultraviolet radiation and pesticides; seven (5.4%) were identified with a previous diagnosis of skin cancer; four (57.1%) of these presented potential skin cancer lesions.CONCLUSIONThis study's results enabled clarifying the combination of clinical knowledge and risk communication regarding skin cancer to rural workers.

OBJETIVOIdentificar la exposición de trabajadores rurales a la radiación solar ultravioleta y los pesticidas; identificar casos anteriores de cáncer de piel y aplicar la acción clínica y comunicativa de Enfermería a los trabajadores rurales con diagnóstico anterior de cáncer de piel.MÉTODOEstudio observacional-exploratorio realizado con trabajadores rurales expuestos a la radiación solar ultravioleta y los pesticidas, en área rural en el extremo sur de Brasil. Se utilizó un modelo adaptado de juicio clínico y comunicación de riesgo para el desarrollo de intervención a los trabajadores con diagnóstico anterior de cáncer de piel.RESULTADOSSe identificaron: 123 (97,7%) trabajadores en condiciones de exposición a la radiación solar ultravioleta y los pesticidas; siete (5,4%) con diagnóstico anterior de cáncer de piel y, de esos, cuatro (57,1%) presentaron lesiones potenciales de cáncer de piel. Conclusión: Los resultados del estudio permitieron elucidar la conjugación entre el conocimiento clínico y la comunicación de riesgo de cáncer de piel para trabajadores rurales.

OBJETIVOIdentificar a exposição de trabalhadores rurais à radiação solar ultravioleta e aos pesticidas; identificar casos pregressos de câncer de pele e aplicar a ação clínica e comunicativa de Enfermagem aos trabalhadores rurais com diagnóstico pregresso de câncer de pele.MÉTODOEstudo observacional-exploratório realizado com trabalhadores rurais expostos à radiação solar ultravioleta e aos pesticidas, em área rural no extremo sul do Brasil. Utilizou-se um modelo adaptado de julgamento clínico e comunicação de risco para o desenvolvimento de intervenção aos trabalhadores com diagnóstico pregresso de câncer de pele.RESULTADOSIdentificou-se: 123 (97,7%) trabalhadores em condições de exposição à radiação solar ultravioleta e aos pesticidas; sete (5,4%) com diagnóstico pregresso de câncer de pele e desses, quatro (57,1%) apresentaram lesões potenciais de câncer de pele.CONCLUSÃOOs resultados do estudo permitiram elucidar a conjugação entre o conhecimento clínico e comunicação de risco de câncer de pele para trabalhadores rurais.

Epidemiological profile of nonmelanoma skin cancer in renal transplant recipients: experience of a referral center

BACKGROUND: Nonmelanoma skin cancer is the most common form of cancer in humans and also the malignant disease that is increasingly common among kidney transplant recipients. OBJECTIVE: To determine the epidemiological characteristics of renal transplant recipients with nonmelanoma skin cancer seen at a referral transplantation center. METHODS: Cross-sectional descriptive study with renal transplant recipients presenting nonmelanoma skin cancer, treated at a transplantation referral center between 08/01/2004 and 08/31/2009. Analyzed variables were: gender, age, skin phototype, occupational and recreational sun exposure, use of photoprotection, personal and family history of non-melanoma skin cancer, clinical type and location, time between transplantation and the appearance of the first nonmelanoma skin cancer, occurrence of viral warts, timing of transplantation, type of donor, cause of kidney failure, previous transplants, comorbidities, pre-transplant dialysis, type and duration of dialysis. RESULTS: 64 subjects were included. Males - 71.9%; low skin phototypes (up to Fitzpatrick III) - 89%; mean age - 57.0 years - and mean age at transplant - 47.3 years; sun exposure - 67.2% occupational - and 64.1% recreational; photoprotection - 78.2% (although only 34.4% in a regular manner); squamous cell carcinoma - 67.2%; squamous cell carcinoma/basal cell carcinoma ratio - 2:1; personal history of nonmelanoma skin cancer - 25% - and family history - 10.9%; location at photoexposed area - 98.4%; average latency time between transplantation and first nonmelanoma skin cancer appearance - 78.3 months; viral warts (HPV) after transplant - 53.1%; average timing of transplantation - 115.5 months; living donor - 64.1%; triple regimen (antirejection) - 73.2%; comorbidities - 92.2%; pre-transplant dialysis - 98.4%; hemodialysis - 71.7%; average duration of dialysis - 39.1 months; previous transplants - 3.1%; hypertension as cause of renal failure ...

A melanoma risk score in a Brazilian population / Um escore de risco para melanoma em uma população brasileira

BACKGROUND: Important risk factors for cutaneous melanoma (CM) are recognized, but standardized scores for individual assessment must still be developed. OBJECTIVES: The objective of this study was to develop a risk score of CM for a Brazilian sample. METHODS: To verify the estimates of the main risk factors for melanoma, derived from a meta-analysis (Italian-based study), and externally validate them in a population in southern Brazil by means of a case-control study. A total of 117 individuals were evaluated. Different models were constructed combining the summary coefficients of different risk factors, derived from the meta-analysis, multiplied by the corresponding category of each variable for each participant according to a mathematical expression. RESULTS: the variable that best predicted the risk of CM in the studied population was hair color (AUC: 0.71; 95% CI: 0.62-0.79). Other important factors were freckles, sunburn episodes, and skin and eye color. Consideration of other variables such as common nevi, elastosis, family history, and premalignant lesions did not improve the predictive ability of the models. CONCLUSION: The discriminating capacity of the proposed model proved to be superior or comparable to that of previous risk models proposed for CM. .

FUNDAMENTOS: importantes fatores de risco para melanoma cutâneo são reconhecidos, mas escores padronizados para avaliação individual ainda precisam ser elaborados. OBJETIVOS: o objetivo deste estudo foi desenvolver um escore de risco de melanoma cutâneo para uma amostra brasileira. MÉTODOS: verificar as estimativas dos principais fatores de risco para melanoma, derivado de uma meta-análise (estudo de base italiano) e, externamente, validar em uma população do sul do Brasil por um estudo caso-controle. Um total de 117 indivíduos foram avaliados. RESULTADOS: a variável com maior poder preditivo para o risco de melanoma cutâneo na população estudada foi a cor do cabelo (AUC: 0,71, IC 95%: 0,62-0,79). Outros fatores importantes para o modelo foram: sardas, queimaduras solares, e cor de pele e cor dos olhos. Adicionando outras variáveis, como os nevos comuns, elastose, história familiar e lesões pré-malignas não houve melhora da capacidade preditiva. CONCLUSÃO: A capacidade discriminatória do modelo proposto mostrou-se superior ou comparável aos modelos de risco anteriores propostos para melanoma cutâneo. .

Assessment of knowledge of skin cancer prevention and its relation with sun exposure and photo protection amongst gym academy members on the south of Santa Catarina, Brazil / Avaliação do conhecimento quanto à prevenção do câncer de pele e sua relação com os hábitos da exposição solar e fotoproteção em praticantes de academia de ginástica do sul de Santa Catarina, Brasil

BACKGROUND: Skin cancer is the most frequent neoplasia in several parts of the world and also in Brazil. There is evidence of an increase in morbidity and mortality from skin cancer. Although the incidence of skin cancer is increasing, it is estimated that 45% of all preventable cancers worldwide are skin neoplasias. Several studies have emphasized the need for campaigns to encourage sun protection. OBJECTIVE: To assess the knowledge about skin cancer prevention and its association with sun exposure and photo protection in gym members. METHODS: We conducted a cross-sectional, descriptive and quantitative study during January to July 2009, including gym members of both sexes in the city of Criciuma. A self-administered questionnaire was used. The statistical analysis was conducted in a descriptive way in regards to the absolute and relative frequencies of the variables under study. RESULTS: Of the 317 questionnaires studied, 62% were from women and 38% from men. Skin types II and III predominated, and the average age was 27.6 years. 94.3% of the participants reported that they had heard about the risks of sun exposure, mostly in terms of skin cancer risk (80.8%). Most participants, especially women, reported some form of sun protective measure. CONCLUSION: The population studied, similar to that in other regions of Brazil and the world, is aware of the risks of excessive sun exposure and skin cancer prevention, but has not yet incorporated appropriate sun protection measures into their daily habits.

FUNDAMENTOS: O câncer da pele é a neoplasia de maior incidência em várias partes do mundo e também no Brasil. Há evidências de aumento da morbidade e mortalidade por câncer da pele. Embora a incidência do câncer da pele esteja aumentando, há estimativas de que em todo o mundo 45% dos cânceres passíveis de prevenção sejam cutâneos. Diversos estudos têm enfatizado a necessidade de campanhas de incentivo à fotoproteção. OBJETIVO: Avaliar o conhecimento quanto à prevenção do câncer da pele e relacioná-lo com os hábitos da exposição solar e fotoproteção em praticantes de academias de ginástica. MÉTODOS: Foi realizado um estudo transversal, descritivo e quantitativo durante o ano de 2009, incluindo praticantes de academias de ginástica em Criciúma, SC, por meio de um questionário autoaplicável. A análise estatística foi realizada de forma descritiva das frequências absolutas e relativas das variáveis em estudo. RESULTADOS: Dos 317 entrevistados, 62% eram do sexo feminino. Prevaleceram os fototipos III e II, e a média de idade foi de 27,6 anos. 94,3% dos entrevistados referiram já ter ouvido falar sobre os riscos da exposição solar, sendo o câncer da pele o mais citado (80,8%). A maior parte das pessoas confirmou o uso de alguma medida de fotoproteção, sendo a maioria delas mulheres. CONCLUSÃO: A população estudada, assim como em outras regiões do Brasil e do mundo, tem noção dos riscos da exposição solar excessiva e das medidas preventivas para o câncer da pele, porém ainda não inseriu em seus hábitos as medidas de fotoproteção de forma adequada.

Psoriasis, lymphoma and etanercept: is there a correlation? / Psoríase, linfoma e etanercepte: existe correlação?

Psoriasis is a chronic inflammatory disease that can affect skin and joints. Their treatment varies depending on the severity and includes topical and systemic. Among the latter are the immunobiological that target the T cell We report a case that demonstrates the close relationship between psoriasis, lymphoma and biologic therapies.

A psoríase é uma doença inflamatória crônica que pode afetar a pele e as articulações. Seu tratamento varia conforme a gravidade e inclui medicamentos tópicos e sistêmicos. Dentre os últimos estão os imunobiológicos, que têm como alvo a célula T. Relatamos um caso que demonstra a estreita relação entre a psoríase, o linfoma e os imunobiológicos.

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.

Squamous cell carcinoma arising from chronic lymphedema: case report and review of the literature / Surgimento de carcinoma escamocelular a partir de linfedema crônico: relato de caso e revisão da literatura

CONTEXT: Squamous cell carcinoma arising from chronic lymphedema has only been reported in the literature 11 times (12 cases). Some aspects of its pathogenesis remain unclear and, for the first time, attention has been drawn to epidemiological data. CASE REPORT: A 90-year-old white female with chronic unilateral lower-limb lymphedema, secondary to trauma 20 years earlier, presented with a three-month history of a vegetating cutaneous lesion. There had not been any previous local ulceration. The tumor was completely excised and the histopathological analysis showed that it was an infiltrating squamous cell carcinoma. A literature review in the Medline (Medical Literature Analysis and Retrieval System Online) and Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) databases using the MeSH (Medical Subject Heading) terms "Carcinoma, Squamous Cell" AND "Lymphedema" identified 112 references and found 12 similar case reports.

CONTEXTO: O crescimento de carcinoma de células escamosas a partir de linfedema crônico foi relatado apenas 11 vezes na literatura (12 casos). Aspectos sobre sua patogênese ainda não foram completamente elucidados e pela primeira vez chama-se atenção para os dados epidemiológicos. RELATO DE CASO: Paciente do sexo feminino, branca, 90 anos de idade, portadora de linfedema crônico unilateral de membro inferior secundário a trauma sofrido há 20 anos, apresentou história de lesão cutânea vegetante de três meses. Não havia relato de lesão local prévia. O tumor foi completamente excisado e sua análise histopatológica mostrou tratar-se de carcinoma escamocelular infiltrante. Uma revisão da literatura nos bancos de dados Medline (Medical Literature Analysis and Retrieval System Online) e Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), utilizando-se dos termos MeSH (Medical Subject Heading) "Carcinoma, Squamous Cell" AND "Lymphedema", identificou 112 citações e encontrou relatos de 12 casos semelhantes.

Inmunosupresores y cáncer de piel / Inmunosuppressive drugs and skin cancer

El trasplante de órganos, uno de los avances más sorprendentes de la medicina junto con el desarrollo de agentes inmunosupresores cada vez más eficaces, modificó el curso de enfermedades terminales devastadoras. Sin embargo, esta práctica médica nos enfrenta a una población cada vez más longeva que padece las complicaciones secundarias de la inmunosupresión crónica, necesaria para asegurar la supervivencia del injerto. La elevada incidencia de neoplasias interna y, en particular, cutáneas plantea la necesidad de un manejo interdisciplinario. En este sentido, el médico dermatólogo desempeña un papel protagónico en la prevención, el diagnóstico y el tratamiento de estos procesos malignos.

Ulcera de Majorlin en cicatriz de quemadura: manejo quirúrgico / Majorlin's ulcer arising in burn scar: surgical management

We discuss the case of a 63-years-old woman presenting with Majorlin's ulcer over the popliteal area. This localization is the most frequent for this lesion. We review the diagnosis, epidemiology, and aggressive surgical treatment with wide excision of the ulcer and repair with fasciocutaneous flap.

Se presenta un caso de úlcera de Majorlin en la región poplítea de una paciente de 63 años de edad. Esta localización es la más frecuente de esta lesión. Se discute su diagnóstico, epidemiología, etiología y tratamiento agresivo con resección amplia de la ulcera y reparación con un colgajo fasciocutáneo.

Conocimientos y hábitos de exposición solar de la población chilena / Sun exposure behaviors and knowledge among Chileans

Background: Ultraviolet light exposure has a pathogenic effect on the development of skin cancer, whose prevalence increases worldwide. In Chile and the rest of the world, preventive educational campaigns are carried out to change high risk sun exposure behaviors. Aim: To study the behavior of the Chilean population towards skin cancer prevention and to identify erroneous preventive practices and concepts. Material and methods: A survey containing 17 questions about sun exposure behaviors, photoprotective measures and knowledge about ultraviolet radiation and skin cancer was used. It was applied during January and February 2004, to 1,143 subjects (mean age 30 years, 409 males), taking vacations in beach resorts in Chile. Results: The hours of higher sun exposure ranged from 12 AM to 4 PM. Thirty seven percent of subjects were exposed more than 2 hours during this high risk lapse. Women and subjects aged less than 25 years were those with the riskiest behaviors. Fifty four percent used some type of photoprotection and 50% used ocular protection. Seventy percent used creams with sun screen and 74% used a sun protection factor higher than 15. Seventy percent applied the sun screen as recommended. Thirty eight percent had at least one sun burn in the last two years. More than 90% of subjects were aware of the relationship between sun exposure and skin cancer but 60% did not know the hours of higher ultraviolet radiation. The information about sun exposure was obtained from television in 57% of surveyed individuals. Conclusions: More educational campaigns about the risk of sun exposure are needed to reduce risky behaviors in the Chilean population.

Factores de riesgo para carcinoma basocelular. Estudio de casos-controles en Córdoba / Risk factors for basal cell carcinoma. Case-control study in Cordoba

El carcinoma basocelular es una enfermedad compleja. Su etiología es todavía poco clara y a pesar de su frecuencia hay pocos datos sobre factores de riesgo. Nosotros evaluamos factores de riesgo potenciales para carcinoma basocelular en una población de Córdoba (Argentina). Este estudio de casos y controles incluyó a 88 casos nuevos de carcinoma basocelular, y 88 controles pareados por sexo y edad. Los siguientes factores de riesgo fueron significativos en el análisis multivariado: fototipos I, II y III, exposición solar recreativa alta después de los 20 años de edad, exposición solar alta en vacaciones en la playa y la presencia de queratosis actínicas.

Basal cell carcinoma is undoubtedly a complex disease. Its etiology is still unclear and despite its frequency, there is a paucity of data on its risk factors. We assessed potential risk factors for basal cell carcinoma in a population from Córdoba (Argentina). This case-control study involved 88 newly diagnosed cases and 88 controls, matched by age and sex. The following risk factors were significant in the multivariate analysis: skin type I-II-III, high recreational sun exposure after 20 years of age, high sun exposure for beach holidays and actinic keratosis.

Fibrohistiocitoma maligno sobre radiodermitis / Malignant fibrous histiocytoma over radiodermitis

Se prsentan dos casos clínicos de fibrohistiocitoma maligno sobre radiodermitis. El primer caso se trata de un paciente de sexo masculino que presenta una lesión tumoral en mejilla derecha, zona de radiodermatitis crónica provocada por tratamiento de acné 25 años atrás. Luego de la escisión quirúrgica la lesión recidivaal año. En el segundo caso una paciente de sexo femenino portadora de carcinoma mamario presenta una lesión tumoral compatible con fibrohistiocitoma maligno localizada en cara anterior de tórax, sobre una radiodermitis crónica por tratamiento de cobalto realizado por su patología de base 23 años atrás. Se derivó al srvicio de cirugía, pero la paciente fallece antes por metástasis del carcinoma. Dada la escasa frecuencia de esta patología se realiza una revisión bibliográfica del tema