RESUMO
PURPOSE: CDKN2A is the main high-risk melanoma-susceptibility gene, but it has been poorly assessed in Latin America. We sought to analyze CDKN2A and MC1R in patients from Latin America with familial and sporadic multiple primary melanoma (SMP) and compare the data with those for patients from Spain to establish bases for melanoma genetic counseling in Latin America. METHODS: CDKN2A and MC1R were sequenced in 186 Latin American patients from Argentina, Brazil, Chile, Mexico, and Uruguay, and in 904 Spanish patients. Clinical and phenotypic data were obtained. RESULTS: Overall, 24 and 14% of melanoma-prone families in Latin America and Spain, respectively, had mutations in CDKN2A. Latin American families had CDKN2A mutations more frequently (P = 0.014) than Spanish ones. Of patients with SMP, 10% of those from Latin America and 8.5% of those from Spain had mutations in CDKN2A (P = 0.623). The most recurrent CDKN2A mutations were c.-34G>T and p.G101W. Latin American patients had fairer hair (P = 0.016) and skin (P < 0.001) and a higher prevalence of MC1R variants (P = 0.003) compared with Spanish patients. CONCLUSION: The inclusion criteria for genetic counseling of melanoma in Latin America may be the same criteria used in Spain, as suggested in areas with low to medium incidence, SMP with at least two melanomas, or families with at least two cases among first- or second-degree relatives.Genet Med 18 7, 727-736.
Assuntos
Inibidor de Quinase Dependente de Ciclina p18/genética , Predisposição Genética para Doença , Melanoma/genética , Receptor Tipo 1 de Melanocortina/genética , Adulto , Idoso , Inibidor p16 de Quinase Dependente de Ciclina , Feminino , Aconselhamento Genético , Mutação em Linhagem Germinativa , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/epidemiologia , Melanoma/patologia , Pessoa de Meia-Idade , Fatores de Risco , EspanhaRESUMO
Ten patients with superficial infantile hemangiomas were treated with imiquimod 5% cream for up to 16 weeks. Four patients achieved complete clinical resolution, 3 had excellent improvement, one showed moderate improvement, and one patient did not respond to therapy. Imiquimod may be an effective alternative for the treatment of superficial hemangiomas.