Non-melanoma skin cancers are the most common malignant neoplasms in humans. About 95% of all non-melanoma skin cancers are represented by basal cell carcinoma and squamous cell carcinoma. Their prevalences are still increasing worldwide, representing an important public health problem. The genetic alterations underlying basal cell carcinoma and squamous cell carcinoma development are only partly understood. Much interest lies in determining the genetic basis of non-melanoma skin cancers, to explain their distinctive phenotypes, biological behaviors and metastatic potential. We present here a molecular genetic update, focusing on the most frequent genes and genomic instability involved in the development and progression of non-melanoma skin cancers. Keywords: Carcinoma, basal cell; Carcinoma, squamous cell; Chromosomal instability; Loss of heterozygosity; Microsatellite repeats; Skin neoplasms; Skin neoplasms/genetics Resumo: Os cânceres cutâneos não melanoma são as neoplasias malignas mais comuns em humanos. O carcinoma basocelular e o carcinoma espinocelular representam cerca de
BACKGROUND: Chronic renal failure affects almost all the systems of the body, including the skin and appendages. The nail disorders most commonly found in patients with chronic renal failure are half and half nails, absent lunula and splinter hemorrhages. OBJECTIVES: To evaluate the spectrum and the frequency of nail disorders in patients with chronic renal failure submitted to hemodialysis and compare them with a paired sample from the general population. METHODS: A case-controlled study paired for gender and age was conducted in which nail disorders were investigated in the two groups. RESULTS: At least one nail disorder was found in 86% of the hemodialysis patients and in 75% of subjects in the control group. Absent lunula (62.9%) and half and half nails (14.4%) were more common in the hemodialysis group compared to the control group and this difference was statistically significant (p<0.05). Longitudinal striae were more common in the control group compared to the hemodialysis group (24.1%). CONCLUSIONS: Absent lunula and half and half nails were the most common nail disorders found in patients on hemodialysis, corroborating the findings of previous studies. Longitudinal striae were more common in the control group and future studies may clarify whether structural abnormalities such as absent lunula may be related to this finding. Key words: chronic renal failure; kidney dialysis; nail disorders. Resumo: FUNDAMENTOS:A insuficiência renal crônica atinge quase todos os sistemas do organismo, inclusive pele e anexos. As alterações ungueais mais observadas nos pacientes com insuficiência renal crônica são: unhas meio a meio, ausência de lúnula e hemorragia em estilhas. OBJETIVOS: Avaliar o espectro e a frequência de alterações ungueais nos pacientes com IRC, submetidos à hemodiálise (HD), e compará-los com uma amostra pareada da população geral. MÉTODOS: Realizado um estudo caso-controle, pareado por gênero e idade, onde 2 grupos foram estudados com relação às alterações ungueais presentes. RESULTADOS: 86% dos pacientes em HD e 75% do grupo controle tiveram, pelo menos, uma alteração ungueal. Ausência de lúnula (62,9%) e unha meio a meio (14,4%) as alterações foram estatisticamente relevantes no grupo HD, em relação ao grupo controle (p<0,05%). Estrias longitudinais foram mais comuns nos controles em relação ao grupo HD (24,1%). CONCLUSÕES: Ausência de lúnula e unha meio a meio as alterações ungueais foram mais encontradas nos pacientes em HD, corroborando com achados relatados, em estudos anteriores. Estrias longitudinais foram mais observadas no grupo controle e estudos posteriores poderão elucidar se alterações estruturais, tal qual a ausência de lúnula, poderiam relacionar-se a este achado.
DEDICATÓRIA ____________________________________________________________________À minha esposa Kátia Rocha Martinez, pelo carinho, amizade e apoio nos momentos difíceis, além da paciência e compreensão ao longo desses anos de cumplicidade e amor.Aos meus queridos irmãos José Roberto e Lílian Cristina que com carinho, amizade e incentivo, contribuíram muito para meu desenvolvimento pessoal Aos meus queridos pais Vicente e Leonora (in memoriam) pelos ensinamentos, princípios e pela minha existência. AGRADECIMENTOS __________________________________________________________
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