Prevalence of Skin Tumors and Non-Tumoral Skin Diseases Determined Van Lake Around
Abstract
Deri hastalıkları fizyolojik, sistemik, hormonal, metabolik, estetik, psikolojik ve sosyal sorunlara yol açabilen veya bu sorunların sonucu olarak karşımıza çıkabilen sık görülen hastalıklardır. Ayrıca bir bölgede koruyucu sağlık hizmetlerinin planlanıp uygun sağlık politikalarının belirlenebilmesi için epidemiyolojik verilerin bilinmesi önem arz etmektedir. Çalışmada yaş-hastalık-cinsiyet dışlanmaksızın geniş bir perspektifte, yöremiz deri hastalıklarının prevelansını ve sosyodemografik özelliklere göre dağılımını belirlemeyi amaçladık. Gereç ve Yöntemler: Bu çalışmada Haziran 2010-Haziran 2019 tarihleri arasında Van Yüzüncü Yıl Üniversitesi (Van YYÜ) Tıp Fakültesi Dursun Odabaş Tıp Merkezi Patoloji Anabilim Dalı'ında histopatolojik tanı almış tüm deri tümörleri ve non-tümöral deri hastalıkları retrospektif olarak analiz edildi. Raporlama çalışmalarında gereklilik halinde histokimyasal, immünhistokimyasal ve/veya immünfloresan bulgular kullanıldı. Olguların hastalık tanıları, yaşları, cinsiyetleri, başvuru yılları, istem yapan bölümler ve biyopsi türleri kaydedildi. Çalışmamızda yaş sınırlaması yapılmadığı için hastalar öncelikle 18 yaş altı ve 18 yaş üstü olarak iki ana gruba ayrıldı. Bu iki ana yaş gurupları da kendi içlerinde üç'er gruba ayrıldı. Başlangıçta hastaların demografik verileri ve tanıları çalışmaya dahil edilen hasta sayısı üzerinden genel bir değerlendirmeye alındı. Daha sonra tanılarla ilgili veriler, demografik veriler eşliğinde, hastalıklar ve genel hastalık grupları üzerinden ayrı ayrı analiz edildi. Ayrıca çalışmada kullanılan tüm histopatolojik ve immünfloresan şekiller bölümümüz arşiv verilerinden elde edilmiştir. Bulgular: Yaş sınırlaması yapılmaksızın sürdürülen arşiv taramasında toplam 7248 hasta girişi tespit edildi. Toplamda 219 hastalık, 26 genel hastalık grubu altında sınıflandırıldı. Hastaların 3616'sı (%49,9) erkek, 3632'si (%50,1) kadın'dı. Kadın ve erkek hastaların başvuru sayıları arasında istatistiksel olarak herhangi bir fark yoktu (p=0,860). En çok hasta sayısının 2016 yılına ait olduğu izlendi. Hastaların ortalama yaşı 38,41±21,40; ortanca yaşı 37(<1-94) olarak hesaplandı. Yaş, cinsiyet gibi demografik parametreler hesaba katılmaksızın en sık tanı alan üç genel hastalık grubu; epidermisin kist ve tümörleri (%18,5), noninfeksiyöz vezikülobüllöz ve vezikülopüstüler hastalıklar (%15,8), noninfeksiyöz eritematöz-papuler ve skuamöz hastalıklar (%14,7)' idi. Hastalık gruplarından ve yine demografik verilerden bağımsız olarak en sık görülen ilk üç hastalık tanısının ise; melanositik nevüs (%9,0), bazal hücreli karsinom (%5,4) ve kontakt dermatit (%5,0) olduğu tespit edildi. Cinsiyet grupları ön plana alınarak yapılan incelemeye göre erkeklerde en sık görülen hastalık tanı grubu epidermisin kist ve tümörleri (%22,9); kadınlarda ise noninfeksiyöz eritematöz, papuler ve skuamöz hastalıklar (%16,1) olarak saptandı. Erkeklerde en sık görülen üç hastalık tanısının melanositik nevüs (%7,6), bazal hücreli karsinom (%6,3) ve kontakt dermatit (%5,0); kadınlarda ise en sık görülen üç hastalık tanısının melanositik nevüs (%10,3), kontakt dermatit (%4,9) ve eritema diskromikum perstans (%4,7) olduğu izlendi. Yaş grupları ön planda tutulduğunda, 18 yaş altı pediatrik olgularda en sık görülen hastalık tanı grubu noninfeksiyöz vezikülobüllöz ve vezikülopüstüler hastalıklar (%18,3) olup; en çok görülen üç hastalık tanısının lökositoklastik vaskülit (%10), melanositik nevüs (%7,3) ve atopik dermatit (%4,8) olduğu saptandı. Yaş grupları ön planda tutulduğunda, 18 yaş ve üzeri grupta ise en sık görülen hastalık tanı grubu epidermisin kist ve tümörleri (%21,5) olup; en sık görülen üç hastalık tanısının melanositik nevüs (%9,4), bazal hücreli karsinom (%6,5) ve kontakt dermatit (%5,3) olduğu saptandı. Hastalıklar ayrıca neoplastik ve non-neoplastik deri hastalıkları olarak da sınıflara ayrılıp değerlendirilmeye tabi tutuldu. Yaş ve cinsiyetten bağımsız olarak çalışmaya dahil edilen 7248 hastanın %64,6'sı non-neoplastik deri hastalıkları grubunda iken %35,4'ü neoplastik deri hastalıkları grubunda yer almaktaydı. Neoplastik deri hastalıklarının %32,3'ünün malign neoplazi, %62,9'unun benign neoplazi ve %4,8'inin prekanseröz ya da borderline lezyonlar olduğu görüldü. Neoplastik deri hastalıkları oranı erkeklerde %37,7 ve kadınlarda %33,1 olduğu saptanırken; cinsiyete göre deri hastalıkları gruplarının istatistiksel olarak anlamlı derecede farklılık gösterdiği saptandı (χ2=17,160; p=<0,001). Ayrıca deri malign neoplazi oranı erkeklerde (%36,5) daha yüksek olduğu saptandı (χ2=24,052; p=<0,001). Yaş sınırlaması yapılmaksızın derinin tüm malign neoplazi grubunda en çok görülen üç hastalık tanısının 'bazal hücreli karsinom' (%46,7), 'skuamöz hücreli karsinom' (%21,8) ve 'mikozis fungoides' (%6,7) olduğu saptanırken; tüm benign neoplazi grubunda en çok görülen beş hastalık tanısının 'melanositik nevüs' (%40,3), 'seboreik keratoz' (%9,7), 'fibroepitelial polip' (%7,6), 'lipom' (%7) ve 'trikilemmal kist' (%6,4) olduğu saptandı. 6 yaş altı ve 6-11 yaş grubunun en sık görülen malign neoplazi hastalık tanısı 'mastositoz' olarak saptanırken; 12-17, 18-40, 41-60 yaş aralıkları ve 60 yaş üstü gruplarında en sık görülen malign neoplazi hastalık tanısı ise 'bazal hücreli karsinom' olduğu görüldü. Van gölü çevresinde histopatolojik tanısı konulmuş 7248 deri hastalığı üzerinden prevelans çalışması yapıldı. Yaptığımız literatür taramasında bu konuda yapılan çalışmaların çok büyük bir oranının poliklinik verilerinden yapılmış klinik çalışma olduğunu tespit ettik. Elde ettiğimiz verileri bu klinik çalışmalar ile karşılaştırdığımızda belirgin farklılıklar mevcuttur. Ancak patoloji arşiv verilerinden yapılan çok sınırlı sayıda çalışma ile karşılaştırdığımızda verilerin çok büyük benzerlik oranına sahip olduğu dikkatimizi çekti. Literatürde deri tümörleri ve non-tümöral deri hastalıklarının tümünü kapsayan, yaş-cinsiyet gibi hiçbir demografik veri kısıtlaması yapılmaksızın yüksek hasta sayısına sahip, ayrıca histopatolojik olarak tanısı kesinleştirilmiş patoloji arşiv verileri ile yapılan çok sınırlı sayıda çalışma mevcuttur. Çalışmamızın, yapılacak olan benzer çalışmalara değerli katkılar sunacağı aşikardır.
Skin diseases can cause physiological, systemic, hormonal, metabolic, esthetical, psychological and social problems or may occur as a result of these problems. Furthermore, it is important that epidemiological data have to be known to plan a protective health services and determine appropriate health policy. In the study, we aimed that to determine the sociodemographic distribution and prevalence of our regional skin diseases, without excluding age-disease-gender in a wide perspective. Material and Methods: In this study, all skin tumors and non-tumoral skin diseases which have been histopathologically diagnosed between June/2010-June/2019, in Department of Pathology, Dursun Odabas Faculty of Medicine, Van YYU, have been retrospectively analyzed. In reporting studies, histochemical, immunhistochemical and/or immunflorecence techniques used when needed. Diagnoses, ages, genders and appeal years of cases, departments which made requests and types of biopsies have been recorded. Patients have been primarily divided into two main groups whom are under 18 years and over 18 years as there was no age limiting in our study. Each other of these two main groups has been divided into three sub-groups. At the beginning, demographical data and diagnoses of patients generally evaluated on the number of patients involved in the study. Later, data about diagnoses accompanied with demographical data, have been analysed on diseases and general disease groups, both. In addition, all histopathological and immunofluorescent figures used in the study were obtained from the archive data of our department. Results: 7248 patients admittances has been detected in the archive scanning maintained without making a age limit. Overall, 219 diseases and 26 general disease groups classificated. 3613 (%49,9) of patients were male, 3632 (%50,1) were female. There was no statistically difference between numbers of admittances of female and male patients (p=0,860). İt has been observed that the biggest number of patient admittances was in 2016. Average patient age was 38,41±21,40 years; mean age was 37 (<1-94) years. Without considering parameters such as age, gender, most frequently diagnosed three general disease groups were, cysts and tumors of epidermis (%18,5), non-infectious vesiculobullous and vesiculopustular diseases (%15,8), non-infectious erythematous-papular and squamous diseases (%14,7). İt has been detected that most frequently diagnosed three diseases independent from disease groups and demographical data were melanocytic nevus (%9), basal cell carcinoma (%5,4) and contact dermatitis (%5,0) According to investigation which has been made featuring genders groups, most frequently disease group in males were cysts and tumor of epidermis (%22,9); non-infectious erythematous-papular and squamous diseases (%16,1) were in females. İt has been observed that most frequently diagnosed 3 diseases in males were melanocytic nevus (%7,6), basal cell carcinoma (%6,3) and contact dermatitis (%5,0); most frequently diagnosed 3 diseases in females were melanocytic nevus (%10,3), contact dermatitis (%5,0) and erythema discromicum perstans (%4,7). When age groups were featured, the most frequently diagnosed disease group in under 18 years old pediatric cases was non-infectious vesiculobullous and vesiculopustular diseases (%18,3); most frequently observed 3 disease diagnoses were, leukocytoclastic vasculitis (%10), melanocytic nevus (%7,3) and atopic dermatitis. Considering the age groups, the most common disease diagnosis group in the age group 18 and over is the cysts and tumors of the epidermis (21.5%); Melanocytic nevus (9.4%), basal cell carcinoma (6.5%) and contact dermatitis (5.3%) were found to be the most common 3 diseases. Diseases have been also separated into neoplastic and non-neoplastic skin diseases groups and evaluated. Although %64,4 of the 7248 patients involved into the study independent from age and gender were in non-neoplastic skin diseases group, %35,4 were in neoplastic skin diseases group. İt has been observed that, of the neoplastic skin diseases group, %32,3 were malign neoplasia, %62,9 were benign neoplasia and %4,8 were pre-cancerous or borderline lesions. While the rate of neoplastic skin diseases is 37.7% in men and 33.1% in women; It was found that there was a statistically significant difference between skin diseases groups according to gender (χ2 = 17.160; p = <0.001). In addition, the rate of skin malignant neoplasia was found to be higher in men (36.5%) (χ2 = 24.052; p = <0.001). It was determined that the most common 3 diseases diagnosed in the skin group of all malignant neoplasia without age limitation were 'basal cell carcinoma' (46.7%), 'squamous cell carcinoma' (21.8%) and 'mycosis fungoides' (6.7%). ; The most common diagnosis of five diseases in all benign neoplasia group were 'melanocytic nevus' (40.3%), 'seborrheic keratosis' (9.7%), 'fibroepithelial polyp' (7.6%), 'lipoma' (7%) and 'trichilemmal cyst' (6.4%). İt has been detected that although the most frequently observed malign neoplastic disease diagnosis of under 6 years and 6-11 years was 'mastocytosis', the most frequently diagnosed malign neoplastic disease in 12-17 years, 18-40 years, 41-60 years and over 60 years was 'basal cell carcinoma'. Conclusion: A prevalence study was conducted on 7248 histopathologically diagnosed skin diseases around Lake Van. In the literature review we conducted, we determined that a great majority of the studies on this subject were clinical studies made from outpatient clinic data. When we compare the data we have obtained with these clinical studies, there are clear differences. However, when we compare it with a very limited number of studies from pathology archive data, it drew our attention that the data have a very high similarity rate. In the literature, there are a very limited number of studies covering all skin tumors and non-tumoral skin diseases, with a high number of patients without any demographic data limitation such as age-gender, and with pathology archive data that have been confirmed histopathologically. It is obvious that our study will make valuable contributions to similar studies to be conducted.
Skin diseases can cause physiological, systemic, hormonal, metabolic, esthetical, psychological and social problems or may occur as a result of these problems. Furthermore, it is important that epidemiological data have to be known to plan a protective health services and determine appropriate health policy. In the study, we aimed that to determine the sociodemographic distribution and prevalence of our regional skin diseases, without excluding age-disease-gender in a wide perspective. Material and Methods: In this study, all skin tumors and non-tumoral skin diseases which have been histopathologically diagnosed between June/2010-June/2019, in Department of Pathology, Dursun Odabas Faculty of Medicine, Van YYU, have been retrospectively analyzed. In reporting studies, histochemical, immunhistochemical and/or immunflorecence techniques used when needed. Diagnoses, ages, genders and appeal years of cases, departments which made requests and types of biopsies have been recorded. Patients have been primarily divided into two main groups whom are under 18 years and over 18 years as there was no age limiting in our study. Each other of these two main groups has been divided into three sub-groups. At the beginning, demographical data and diagnoses of patients generally evaluated on the number of patients involved in the study. Later, data about diagnoses accompanied with demographical data, have been analysed on diseases and general disease groups, both. In addition, all histopathological and immunofluorescent figures used in the study were obtained from the archive data of our department. Results: 7248 patients admittances has been detected in the archive scanning maintained without making a age limit. Overall, 219 diseases and 26 general disease groups classificated. 3613 (%49,9) of patients were male, 3632 (%50,1) were female. There was no statistically difference between numbers of admittances of female and male patients (p=0,860). İt has been observed that the biggest number of patient admittances was in 2016. Average patient age was 38,41±21,40 years; mean age was 37 (<1-94) years. Without considering parameters such as age, gender, most frequently diagnosed three general disease groups were, cysts and tumors of epidermis (%18,5), non-infectious vesiculobullous and vesiculopustular diseases (%15,8), non-infectious erythematous-papular and squamous diseases (%14,7). İt has been detected that most frequently diagnosed three diseases independent from disease groups and demographical data were melanocytic nevus (%9), basal cell carcinoma (%5,4) and contact dermatitis (%5,0) According to investigation which has been made featuring genders groups, most frequently disease group in males were cysts and tumor of epidermis (%22,9); non-infectious erythematous-papular and squamous diseases (%16,1) were in females. İt has been observed that most frequently diagnosed 3 diseases in males were melanocytic nevus (%7,6), basal cell carcinoma (%6,3) and contact dermatitis (%5,0); most frequently diagnosed 3 diseases in females were melanocytic nevus (%10,3), contact dermatitis (%5,0) and erythema discromicum perstans (%4,7). When age groups were featured, the most frequently diagnosed disease group in under 18 years old pediatric cases was non-infectious vesiculobullous and vesiculopustular diseases (%18,3); most frequently observed 3 disease diagnoses were, leukocytoclastic vasculitis (%10), melanocytic nevus (%7,3) and atopic dermatitis. Considering the age groups, the most common disease diagnosis group in the age group 18 and over is the cysts and tumors of the epidermis (21.5%); Melanocytic nevus (9.4%), basal cell carcinoma (6.5%) and contact dermatitis (5.3%) were found to be the most common 3 diseases. Diseases have been also separated into neoplastic and non-neoplastic skin diseases groups and evaluated. Although %64,4 of the 7248 patients involved into the study independent from age and gender were in non-neoplastic skin diseases group, %35,4 were in neoplastic skin diseases group. İt has been observed that, of the neoplastic skin diseases group, %32,3 were malign neoplasia, %62,9 were benign neoplasia and %4,8 were pre-cancerous or borderline lesions. While the rate of neoplastic skin diseases is 37.7% in men and 33.1% in women; It was found that there was a statistically significant difference between skin diseases groups according to gender (χ2 = 17.160; p = <0.001). In addition, the rate of skin malignant neoplasia was found to be higher in men (36.5%) (χ2 = 24.052; p = <0.001). It was determined that the most common 3 diseases diagnosed in the skin group of all malignant neoplasia without age limitation were 'basal cell carcinoma' (46.7%), 'squamous cell carcinoma' (21.8%) and 'mycosis fungoides' (6.7%). ; The most common diagnosis of five diseases in all benign neoplasia group were 'melanocytic nevus' (40.3%), 'seborrheic keratosis' (9.7%), 'fibroepithelial polyp' (7.6%), 'lipoma' (7%) and 'trichilemmal cyst' (6.4%). İt has been detected that although the most frequently observed malign neoplastic disease diagnosis of under 6 years and 6-11 years was 'mastocytosis', the most frequently diagnosed malign neoplastic disease in 12-17 years, 18-40 years, 41-60 years and over 60 years was 'basal cell carcinoma'. Conclusion: A prevalence study was conducted on 7248 histopathologically diagnosed skin diseases around Lake Van. In the literature review we conducted, we determined that a great majority of the studies on this subject were clinical studies made from outpatient clinic data. When we compare the data we have obtained with these clinical studies, there are clear differences. However, when we compare it with a very limited number of studies from pathology archive data, it drew our attention that the data have a very high similarity rate. In the literature, there are a very limited number of studies covering all skin tumors and non-tumoral skin diseases, with a high number of patients without any demographic data limitation such as age-gender, and with pathology archive data that have been confirmed histopathologically. It is obvious that our study will make valuable contributions to similar studies to be conducted.
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Keywords
Patoloji, Deri hastalıkları, Deri hastalıkları, Deri neoplazmları, Neoplazmlar, Prevalans, Van Gölü, Pathology, Skin diseases, Skin diseases, Skin neoplasms, Neoplasms, Prevalence, Van Lake
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97