Federal University of Maranhao, Brazil
Title: Title: Basal cell carcinoma in African-Americans: Two case reports
Dimitre Luz Felipe da Silva is a medical student at Federal University of Maranhao, Brazil. In june 2012, he received a scholarship from the Brazilian government through the program Science Without Borders, studying at Cal. State Fullerton during the summer, where he received the prize Dean’s list, and then, studying at Loyola University Chicago, where he is involved with the project “Psoriasis patient education study”. Back in Brazil, he is heading the project “Social impact caused in patients with acne”. He was president of the Dermatology League and received a scholarship for the project “Reconstructive Surgery in patients with skin cancer”.
Introduction: Basal Cell Carcinoma (BCC) is the less aggressive type of skin tumor. It consists of cells which resemble
epidermis basal cells, and metastases are described as exceptions. However, it can invade and destroy adjacent tissues,
including bones. It is the most common cutaneous malignancy, with 65% of the total. It usually occurs after 40 years old,
with sun exposure and fair skin as related factors, being rare in African-Americans. BCC is generally located on sunexposed
areas, like face (nose, ears and neck) and less commonly in trunk and extremities. The most frequent skin cancer
in blacks is Squamous Cell Carcinoma, followed by BCC. There are different histologic patterns in BCC and the main
characteristic is the presence of palisade basaloid cells masses arranged peripherally. The diagnosis is clinical and must be
confirmed histologically. The choice for therapeutic procedures depends on the location, size and depth of the lesion.
Case Reports: Case 1: A 53-years-old male, black, husbandman, presenting plaque lesion with pearly and pigmented edges on the nasal dorsum (Figure 1). Wide resection was made with safety margin, followed by reconstruction with a graft of frontal region (Figure 2). Case 2: A 57-years-old male, black, husbandman, presenting nodular-ulcerated lesion with pearly and pigmented edges on the right nasal ala (Figure 3). The resection with a wide safety margin was made, followed by reconstruction with graft of right genian region, bent at its end to reconstructing the inner portion of the nostril after two weeks (Figure 4). The diagnosis was confirmed through histopathology, which showed clear surgical margins
Discussion: Skin cancer affects mainly Caucasian people. It is rare in blacks, because the higher melanin content and dispersion pattern of melanosomes protect against the carcinogenic effects of sunlight. These cases are rare, but confirmed that ultraviolet radiation is an important risk factor for skin cancer, especially BCC. These two patients were over 40 years old; group most affected by skin cancer, and was submitted to prolonged sun exposure. Surgical resection was curative in both cases, since it was accomplished with good safety margin.