Dermatoscopy is effective method for diagnostics of skin neoplasms in workers with industrial carcinogens

Introduction. One of the urgent problems of medicine around the world is the growth of malignant diseases. The impact of the production environment in developing professional and production-related skin malignancies is a sensitive area of occupational health.

The high prevalence of precancerosis and the increase in the incidence of skin cancer in people of working age indicates the need to improve diagnostic and preventive measures. One of the most effective recognized non-invasive differential diagnoses of skin tumors with high diagnostic accuracy and sensitivity is dermatoscopy.

The study aims to substantiate the importance of dermatoscopic diagnosis of skin neoplasms in workers with industrial carcinogens.

The researchers analyzed the available literature and statistical data on the impact of industrial carcinogens on benign and malignant skin lesions in workers in various industries.

Specialists from Clinic of the "Izmerov Research Institute of Occupational Health" examined 1,136 people during periodic medical examinations. The features of the signs of neoplasms evaluate according to the principle of their presence or absence.

There were two groups: group 1 (n=648) consisted of persons who have contact with industrial carcinogens according to the special assessment of working conditions (SAWC), group 2 (n=488) — persons who do not have contact with carcinogens in the workplace.

We found that the frequency of benign skin neoplasms increases depending on the length of work in contact with a production carcinogen.

Researchers developed the criteria of clinical and anamnestic signs (the main of which are the working conditions). Dermatoscopic criteria for the initial signs of malignancy of skin neoplasms allow us to form a group of dynamic observations of skin neoplasms in patients working with carcinogens during periodic medical examinations.

We formed a group of 38 people (29 from the first and 9 from the second group) for monitoring the dynamics of changes in neoplasms with an appearance to a dermatovenerologist after three months. Specialists sent seven people for additional examination by an oncologist to clarify the degree of existing signs of dysplasia.

The formation of a dynamic observation group with the risk of malignancy of skin neoplasms will optimize early diagnosis and ensure high efficiency of treatment in outpatient settings.

1. Christina Fitzmaurice, MD; Degu Abate, MSc; Naghmeh Abbasi, MSc; Hedayat Abbastabar, PhD; Foad Abd-Allah, MD; Omar Abdel-Rahman, MD. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017. A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncology. 2019; 5(12).

2. The state of cancer care for the population of Russia in 2019. Ed. A.D. Kaprina, V.V. Starinsky, A.O. Shahzadova. M.: Moscow Scientific Research Institute of P.A. Herzen — branch of the National Medical Research Center of Radiology; 2020.

3. Lavlinskaya L.I., Vasilieva D.N. Organizational model of improving the prevention of patients with paraneoplastic skin diseases. Voronezh: LLC "PT"; 2014.

4. Izmerov N.F. The concept of long-term socio-economic development of the Russian Federation for the period up to 2020 ("strategy 2020") and the preservation of the health of the working population of Russia. Med. truda i prom. ekol. 2012; 3: 1–8.

5. Gelfond M.L. Differential diagnosis of skin tumors in the practice of dermatologists and cosmetologists of the FSBI "Research Institute of Oncology named after N.N. Petrov "Ministry of Health and Social Development of the Russian Federation. St. Petersburg; 2012.

6. Gantsev Sh.Kh., Yusupov A.S. Squamous cell carcinoma of the skin. Prakticheskaya onkologiya. 2012; 13(2): 80–91.

7. Shpagina L.A., Panacheva L.A. Ecological and industrial aspects of tumor diseases. Novosibirsk: Sibmedizdat NSMU; 2008.

8. Smulevich V.B. Profession and cancer. M.: Medicine; 2000.

9. Serebryakov P.V. Features of examination of occupational carcinogenic risk. Gigiyena i sanitariya. 2015; 94 (2): 69–72.

10. Starinskiy V.V., Sosnovskaya E.Ya., Gretsova O.P., Petrova G.V. Modern aspects of professional oncopathology. Onkologiya. Zhurnal imeni P.A. Gertsena. 2014; 3 (6): 41–5.

11. Vavrinchuk A.S., Marochko A.Yu. Skin cancer: risk factors, epidemiology in Russia and in the world. Sovremennye problemy nauki i obrazovaniya. 2015; 6.

12. Kubanov A.A., Sysoeva T.A., Gallyamova Yu.A., Bisharova A.S., Mertsalova I.B. Algorithm for examining patients with skin neoplasms. Meditsinskij nauchno-prakticheskij zhurnal "Lechashhij vrach". 2018-03-20.

13. Valeeva E.T. et al. Occupational diseases and intoxication developing in workers of petrochemical plants in modern conditions. Ekologiya cheloveka. 2010; 3: 19–23.

14. Young C., Rushton L. Occupational cancer in Britain: Skin cancer. Br J Cancer. 2012; 107(Suppl 1): S71–5.

15. Timasheva G.V. et al. The role of laboratory research in the diagnosis of early metabolic disorders in workers of petrochemical production. Med truda i prom. ekol. 2013; 3: 4–15.

16. Cancer Risk Associated With Exposure to Bitumen and Bitumen Fumes: An Updated Systematic Review and Meta-Analysis Mundt, Kenneth A.; Dell, Linda D.; Crawford, Lori. More Journal of Occupational and Environmental Medicine. 60(1): e6–e54.

17. Gelfond M.L. Differential diagnosis of skin tumors in the practice of dermatologists and cosmetologists. Prakticheskaya onkologiya. 2012; 13(2): 69–79.

18. Dermatoscopy. G. Peter Sawyer, Giuseppe Argenziano, Rainer Hoffmann-Wellengof, Iris Zalaudek; transl. from English. M.: MEDpress-inform; 2014.

19. Rashmi G.S. Phulari, Khushbu Buddhdev, Rajendrasinh Rathore, Sweety Patel. Seborrheic keratosis. Journal of Oral and Maxillofacial Pathology. 2014; 18(2): 327–30.

20. Joseph R. Kallini, Supriya Jain, Amor Khachemoune. Lentigo Maligna: Review of Salient Characteristics and Management. American Journal of Clinical Dermatology. 2013; 14(6).

21.