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. 40year year 40 BlumenauSC SC 198 2019 retrospective crosssectional cross sectional 2336 2 336 2,33 city location type Clark, Clark , (Clark) Breslow. . (Breslow) 4426 44 26 44.2 cases100000 100 000 cases/100,00 inhabitantsyear 5287 52 87 52.8 4673 46 73 46.7 100000 100,00 7 over 42 30 645 64 5 64.5 228 22 8 22.8% 1900 05 0 0. mm therefore underestimated reality 200 4 19 201 233 33 2,3 (Clark (Breslow 442 44. cases10000 10 00 cases/100,0 528 52. 467 46. 10000 100,0 3 6 64. 22.8 190 20 1 23 2, cases1000 cases/100, 1000 100, 22. cases100 cases/100 cases10 cases/10 cases1 cases/1 cases/

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.

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.

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.

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.

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.

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.

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.

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% nos pacientes com melanoma maligno e de 31,2% 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% 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.

FUNDAMENTOS: A morbidade dos carcinomas basocelulares da pele vem aumentando no mundo. No Brasil não existem dados sobre coeficientes de morbidade desses cânceres. OBJETIVOS: Detectar a morbidade, analisar e classificar os cânceres basocelulares da pele em Blumenau, de 1980 a 1999, segundo as principais características clínicas e histológicas. MÉTODOS:Utilizaram-se exames histopatológicos oriundos dos laboratórios de Blumenau, revisados quanto às variáveis sexo, idade, localização primária e tipo histológico. Os coeficientes de morbidade anuais foram calculados utilizando o número de casos de neoplasias encontradas e a população anual estimada entre 1980 e 1999. RESULTADOS: Identificaram-se 5.254 carcinomas basocelulares, com maior freqüência nas mulheres e na faixa etária acima de 50 anos. A localização primária em áreas expostas foi predominante. Os coeficientes de morbidade encontrados variaram entre 51,5 casos por 100.000 habitantes em 1980 e 225 casos por 100.000 habitantes em 1999. CONCLUSÕES: Os cânceres basocelulares da pele encontrados em Blumenau estão dentro do padrão encontrado na literatura de acordo com a idade, localização anatômica e tipos histológicos. Os coeficientes de morbidade desse tumor são os únicos encontrados na literatura brasileira pesquisada.

BACKGROUND: Morbidity from basal cell carcinomas is increasing worldwide. In Brazil there are no studies about morbidity rates of this type of cancer. OBJECTIVES: To determine morbidity and to analyze and classify the basal cell carcinomas diagnosed in the city of Blumenau, from 1980 to 1999, according to their major clinical and histological features. METHODS:The author reviewed the histopathological findings of two laboratories of the city of Blumenau, considering the variables sex, age, primary site and histological type. The morbidity rates were calculated using the number of basal cell carcinomas found and the annual population estimated from 1980 to 1999. RESULTS: A total of 5254 tumors were identified, with a higher incidence in females and in subjects older than 50 years. Primary site in exposed areas was predominant. Morbidity rates varied from 51.5 cases per 100,000 inhabitants/year in 1980 to 225 cases per 100000 inhabitants in 1999. CONCLUSIONS: Basal cell carcinomas in Blumenau have distribution patterns similar to those reported in the literature regarding age, anatomical site and histological types. Morbidity rates of this tumor were found in the Brazilian literature.

FUNDAMENTOS: A morbidade dos carcinomas espinocelulares da pele vem aumentando no mundo. No Brasil não existem dados sobre coeficientes de morbidade desses cânceres. OBJETIVOS: Detectar a morbidade, analisar e classificar os cânceres espinocelulares da pele e semimucosa do lábio em Blumenau, de 1980 a 1999, segundo as principais características clínicas e histológicas. MÉTODOS: Foram utilizados exames histopatológicos oriundos dos laboratórios de Blumenau, revisados quanto às variáveis sexo, idade, localização primária e tipo histológico. Os coeficientes de morbidade anuais foram calculados utilizando o número de casos de neoplasias encontradas e a população anual estimada entre 1980 e 1999. RESULTADOS: Identificaram-se 2.195 tumores, com maior freqüência em homens e na faixa etária acima de 60 anos. A localização primária em áreas expostas foi predominante. Os coeficientes de morbidade encontrados variaram entre 31,1 casos por 100.000 habitantes em 1980 e 86,3 casos por 100.000 habitantes em 1989. CONCLUSÃO: Os cânceres espinocelulares da pele e semimucosa do lábio encontrados em Blumenau, de acordo com a idade, localização anatômica e tipos histológicos, têm semelhança com os da literatura, e os coeficientes de morbidade são os únicos encontrados na literatura brasileira pesquisada.

BACKGROUND: The morbidity from skin squamous cell cancers is increasing worldwide. In Brazil there are no studies on the morbidity coefficients for this type of cancer. OBJECTIVES: To determine the morbidity coefficients, analyze and classify the squamous cell cancers diagnosed in the city of Blumenau-SC-Brazil, from 1980 to 1999, according to their most important clinical and histologic features. METHODS: The author reviewed the histopathological exams at two laboratories in the city of Blumenau, with respect to sex, age, anatomical site and histologic type. The morbidity coefficients were calculated using the number of squamous cell cancers found and estimated annual population. RESULTS: We identified 2,195 tumors, with a higher incidence in males and individuals over 60 years of age. Regarding the anatomical site, we found more tumors in sun exposed areas. The morbidity coefficients varied from 31.1 cases per 100,000 inhabitants/year in 1980 to 86.3 cases per 100,000 inhabitants in 1989. CONCLUSIONS: Squamous cell cancers in Blumenau present similar patterns of distribution according to age, anatomical site and histological types as the world literature and the coefficients of morbidity were the only ones found in the Brazilian literature consulted.