BackgroundMelanoma is a malignant neoplasia that shows high mortality when diagnosed in
advanced stages. Early identification of high-risk patients for the
development of melanoma metastases is the main strategy to reduce
mortality.ObjectiveTo assess the influence of eight epidemiological and histopathologic features
on the development of metastases in patients diagnosed with primary
cutaneous melanoma.MethodsOur historical cohort comprised patients with invasive primary cutaneous
melanoma seen between 1995 and 2012 at a public university hospital and a
private oncologic surgery institution in Southeastern Brazil. The following
variables were analyzed: gender, age, family history of melanoma, site of
the primary tumor, clinical and histologic subtype, Breslow thickness,
histologic ulceration and the mitotic index. Kaplan-Meier univariate test
and multivariate Cox proportional hazard analysis were used to assess
factors associated with disease-free survival.ResultsFive hundred and fourteen patients were enrolled. The univariate analysis
identified the following significant risk factors: gender, age, site of the
tumor, clinical and histologic subtype, Breslow thickness, histologic
ulceration and mitotic index. Multivariate analysis included 244 patients
and detected four significant prognostic factors: male gender, nodular
clinical and histologic subtype, Breslow thickness > 4mm, and histologic
ulceration. The mitotic index was not included in this analysis.Study limitationsSmall number of patients in multivariate analysis.ConclusionsThe following prognostic factors to the development of melanoma metastasis
were identified in the study: male gender, nodular histologic subtype,
Breslow thickness > 4mm and ulceration.
Dyschromicum erythema perstans, or ashy dermatosis, is a rare chronic acquired skin disease characterized by gray hyperpigmented patches with erythematous borders. Its etiology is unknown and there is no specific treatment for the condition. We report a case of ashy dermatosis in a 41-year-old patient with extensive lesions on the trunk and limbs.
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