RESUMO
Solid organ transplant recipients (SOTRs) are at high risk of cutaneous squamous cell carcinoma (cSCC) metastasis. Despite prior studies identifying risk factors, mortality remains high. Understanding additional risk factors may aid in reducing mortality in this population. This study aimed to investigate risk factors and predictive variables for metastatic cSCC in SOTRs. The primary goal was to accurately identify transplant patients at increased risk of metastatic cSCC. A retrospective case-control study in a single institution of 3576 cases of organ transplants were identified from January 1991 to July 2022. A cohort of metastatic cancer patients and two randomly generated age and organ matched control cohorts were identified. 16 SOTR patients developed metastatic cSCC. The majority were male, with high-risk tumor sites. Tumor depth varied and half exhibited perineural invasion. Cylex® (p = 0.05) and white blood cell counts (p = 0.04) were significantly lower in these patients compared to control. Lung transplants were at highest risk relative to other solid organ transplants. Voriconazole exposure was also associated with increased metastatic risk (p = 0.04). Small sample size at a single institution. Close monitoring of SOTR, especially those with lung transplants given their increased risk, reducing immunosuppression, and limiting exposure to voriconazole can improve outcomes in SOTRs with metastatic cSCC.
Assuntos
Centros Médicos Acadêmicos , Carcinoma de Células Escamosas , Transplante de Órgãos , Neoplasias Cutâneas , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/secundário , Fatores de Risco , Estudos Retrospectivos , Transplante de Órgãos/efeitos adversos , Estudos de Casos e Controles , Idoso , Centros Médicos Acadêmicos/estatística & dados numéricos , Transplantados/estatística & dados numéricos , AdultoRESUMO
Heart transplant patients have an increased risk of developing cancer. Patients who underwent HTx between 1985 and 2017 were included. Detection of cancer was obtained by cross-checking the study population with the Swedish Cancer-Registry and the Cause-of-Death-Registry. A total of 664 patients were followed for a median of 7.7 years. In all, 231 malignancies were diagnosed in 138 patients. Compared to the general population the excess risk of cancer following HTx was 6.2-fold calculated as the standardized incidence ratio (SIR) and 2.9-fold after exclusion of non-melanoma skin cancer (NMSC). The most common malignancies were NMSC, non-Hodgins lymphoma, and lung cancer. There was no significant difference in overall survival between those with and without a history of cancer before HTx (p = 0.53). During a median follow-up of 7.7 years, 19% of HTx recipients developed cancer, 6.2-fold higher relative to the general population, and 2.9-fold higher when excluding NMSC. Risk factors for malignancies (excluding NMSC) included previous smoking, hypertension and prolonged ischemic time; and for NMSC, increasing age, seronegative CMV-donors, and azathioprine. A previous cancer in selected recipients results in similar survival compared to those without cancer prior to HTx.
Assuntos
Transplante de Coração , Neoplasias , Humanos , Transplante de Coração/efeitos adversos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Suécia/epidemiologia , Fatores de Risco , Neoplasias/epidemiologia , Neoplasias/etiologia , Incidência , Idoso , Sistema de Registros , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/epidemiologia , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologiaRESUMO
Lung transplantation (LTx) is a well-known treatment for end-stage lung disease. This study aimed to report the incidence of cancer after LTx and long-term outcome among lung transplant recipients with a pretransplant diagnosis of cancer. Patients who underwent LTx between 1990-2016 were included in the study. Detection of cancer was obtained by cross-checking the study population with the Swedish Cancer Registry and the Cause-of-Death registry. A total of 614 patients were followed for a median of 5.1 years. In all, 159 malignancies were diagnosed. The excess risk of cancer or standardized incidence ratio (SIR) following LTx was 5.6-fold compared to the general Swedish population. The most common malignancies were non-melanoma skin cancer (NMSC) (SIR 76.5 (95%CI 61.7-94.8); non-Hodgkin lymphoma (SIR 23.5, 95%CI 14.8-37.2); and lung cancer (SIR 8.89, 95%CI 5.67-13.9). There was no significant difference in overall survival between those with and without a history of cancer before LTx (p = 0.56). In total, 159 malignancies were identified after LTx, which was a 5.6-fold higher relative to the general population. A history of previous cancer yields similar survival in selected recipients, compared to those without cancer prior to LTx.
Assuntos
Transplante de Pulmão , Sistema de Registros , Humanos , Transplante de Pulmão/efeitos adversos , Masculino , Feminino , Pessoa de Meia-Idade , Suécia/epidemiologia , Adulto , Incidência , Idoso , Neoplasias/epidemiologia , Neoplasias/etiologia , Neoplasias Pulmonares/epidemiologia , Adulto Jovem , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologia , Fatores de Risco , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologiaRESUMO
Asthma is a respiratory disorder caused by airway inflammation which may worsen after allergen exposure. Recent cohort studies demonstrate a positive association between skin cancer and asthma or hay fever (allergy to outdoor allergens such as pollen). Nationally-representative data for adults in the United States remains limited. We aimed to characterize skin cancer prevalence among individuals in the United States who have asthma or hay fever. To achieve this aim, we extracted nationwide cross-sectional data from 16,277 adult participants (total survey-weighted sample = 174,765,931) of the Third National Health and Nutrition Examination Survey from 1988 to 1994. This study uses survey-weighted regression to compare the nationwide prevalence of skin cancer among participants with or without a history of asthma or hay fever. Sensitivity analysis examined the influence of sex, 25-hydroxyvitamin D, chronic bronchitis or emphysema, geographical region, urban proximity, and oral glucocorticoid use. Of the included participants, the age-adjusted prevalence of skin cancer was 7.2%, similar to national estimates. Skin cancer prevalence was higher among participants who had asthma with hay fever (adjusted prevalence ratio, 1.79; 95% confidence interval, 1.16, 2.76), but not among participants with asthma only or hay fever only. Similarly, skin cancer prevalence was higher for those with asthma and positive pollen allergen skin prick testing (SPT), but not for those with hay fever and positive pollen SPT. No association was noted between skin cancer and wheezing triggered by pollen. Hay fever or immunoglobulin-E sensitization to pollen may increase skin cancer prevalence among individuals with a history of asthma.
Assuntos
Asma , Inquéritos Nutricionais , Rinite Alérgica Sazonal , Neoplasias Cutâneas , Humanos , Estudos Transversais , Masculino , Rinite Alérgica Sazonal/epidemiologia , Rinite Alérgica Sazonal/imunologia , Rinite Alérgica Sazonal/diagnóstico , Feminino , Adulto , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/diagnóstico , Prevalência , Asma/epidemiologia , Asma/imunologia , Asma/diagnóstico , Alérgenos/imunologia , Alérgenos/efeitos adversos , Testes Cutâneos , Idoso , Adulto Jovem , Pólen/imunologia , Pólen/efeitos adversos , Fatores de RiscoRESUMO
Immunosuppression after solid organ transplantation is associated with an increased risk of keratinocyte carcinoma (KC). Despite its established morbidity, KC risk in liver transplant (LT) recipients is understudied, including the contribution of immunosuppression regimen and latitude. A retrospective cohort of 9,966 adult first LT alone recipients alive with their native allograft at 1-year post-LT without prior KC between 2007 and 2016 were identified using linked data from the Organ Procurement and Transplantation Network and Medicare administrative claims. The primary exposures were immunosuppression regimen and latitude of residence. The primary outcome was incident, de novo KC occurring at least 1-year after LT. Adjusted Cox regression analysis stratified by transplant center was used in all analyses. The cohort was 63.4% male, 70.2% White and with median age 61 years (interquartile range, IQR, 54-66) at transplant. Calcineurin inhibitor (CNI) with anti-metabolite combination was independently associated with incident KC when measured as intention-to-treat (adjusted hazard ratio (aHR) 1.21 vs. CNI monotherapy, 95% CI 1.02-1.43, p = 0.026), in a time-updating as-treated analysis (aHR 1.61, 95% CI 1.34-1.93; p < 0.001) and when measured as cumulative exposure (aHR 1.13 per 6-month increase, 95% CI: 1.02-1.33; p = 0.027). More southern latitude of residence was also independently associated with incident KC with an aHR of 1.26 per 5°N decrease towards the Equator (95% CI: 1.08-1.47, p = 0.003). We demonstrate independent effects of CNI with antiM immunosuppression regimen and latitude of residence on the risk of post-LT KC, which will better inform screening practices and immunosuppression management.
Assuntos
Terapia de Imunossupressão , Imunossupressores , Transplante de Fígado , Neoplasias Cutâneas , Humanos , Transplante de Fígado/efeitos adversos , Transplante de Fígado/estatística & dados numéricos , Pessoa de Meia-Idade , Masculino , Feminino , Estudos Retrospectivos , Idoso , Estados Unidos/epidemiologia , Imunossupressores/efeitos adversos , Neoplasias Cutâneas/epidemiologia , Terapia de Imunossupressão/efeitos adversos , Fatores de Risco , Incidência , Queratinócitos/imunologia , Inibidores de Calcineurina/efeitos adversos , Carcinoma Basocelular/epidemiologiaRESUMO
Background Primary cutaneous lymphomas (PCLs) are rare diagnoses in Nepal and are not well characterized till date. Objective To evaluate clinical and pathological features of Primary cutaneous lymphomas in Nepal. Method We retrospectively reviewed outpatient and inpatient records of a dermatology referral centre of Kathmandu, Nepal for clinical and pathological findings of cases diagnosed as cutaneous lymphomas from July 2010 through July 2020. The final diagnosis was made based on 2008 World Health Organization classification and its update 2018. Result There were 12 cases of Primary cutaneous lymphomas diagnosed during this period. The age of presentation ranged from 19 years to 81 years (Mean: 53.4 years ± 21.5 years, SD). There were ten cases of cutaneous T-cell lymphoma (CTCLs) and two cases of cutaneous B- cell lymphomas (CBCLs). Among cutaneous T-cell lymphoma, there were four cases of primary cutaneous anaplastic large- cell Lymphoma (PCALCL), two cases of classic (patch/plaque) mycosis fungoides (MF), two cases of folliculotropic mycosis fungoides (FMF), and one case each of primary cutaneous aggressive epidermotropicCD8+ T-cell lymphoma and lymphomatoid papulosis. Among cutaneous B- cell lymphomas, there was one case of primary cutaneous marginal zone B- cell lymphoma, and one case of primary cutaneous follicle centre lymphoma. Most cases of MF presented at stage IB (75%), and three patients of primary cutaneous lymphomas died during this period. Conclusion Primary cutaneous lymphomas appear to be very rare in this study and presentations ranged from classic Mycoses Fungoides to aggressive T-cell lymphomas. Cutaneous T-cell lymphomas appeared to be more common than cutaneous B- cell lymphomas in this study.
Assuntos
Linfoma Cutâneo de Células T , Neoplasias Cutâneas , Humanos , Nepal/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Masculino , Feminino , Adulto , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Linfoma Cutâneo de Células T/patologia , Linfoma Cutâneo de Células T/epidemiologia , Adulto Jovem , Estudos de Coortes , Linfoma de Células B/epidemiologia , Linfoma de Células B/patologia , Dermatologia , Micose Fungoide/patologia , Micose Fungoide/epidemiologiaAssuntos
Asiático , Dermatofibrossarcoma , Programa de SEER , Neoplasias Cutâneas , Humanos , Dermatofibrossarcoma/epidemiologia , Dermatofibrossarcoma/diagnóstico , Dermatofibrossarcoma/patologia , Programa de SEER/estatística & dados numéricos , Asiático/estatística & dados numéricos , Feminino , Masculino , Neoplasias Cutâneas/epidemiologia , Adulto , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Idoso , Adulto Jovem , Adolescente , IncidênciaRESUMO
The prognosis of patients with mycosis fungoides is variable. As the current literature is scarce and shows mixed results this study investigates the incidence of other primary malignancies in mycosis fungoides patients. A retrospective, nationwide, population- based cohort study was performed with patients with mycosis fungoides between 2000 and 2020 in The Netherlands. All histopathology reports were requested from the Nationwide Network and Registry of Histo- and Cytopathology and screened for other primary malignancies. Lifelong incidence rates were used to compare the incidence of malignancies in mycosis fungoides patients and the general population. In total 1,024 patients were included with a mean follow-up of 10 years (SD 6). A total of 294 cases of other primary malignancies were found with 29% of the mycosis fungoides patients developing at least 1 other primary malignancy. Only cutaneous (odds ratio [OR] 2.54; CI 2.0-3.2) and haematological malignancies (OR 2.62; CI 2.00-3.42) had a statistically significant higher incidence than the Dutch population overall. Mycosis fungoides patients have a significantly increased risk of developing melanomas (OR 2.76; CI 2.11-3.59) and cutaneous squamous cell carcinomas mycosis fungoides (OR 2.34; CI 1.58-3.45). This study shows no association between mycosis fungoides and other solid organ tumours; however, such patients are significantly at risk of developing other haematological and cutaneous malignancies. Clinicians should be aware of this increased risk.
Assuntos
Micose Fungoide , Neoplasias Cutâneas , Humanos , Micose Fungoide/epidemiologia , Micose Fungoide/patologia , Estudos Retrospectivos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Países Baixos/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Incidência , Idoso , Adulto , Fatores de Risco , Sistema de Registros , Neoplasias Hematológicas/epidemiologia , Melanoma/epidemiologia , Medição de Risco , Fatores de TempoRESUMO
BACKGROUND: Ultraviolet (UV) radiation is the most important risk factor for skin cancer development. Sunlight is the main source of UV radiation in the general population. In addition, tanning beds are a source of artificial UV radiation. Since the incidence of skin cancer is increasing worldwide, it is necessary to monitor UV-related risk behaviors such as intentional indoor and outdoor tanning, as well as sun protection behavior in the general population and specific subgroups and settings. This is the aim of the National Cancer Aid Monitoring online (NCAM-online), a continuation and further development of the NCAM. METHODS: The NCAM-online is a longitudinal trend study consisting of four annual survey waves. Each year, 4,000 individuals aged 16-65 years living in Germany will be surveyed using online questionnaires. Each year, intentional indoor and outdoor tanning will be assessed. In addition, varying specific topics regarding skin cancer prevention, such as the utilization of skin cancer screening, will be addressed in the questionnaires. DISCUSSION: The findings of the NCAM-online will provide an important basis for the German Cancer Aid and Working Group on Dermatologic Prevention (Arbeitsgemeinschaft Dermatologische Prävention, ADP) to develop targeted prevention campaigns and projects aimed at preventing skin cancer. The explorative nature of the NCAM-online allows for the identification of new potential starting points for prevention and education. In addition, the longitudinal design allows for a description of the trend in the prevalence of intentional tanning. For tanning bed use, representative trend data from 2012 are available for Germany, to which NCAM-online will add annual data until 2027.
Assuntos
Neoplasias Cutâneas , Raios Ultravioleta , Humanos , Pessoa de Meia-Idade , Alemanha/epidemiologia , Adulto , Raios Ultravioleta/efeitos adversos , Adolescente , Idoso , Neoplasias Cutâneas/prevenção & controle , Neoplasias Cutâneas/epidemiologia , Masculino , Feminino , Adulto Jovem , Estudos Longitudinais , Inquéritos e Questionários , Banho de Sol/estatística & dados numéricos , Internet , Comportamentos Relacionados com a Saúde , Neoplasias Induzidas por Radiação/prevenção & controle , Neoplasias Induzidas por Radiação/epidemiologia , Fatores de RiscoRESUMO
Melanoma is a malignant tumor with the highest growth rate in the incidence and is the leading cause of death due to skin cancers. In Poland, approximately 1500 cases of melanoma are detected annually in advanced or metastatic stages. Intensive preventive measures can contribute to its early-stage diagnosis, consequently reducing the number of fatalities. The aim of the study was to assess the occurrence of melanoma risk factors among the residents of Silesia region and their knowledge about the diagnosis and prevention of this cancer. An original questionnaire was used in the study, and its completion was anonymous. The study was conducted among the residents of the Silesian Voivodeship. A total of 400 (100%) individuals were examined. Among them were 243 women and 157 men. The participants' ages ranged from 16 to 84 years (mean ageâ =â 34.38â ±â 18.39). The participants were burdened with melanoma development risk factors such as fair skin complexion (235; 58.75%), having more than 50 pigmented lesions (158; 39.50%) and sunburns (105; 26.25%). Over 40% (166; 41.50%) of the participants had never examined their pigmented lesions. A staggering 78% (311; 77.75%) of the respondents had never undergone dermatoscopic examination, and over 50% (215; 53.75%) did not know what this examination entailed. Just under 16% (63; 15.75%) of the participants stated that their family doctor had examined their pigmented lesions, and almost % (154; 97.47%) of those with numerous pigmented lesions had never been referred to a dermatologist for dermatoscopy. The surveyed residents of the Silesian Voivodeship were burdened with numerous risk factors for melanoma development, with the most common being fair skin complexion, having more than 50 pigmented lesions, and sunburns. The knowledge of the participants regarding the diagnosis and prevention of melanoma development was insufficient, thus highlighting the necessity for conducting systematic educational initiatives in the mentioned field. These initiatives should ultimately lead to the preservation of health and life, as well as the maintenance of its high quality.
Assuntos
Melanoma , Neoplasias Cutâneas , Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Melanoma/prevenção & controle , Melanoma/diagnóstico , Melanoma/epidemiologia , Polônia/epidemiologia , Neoplasias Cutâneas/prevenção & controle , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Idoso , Adulto Jovem , Adolescente , Idoso de 80 Anos ou mais , Fatores de Risco , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos e Questionários , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricosRESUMO
BACKGROUND: Keratinocyte cancer (KC) in Australia poses a unique healthcare challenge due to its high prevalence and the requirement for multidisciplinary management of many cases. Advances in radiation therapy (RT) have increased its use in treating different keratinocyte cancer presentations. Understanding the indications for RT and the role that general practitioners (GPs) play in the treatment pathway are imperative to ensure best patient outcomes. OBJECTIVE: This review examined the efficacy, advances and treatment considerations of RT for the management of keratinocyte cancer, and role of the GP in the treatment pathway. DISCUSSION: Radiation therapy offers effective alternatives to, or adjuvants for, surgery in existing keratinocyte cancer treatments in appropriate cases. The evolving RT landscape necessitates GPs to be well informed for effective case identification, referral and management. This includes understanding RT advances, protocols, treatment reactions and managing patient expectations. Continuing education in this space is important for GPs to understand the suitability of RT for their patients.
Assuntos
Clínicos Gerais , Neoplasias Cutâneas , Humanos , Austrália/epidemiologia , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/radioterapia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/radioterapia , Queratinócitos/patologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/radioterapiaRESUMO
PURPOSE: Long-term use of hydrochlorothiazide increases the risk of non-melanoma skin cancer. We aimed to evaluate potential changes in the use of hydrochlorothiazide in Switzerland after a direct healthcare professional communication (DHPC) in November 2018 by Swissmedic. METHODS: We performed interrupted time-series analyses using a large Swiss healthcare claims database (2015-2021). Within monthly intervals, we quantified the total number of claims and the total dispensed 'defined daily doses' (DDD) for preparations containing (1) hydrochlorothiazide, (2) angiotensin-converting enzyme (ACE) inhibitors and angiotensin-II-receptor blockers (ARB), (3) calcium-channel blockers (CCB) and (4) thiazide-like diuretics per 10 000 persons. Using segmented linear regression, we quantified the pre-DHPC trend, the immediate change and the post-DHPC change in trend for total claims and DDD for the four drug classes weighted for the demographic distribution of the Swiss population. RESULTS: ACE inhibitors and ARB were the most frequently claimed antihypertensive drugs with 300-400 claims per 10 000 persons, which increased by 5.4% during the study period. The average number of hydrochlorothiazide claims (157/10 000 persons in 2015) declined by 35% between 2015 and 2021. The decrease started prior to the DHPC, but the DHPC was associated with an immediate 6.1% decline and an accelerated decline in claims over time after the DHPC (similar results for DDD). This coincided with a 23% increase in claims of CCB (dihydropyridine type) over 7 years, whereas use of other antihypertensives increased less. CONCLUSION: Our results suggest that the DHPC by Swissmedic in 2018 accelerated a pre-existing decline in the use of hydrochlorothiazide in Switzerland.
Assuntos
Anti-Hipertensivos , Hidroclorotiazida , Análise de Séries Temporais Interrompida , Neoplasias Cutâneas , Humanos , Suíça/epidemiologia , Hidroclorotiazida/efeitos adversos , Anti-Hipertensivos/efeitos adversos , Neoplasias Cutâneas/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Bases de Dados Factuais/estatística & dados numéricos , Adulto , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Antagonistas de Receptores de Angiotensina/efeitos adversos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologiaRESUMO
Monitoring melanoma incidence time trends by tumour thickness is essential to understanding the evolution of melanoma occurrence and guiding prevention strategies. To assess long-term incidence trends, tumour thickness was extracted from pathology reports in the Cancer Registry of Norway (1983-2007) and the Norwegian Melanoma Registry (2008-2019), n = 45,635 patients. Across all anatomic sites, T1 (≤ 1 mm) incidence increased most (men annual percentage change [AAPC] = 4.6, 95% confidence interval [95% CI] 4.2-5.0; women AAPC = 3.2, 95% CI 2.8-3.6); the increase was steep until 1989/90, followed by a plateau, and a further steep increase from 2004/05. Increased incidence was also observed for T2 (>1.0-2.0) melanoma (men AAPC = 2.8, 95% CI 2.4-3.2; women AAPC = 1.5, 95% CI 1.1-1.9), and T3 (>2.0-4.0) in men (AAPC = 1.4, 95% CI 0.9-1.9). T4 (>4.0) melanoma followed a similar overall pattern (men AAPC = 1.3, 95% CI 0.9-1.7, head/neck, upper limbs, and trunk; women AAPC = 0.9, 95% CI 0.4-1.4, upper limbs and trunk). Men had the highest T3 and T4 incidence and the sex difference increased with age. Regarding birth cohorts, age-specific incidence increased in all T categories in the oldest age groups, while stabilizing in younger patients born after 1950. Overall, the steep increase in T1 melanoma was not accompanied by a decrease in thick melanoma.
Assuntos
Melanoma , Sistema de Registros , Neoplasias Cutâneas , Humanos , Melanoma/epidemiologia , Melanoma/patologia , Noruega/epidemiologia , Masculino , Feminino , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Incidência , Pessoa de Meia-Idade , Idoso , Adulto , Invasividade Neoplásica , Fatores de Tempo , Estadiamento de Neoplasias , Distribuição por Sexo , Adulto Jovem , Idoso de 80 Anos ou mais , Distribuição por IdadeRESUMO
OBJECTIVES: To estimate the incidence of melanoma in Australia among people with ancestries associated with low, moderate, or high risk of melanoma, by sex and 5-year age group; to establish whether age-specific incidence rates by ancestry risk group have changed over time. STUDY DESIGN: Modelling study; United States (SEER database) melanoma incidence rates for representative ancestral populations and Australian census data (2006, 2011, 2016, 2021) used to estimate Australian melanoma incidence rates by ancestry-based risk. SETTING, PARTICIPANTS: Australia, 2006-2021. MAIN OUTCOME MEASURES: Age-specific invasive melanoma incidence rates, and average annual percentage change (AAPC) in age-specific melanoma rates, by ancestry-based risk group, sex, and 5-year age group. RESULTS: The proportion of people in Australia who reported high risk (European) ancestry declined from 85.3% in 2006 to 71.1% in 2021. The estimated age-standardised melanoma incidence rate was higher for people with high risk ancestry (2021: males, 82.2 [95% confidence interval {CI}, 80.5-83.8] cases per 100 000 population; females, 58.5 [95% CI, 57.0-59.9] cases per 100 000 population) than for all Australians (males, 67.8 [95% CI, 66.5-69.2] cases per 100 000 population; females, 45.4 [95% CI, 44.3-46.5] cases per 100 000 population). AAPCs were consistently positive for Australians aged 50 years or older, both overall and for people with high risk ancestry, but were statistically significant only for some age groups beyond 65 years. AAPCs were negative for people aged 34 years or younger, but were generally not statistically significant. CONCLUSIONS: Melanoma incidence has declined in some younger age groups in Australia, including among people with high risk ancestry. Social and behavioural changes over the same period that lead to lower levels of ultraviolet radiation exposure probably contributed to these changes.
Assuntos
Melanoma , Neoplasias Cutâneas , Humanos , Melanoma/epidemiologia , Austrália/epidemiologia , Incidência , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Idoso , Neoplasias Cutâneas/epidemiologia , Adulto Jovem , Distribuição por Idade , Adolescente , Idoso de 80 Anos ou mais , Fatores de Risco , População Branca/estatística & dados numéricos , Criança , Distribuição por Sexo , Fatores EtáriosAssuntos
COVID-19 , Melanoma , Neoplasias Cutâneas , Humanos , Melanoma/mortalidade , Melanoma/epidemiologia , COVID-19/epidemiologia , COVID-19/mortalidade , Estados Unidos/epidemiologia , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/epidemiologia , Masculino , Feminino , Pandemias , SARS-CoV-2 , Pessoa de Meia-IdadeRESUMO
Several studies have described increased risk ratios of certain types of malignancies in patients with severe psoriasis. Among these, the lymphoproliferative disorders, including non-Hodgkin's lymphoma, cutaneous T-cell lymphoma and non-melanoma skin cancer, have been described most frequently. In addition to traditional cancer risk factors, some psoriasis treatments may also be implicated as potential carcinogens. The aim of this study was to perform a review of current literature on the association between psoriasis, the therapies against this disease and skin cancer, focusing on both epidemiology and the potential mechanism involved. Some psoriasis treatments, such as psoralen and ultraviolet A (PUVA) therapy and cyclosporine, have been associated with increased risk of skin cancer. Variable data have been reported for anti-tumour necrosis factor (TNF) drugs, whereas other class of biologics, like anti-IL17 and IL23, as well as ustekinumab, seem not to be related to skin cancer risk, such as the case of currently available small molecules.
Assuntos
Psoríase , Neoplasias Cutâneas , Humanos , Psoríase/tratamento farmacológico , Neoplasias Cutâneas/epidemiologia , Ciclosporina/uso terapêutico , Ciclosporina/efeitos adversos , Fatores de Risco , Terapia PUVA/efeitos adversos , Fármacos Dermatológicos/uso terapêutico , Fármacos Dermatológicos/efeitos adversos , Fator de Necrose Tumoral alfa/antagonistas & inibidoresRESUMO
BACKGROUND: Basosquamous carcinoma (BSC) is a rare and aggressive nonmelanoma skin cancer (NMSC) that exhibits features of both BCC and squamous cell carcinoma (SCC). The gold standard for diagnosis is histopathological examination. BSC is often challenging to diagnose and manage due to its mixed histological features and potential for aggressive behavior AIM: To identify specific features aiding clinicians in differentiating BSCs using non-invasive diagnostic techniques. METHODS: We conducted a retrospective descriptive, monocentric study of the epidemiological clinical, dermoscopic, and reflectance confocal microscopy (RCM) features of histopathologically proven BSCs diagnosed between 2010 and 2023. A total of 192 cases were selected. RESULTS: The study population consisted of 17 men (60.9%). Total 95.8% of patients at the time of diagnosis were ≥50 years. BSC occurred in the head and neck area in 124 cases (63.1%) of which 65 (33.9%) were in the H-zone. For 47.4% of patients, BSC presented as a macule with undefined clinical margins (43.3%). Dermoscopic images were available for 98 cases: the most common parameter was the presence of whitish structureless areas (59 [60.2%]), keratin masses (58 [59.2%]), superficial scales, and ulceration or blood crusts (49 [50%] both). Vessels pattern analysis revealed hairpin vessels (exclusively) and linear irregular vessels as the most frequent (55 [56.1%] both). RCM examination was performed in 21 cases which revealed specific SCC features such as solar elastosis (19 [90.5%]), atypical honeycomb pattern (17 [89%]), proliferation of atypical keratinocytes (16 [80%]) combined with BCC' ones as bright tumor islands (12 [57.8%]), and cleft-like dark spaces (11 [53.4%]). DISCUSSION: Our study reflects the largest cohort of BSCs from a single institution. We described an incidence rate of 4.7%, higher than reported in the Literature, with the involvement of patients ≥50years in almost 96% of cases and an overall male predominance. At clinical examination, BSC was described as a hyperkeratotic macule with undefined clinical margins with one or more dermoscopic SCC' features, whereas the presence of typical BCC aspects was observed in less than 10% of cases, differently from what was previously reported. At RCM analysis, BSCs presented with an atypical honeycomb pattern with proliferation of atypical keratinocytes, hyperkeratosis, and in nearly 55% of patients, bright tumor islands with cleft-like dark spaces. CONCLUSION: The distinctive dermoscopic patterns, along with the RCM features aid in the differentiation of BSCs from other NMSCs.
Assuntos
Carcinoma Basoescamoso , Dermoscopia , Microscopia Confocal , Neoplasias Cutâneas , Humanos , Masculino , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/epidemiologia , Dermoscopia/métodos , Pessoa de Meia-Idade , Feminino , Carcinoma Basoescamoso/patologia , Carcinoma Basoescamoso/diagnóstico por imagem , Carcinoma Basoescamoso/epidemiologia , Estudos Retrospectivos , Idoso , Microscopia Confocal/métodos , Idoso de 80 Anos ou mais , AdultoRESUMO
Sunscreen greatly reduces the risk of skin cancer and is recommended as a critical component of sun protection. There is limited literature on patient preferences for sunscreen characteristics. A cross-sectional survey was administered to patients in an urban city and rural area in the United States. Sun Protection Factor (SPF) was consistently the most important factor for patients when selecting sunscreen. However, numerous preferences for sunscreen characteristics vary between the 2 regions, including dermatologist recommendation, texture, ingredients, cost, broad-spectrum, and brand. Gaps in patient knowledge of sunscreen recommendations may be present and further educational programs may be necessary. J Drugs Dermatol. 2024;23(8):e171-e172. doi:10.36849/JDD.8449.
Assuntos
Preferência do Paciente , População Rural , Neoplasias Cutâneas , Fator de Proteção Solar , Protetores Solares , População Urbana , Humanos , Protetores Solares/administração & dosagem , Estudos Transversais , População Rural/estatística & dados numéricos , Estados Unidos , Feminino , População Urbana/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Adulto , Neoplasias Cutâneas/prevenção & controle , Neoplasias Cutâneas/epidemiologia , Idoso , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem , Queimadura Solar/prevenção & controle , Queimadura Solar/epidemiologia , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
Secondary prevention of skin cancer consists in early detection of malignant lesions through patients' mole self-examination and medical examination. The objective of this study was to assess the self-reported frequency of mole examination in a large, representative sample of the adult general population of 17 countries from all continents. Of a total of 17,001 participants, 4.8% had their moles checked by a dermatologist more than once a year, 11.3% once a year, 8.4% every 2-3 years, 12.4% once in a while, 10.3% once in lifetime, and 52.6% of participants had never performed a mole examination. Egypt was the country with the highest prevalence of people who performed a moles check more than once a year (15.9%), followed by Brazil and the USA. A higher frequency of mole checks was associated with sex (man vs woman), higher education, higher income, fair phototype, history of skin cancer, medical insurance, and sun-protective behaviours. Despite recommendations by health providers, it appears that the frequency of mole checks in the general population is still low. It is necessary for dermatologists to keep informing at-risk populations about the importance of moles check, with particular care regarding categories that less frequently adhere to secondary prevention measures.