BACKGROUNDThe incidence of melanoma has been steadily rising in past decades. Although it accounts for only 3% of all skin cancers, it is responsible for 75% of deaths. OBJECTIVEto describe the epidemiological aspects of melanoma in a university hospital setting over a period of 20 years. METHODSA total of 166 patients were analyzed between January 1990 and January 2010 for clinical and histological variables and correlations between them. A 5% level of significance was adopted. RESULTSThe majority of patients were Caucasians (74%), females (61%), with a mean age at diagnosis of 55. The predominant histological type was lentigo maligna/lentigo maligna melanoma (35.7%) and the head and neck was the most affected site (30.7%). Among non-Caucasians, the acral region was the most affected. Most tumors were in situ (41.1%). Growth of the lesion was the most frequent complaint (58.1%) and bleeding was most frequently associated with melanomas with a depth > 4mm. There were seven deaths (4.2%), with a high risk among men, non-Caucasians and those under 20 years of age, with a Breslow's depth > 2mm, with lentiginous acral melanoma and with a history of growth and bleeding. CONCLUSIONSOur sample differs from most of the studies in the predominant location (head and neck), histological type (lentigo maligna/ lentigo maligna melanoma) and a major risk of death under the age of 20, which could be with a reflex of regional variation. Broader studies are necessary for validation of the results.

História da doençaPaciente pardo, de 16 anos, com manchas hiper e hipocrômicas no tronco desde o nascimento, cujo tamanho aumentou durante a infância, proporcionalmente ao seu crescimento.Ao exame notavam-se máculas hiper e hipocrô-micas adjacentes, de contorno geográfico, no lado direito do tronco, anterior e posteriormente, ultrapassando a linha média e estendendo-se para o braço direito e região axilar (Figuras 1, 2 e 3).Exame histopatológico: pele normal. Comentários

Fibromatose hialina juvenil e hialinose sistêmica infantil são desordens autossômicas recessivas, raras da infância. À histologia, há depósito de material hialino na derme e subcutâneo. As características clínicas principais são: lesões pápulo-nodulares, hipertrofia gengival, contratura articular, lesões ósseas osteolíticas e retardo no crescimento. Mutações no mesmo gene foram identificadas nas duas condições, sugerindo que sejam espectros da mesma doença.

An 8-year-old girl was referred for evaluation of multiple lesions on the neck, axillae, and genitalia. A great number of milia-like lesions were also noticed on the palms and discrete keratotic plugs on the soles. Histopathology from lesions on the neck, axilla, and vulva were consistent with syringoma. On the palms and soles, eccrine ducts cystically dilated filled with proteinaceous material and calcifications were found. Although the nature of palmar and plantar lesions in our patient is uncertain, we think that they should be related to the other syringomas on her skin.