marcadores e fatores de risco para queratoses actínicas e carcinomas basocelulares: um estudo de caso-controle risk markers and risk factors for actinic keratosis and basal cell carcinoma: a case-control study

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ID: 158831
2004
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Abstract
FUNDAMENTOS: A incidência das neoplasias malignas cutâneas vem aumentando em todo o mundo, havendo pouca informação no Brasil sobre seus marcadores e suas lesões precursoras. OBJETIVOS: Identificar fatores de risco e marcadores cutâneos para essas lesões MÉTODOS: Caso-controle aninhado num estudo de prevalência de base populacional com adultos com idade igual ou superior a 50 anos, moradores da zona urbana de Pelotas. No estudo de prevalência aplicou-se um questionário com questões específicas para rastreamento de possíveis lesões cutâneas malignas ou pré-malignas recentes. As pessoas que responderam afirmativamente foram examinadas por dois médicos especialistas (padrão ouro). Uma subamostra daqueles que responderam não às perguntas já mencionadas foi sorteada e também foi examinada. A amostra total ficou constituída por 288 pessoas: 74 casos positivos, conforme o padrão ouro, e 214 controles sem lesões. O número e o tipo de lesão foram avaliados no momento da consulta com os especialistas. O protocolo continha variáveis sociodemográficas, comportamentais e exame dermatológico. A medida de efeito utilizada foi o Odds Ratio (OR), e para o controle dos fatores de confusão utilizou-se a regressão logística, com modelo hierarquizado RESULTADOS: Na análise multivariada permaneceram significativas as seguintes variáveis: idade 80 anos OR=10,21, pele branca OR=4,85, cabelos loiros/vermelhos OR= 3,69; como marcadores de risco: elastose solar OR=4,35, cutis rhomboidalis nuchae OR= 2,88 e mais de 10 melanoses solares no dorso das mãos OR= 6. CONCLUSÃO: Pessoas idosas, com pele clara, cabelos claros, com elastose solar, cutis rhomboidalis nuchae e grande número de melanoses solares nas mãos têm maior risco de apresentar queratoses actínicas e carcinomas basocelulares.
BACKGROUND: Incidence of cutaneous neoplasms is increasing worldwide and there is little information from South Brazil about its markers and premalignant lesions. OBJECTIVES: To identify the risk factors and dermatological risk markers for cutaneous malignancies. METHODS: A case-control study nested in a population-based prevalence survey was performed in adults aged 50 living in the urban area of Pelotas. In the prevalence study, a questionnaire was applied to identify possible malignant or premalignant lesions and these subjects were examined by two doctors (gold standard). A sub-sample of the persons who answered No to the questions was also sent to the Ambulatory for the same procedure. The sample was constituted of 288 persons: 74 cases and 214 controls. The number and the type of efflorescence was evaluated at the interview with the doctors. The questionnaire also investigated socioeconomic level, behavioral variables and skin examination. The measure of effect used was the Odds Ratio (OR); and to control confounding factors, logistic regression, with hierarchical pattern, was utilized. RESULTS: In the multivariate analysis, the following variables remained significant: age 80 years (OR = 10.21), white skin (OR = 4.85), blond or red hair (OR = 3.69) and risk markers: solar elastosis (OR = 4.35), cutis rhomboidalis nuchae (OR = 2.88) and more than 10 melanoses on the back of the hands (OR = 6.0). CONCLUSION: Elderly individuals, with fair skin and hair, solar elastosis, cutis rhomboidalis nuchae and a great number of melanoses on the hands, are at high risk for actinic keratosis and basal cell carcinoma.
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Authors ;Fernando Passos da Rocha;Ana M. B. Menezes;Hiram Larangeira de Almeida Junior;Elaine Tomasi
Journal Theriogenology
Year 2004
DOI
10.1590/S0365-05962004000400006
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