Medicina

URI Permanente desta comunidadehttps://repositorio.cesupa.br/handle/prefix/40

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Análise transversal da casuística de câncer não-melanoma atendida no serviço de dermatologia do Centro de Especialidades Médicas do Centro Universitário do Estado do Pará (2012-2020)
(Centro Universitário do Estado do Pará, 2022-11-10) Dória, Beatriz Cavalcanti; Monteiro, Bruna Nogueira; Texeira, Cláudio Eduardo Corrêa; http://lattes.cnpq.br/7448998858430931; Amin, Gabriela Athayde; http://lattes.cnpq.br/8604283847300465; Moutinho, Ana Thais Machado; http://lattes.cnpq.br/3065574302582680
The skin is the largest organ in the human body. Among the diseases that can affect it, that is the skin cancer, which is of great relevance to the public health. To carry out a sectional analysis of the non-melanoma cancer series treted at the Dermatology Service of the Medical Specialties Center (CEMEC) of the University Ceter of the State of Pará (CESUPA, 2012-2020). Observational, cross-sectional, analytical and descriptive study. Data were collected directly from the medical records of patients treated at the Center for Medical Specialties of CESUPA between 2012 and 2020. After pre-analysis, the sample consisted of n = 65 of all patients seen, who have a diagnosis of skin cancer non-melanoma evidenced by biopsy. Data analysis was performed by comparing prevalent proportions with the “N-1” chi-square test (n = 65, ⍺ = 0,05, Cohen’s D: 0,2, test power: < 0,25) and by calculating the 95% confidence interval for the difference in prevailing proportions. The entire analytical process was performed using the R statistical computing program (www.r-project.org). In the period evaluated, it was evident that, within this sample, the prevalence of elderly people ( n = 50) was higher that that of adults (n = 15). Regarding gender, there was a predominance of females (n = 39). Addressing the phototype, IV (n = 18) prevailed in relation to III (n = 10), II (n = 5), and I (n = 1). The absence of phototype information was also identified in 46% of the collected medical records. As for photoexposure, 22 (34%) had no record of this information, while 43 (66%) had photoexposure. Photoprotection, in turn, was presented in the minority of patients (n = 3) in relation to the majority not photoprotected (n = 25), and this information was not present in 38% (n = 25) of the evaluated medical records. Going to the type of skin cancer, most were diagnosed with BCC (n = 42), followed by Bowen’s Disease (n = 10), SCC (n = 4) and, finally, 8% (n = 4) had other less prevalent alterations. The recurrence of BCC was higher (n = 9) than other types. It is possible to conclude that the general profile with the highest prevalent proportion was of elderly patients, female, phototypes III and IV, without photoprotection, diagnosed with nodular BCC, without recurrence after surgical treatment and lesion removal. However, the scarcity of complete records in the medical records proved to be a limiting factor for measuring potential associations and clarifications.
Aspectos clínicos e histopatológicos do lúpus eritematoso cutâneo registrados em serviço de referência do estado do Pará no período de 2010 a 2017
(Centro Universitário do Estado do Pará, 2019) Lima, Luis Felipe Silva; Gouvêa, Rebecca Ribeiro; Bittencourt, Maraya de Jesus Semblano; Amin, Gabriela Athayde; http://lattes.cnpq.br/8604283847300465; http://lattes.cnpq.br/6566823528602319
INTRODUCTION: Systemic Lupus erythematosus (SLE) is an autoimmune and multifactorial disease characterized by a chronic inflammatory process resulting from changes in immune regulation due to the production of autoantibodies against various cellular constituents. The skin is one of the target organs most affected by the disease, and genetic, hormonal and environmental factors interact and interfere with the development of skin disease. The cutaneous manifestations can be divided into specific and nonspecific, according to their clinical and histological characteristics, and the specific ones can be found in the skin in three ways: chronic (CCLE) ; Subacute (SCLE) and Acute (ACLE). It presents genetic, autoimmune, hormonal and environmental factors as pathogenic substrates, and its clinical and laboratory characteristics help the diagnosis, which can be confirmed by histopathological study. OBJECTIVES: This study aims to elucidate the histopathological changes that occur in the LECC and its subtypes, correlating the disorders analyzed in the slides with the clinical manifestations presented by the patient. MATERIAL AND METHODS: This was a cross-sectional, retrospective and descriptive study conducted at the dermatology service of the Federal University of Pará through the analysis of medical records in which the disease was histologically confirmed. RESULTS: We analyzed epidemiological and clinical data from a group of 55 patients with Cutaneous lupus erythematosus (CLE) . The average age at disease onset was 42 years. There was a predominance of females (80% of cases). 64% of the cases affected the face, and 51% were disseminated or generalized in the skin (with lesions also below the neck). There was a predominance of erythema and peeling (87% and 47% of cases), followed by atrophy (42%). The most affected phototype was IV in 61.8% of cases. 33% of the cases were CCLE, followed by ACLE in 13 patients (24%) and SCLE in four patients (7%). The most frequent dermatological lesion was erythema (87%), followed by scaling, infiltration and atrophy. 29% of patients had positive antinuclear factor. In the epidermis it was observed that all cases presented vacuolar alteration, 64% of patients presented basal thickening and 58% atrophy. In the dermis, all patients presented lymphocytes in the infiltrate and 87% presented mucin in the connective interstices. CONCLUSION: Understanding the changes that appear at the microscopic level is of paramount importance for understanding the course of the disease and, thus, enabling the elaboration of an appropriate therapeutic approach. The medical professional plays a fundamental role in the management of patients with Cutaneous lupus erythematosus, and their duty is to understand all its universality for a satisfactory clinical follow-up and the prevention of possible injuries. Although not a common disease, its chronicity leads to the accumulation of cases in clinical outpatient clinics. In addition, although progress is good in most cases, delayed initiation of treatment can lead to disfiguring scars.
Avaliação do uso de hidroclorotiazida em pacientes com carcinoma basocelular atendidos em ambulatório de dermatologia
(Centro Universitário do Estado do Pará, 2019-11-20) Rodrigues, Pedro Henrique Pantoja Souza; Franco, Rodrigo Carneiro; Amin, Gabriela Athayde; Carneiro, Francisca Regina Oliveira; http://lattes.cnpq.br/1387234135281918; http://lattes.cnpq.br/8604283847300465; Bittencourt, Maraya de Jesus Semblano; http://lattes.cnpq.br/6566823528602319; Lima, Caren dos Santos; http://lattes.cnpq.br/6225022147519510
Introduction: According to the National Cancer Institute (INCA), nonmelanoma skin cancer represents 30% of all malignant neoplasm in Brazil. These tumors have low lethality but high morbidity, so recognition of risk factors and early diagnosis are determinant for prognosis. Basal cell carcinoma arises from non-keratinized cells from the basal layer of the epidermis and represents 76% of all non-melanoma skin cancer (CPNM). In Brazil, approximately 165,580 new cases of this neoplasm were estimated, with tendency to increase this rate for the next years. It is locally invasive, usually nonagressive and destructive of skin, despite its low metastatic potential, being more common among the elderly, white populations and male. Its main clinical presentation is a papule ou nodule with a pearly aspect, often with typical telangectasy located mainly in the head and neck region. Some studies have related hydrochlorothiazide, one of the main antihypertensive drugs used in Brazil, as a potential risk factor for the development of Basal Cell Carcinoma (CBC). This led the National Health Surveillance Agency (ANVISA) to release a note informing about the increased risk of nonmelanoma skin cancer with the use of the drug and recommending that physicians report this risk to patients, as well to guide patients for regular self-examination of the skin looking for new lesions. Current studies, however, are recent and conflicts about this association. Objective: Evaluate the relationship between hydrochlorothiazide use and the risk of developing basal cell carcinoma. Materials and Methods: A population-based case-control study was conducted, collecting cases (histopathological CBC confirmations) of the Pathology Laboratory of the Dermatology Service of the Center for Medical Specialties of the University Center of Pará (CESUPA). Controls were matched 3:1 by age and sex. Data was obtained from medical record or interview. Analytical statistics were used to evaluate the results of the categorical variables of the sample through the G and Chi-squared tests adherence and independence. Odds Ratio was calculated using Logistic Regression, with a 95% confidence interval. Results: We obtained 36 cases of BCC and 108 controls. The use of hydrochlorothiazide increased the risk of developing basal cell carcinoma (Odds Ratio 2.53 and 95% CI 1.04 - 6.14). There seems to be a cumulative dose relationship, evidenced by Odds ratio 2.80 and 95% CI 1.01 - 7.77 for doses greater than or equal to 27,000mg, corresponding to 3 years or more of use, which is not observed at doses lower than this. Conclusion: The use of hydrochlorothiazide increase the risk of developing basal cell carcinoma.

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