| Autor: |
Cabezas JE; School of Medicine, Pontificia Universidad Católica del Ecuador, Quito, Ecuador., Cabezas M; School of Medicine, Pontificia Universidad Católica del Ecuador, Quito, Ecuador., Ureña-López V; Dermatology Service, Centro de la Piel 'CEPI', Quito, Ecuador., Lafuente LV; Dermatology Service, Centro de la Piel 'CEPI', Quito, Ecuador., Méndez-Flores KM; Dermatology Service, Centro de la Piel 'CEPI', Quito, Ecuador., Luna JF; Health Science Faculty, Universidad Internacional SEK, Quito, Ecuador., Miño C; School of Medicine, Pontificia Universidad Católica del Ecuador, Quito, Ecuador.; Public Health School, London School of Hygiene & Tropical Medicine, London, United Kingdom., Palacios-Alvarez SA; School of Medicine, Pontificia Universidad Católica del Ecuador, Quito, Ecuador.; Dermatology Service, Centro de la Piel 'CEPI', Quito, Ecuador. |
| Abstrakt: |
BACKGROUND High altitude increases sunlight exposure, resulting in actinic keratosis, which predisposes people to skin cancer. The dermoscopy procedure evaluates keratotic and pigmented skin changes. This study aimed to describe the clinical and dermoscopic actinic changes in the lips of 25 indigenous children living at high altitude in Ecuador. MATERIAL AND METHODS An observational study was conducted in a public school in the Andes region of Ecuador (August-November 2019). Twenty-five children, males and females, age 5-15 years were assessed by complete physical examination, digital dermoscopic photographs, and punch biopsies. Descriptive statistics and Fisher's exact test were used to summarize and analyze the data. RESULTS We included 17 (68%) boys and 8 (32%) girls with a mean age of 9.8±2.0 years. Clinical lips findings reported desquamation [52% Upper Lip (UL); 40% Lower Lip (LL)], fissuring (8% UL; 8% LL), scabs (8% UL; 8% LL), and discoloration (40% UL; 20% LL). Dermoscopic features included a white-yellow lip color (24% UL; p=0.02). The main morphologic pattern of blood vessels was monomorphic (88% UL; p<0.001), polymorphous (60% LL; p<0.001), dotted pattern (64% UL; 28% LL; p=0.02), and linear-irregular (32% UL; 72% LL; p=0.01). Girls had radiating white structures on UL (p=0.025), while boys presented white structureless areas (UL 63.6%; LL 77.8%; p=0.032). No differences in dermoscopic findings were observed according to Fitzpatrick scale score (FSS). Punch biopsies showed no indications of actinic cheilitis. CONCLUSIONS Dermoscopic features in indigenous children living in high altitudes were related to actinic damage, but histopathological findings were negative. |
