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Resumen: A nivel dermatológico, la elevada exposición solar a radiación ultravioleta asociada a la práctica de actividades deportivas al aire libre, máxime en actividades recreativas de larga duración como son los corredores de fondo, aumenta el fotoenvejecimiento de la piel y la incidencia de cáncer de piel. El propósito del estudio fue evaluar los hábitos, actitudes y conocimientos sobre la exposición solar de corredores de fondo de nuestra comunidad. Se realizó un estudio transversal descriptivo mediante encuesta con un muestreo de conveniencia entre aquellos participantes de las medias maratones populares de Fuengirola y Marbella celebradas en el mes de septiembre del año 2016. En la muestra evaluada se ha hallado una intensa exposición solar realizando actividades al aire libre, asociado ello a una prevalencia de quemaduras solares elevada (uno de cada 2 corredores). Abstract: Exposure to UV radiation during the practice of sports in the open air is especially high in sustained recreational activities such as long-distance running. UV exposure increases skin photoaging and the incidence of skin cancer. This study aimed to describe habits and attitudes related to sun exposure among long-distance runners in our area of southern Spain as well as to evaluate the runners’ knowledge of exposure. A cross-sectional descriptive study was designed to survey a convenience sample of participants in half marathons in Fuengirola and Marbella in September 2016. We found a high level of sun exposure among participants in this outdoor activity. The prevalence of sunburn was also high, experienced by half of the runners surveyed.

Las campañas escolares de prevención del cáncer cutáneo han demostrado ser eficaces y costo-efectivas. Su éxito depende de un adecuado dise˜no, basado en la encuestación previa de la población diana (alumnos, profesores y padres). Sin embargo, son escasos los cuestionarios validados en castellano que estudien hábitos y conocimientos sobre exposición solar en infancia, y nulos en la población adultojuvenil. Objetivos: Elaborar y validar un cuestionario que explore las conductas relacionadas con la exposición solar en población adultojuvenil. Metodología: Se elaboraron 2 cuestionarios, dirigidos a población adulta (mayor de 18 a˜nos) y juvenil (11-17 a˜nos), incluyendo datos demográficos, color de piel, fototipo, quemaduras solares, prácticas, actitudes y conocimientos relacionados con la exposición solar. Tras el pilotaje y análisis de validez de contenido, se dise˜nó un estudio de validación en 2 fases: I) Análisis de la validez y consistencia interna de los ítems (estudio trasversal sobre 1.482 adolescentes-adultos, con estudio de validez de constructo [mediante análisis factorial exploratorio] y de consistencia interna [alfa de Cronbach]), II) Estudio de la estabilidad (test-retest sobre 39 sujetos). Resultados: El pilotaje demostró la validez de contenido de sendos cuestionarios. El análisis de los componentes principales reveló 2 componentes en cada dimensión estudiada, explicando más del 50% de la varianza. Todos los ítems mostraron buena correlación entre ellos. Se demostró validez en la fase i (coeficiente alfa de Cronbach entre 0,45-0,8, excepto el área de conocimientos [0,335]) y estabilidad en la fase ii (acuerdo absoluto > 60%). Skin cancer prevention campaigns in schools have been shown to be both effectiveand cost-effective. The success of such programs depends on the use of an appropriate designinformed by a prior survey of the target population (pupils, teachers, and parents). There are,however, very few validated Spanish-language questionnaires designed to study the habits andknowledge of this population with respect to sun exposure in childhood and none designed foruse with a young adult population.Objectives: To construct and validate a questionnaire designed to explore sun exposure beha-viors in a young adult population.Methodology: Two questionnaires were developed, one for adults (18+) and the other for youngadults (11-17); both included demographic information, skin color, Fitzpatrick skin type, andhistory of sunburn as well as questions on knowledge, attitudes and practices related to sunexposure. The content was then piloted and its validity analyzed. The subsequent validationstudy was divided into 2 phases as follows: 1) analysis of the validity and internal consistencyof the items in a cross-sectional study of 1,482 adults and adolescents, using exploratory factoranalysis to test construct validity and Cronbach to measure internal consistency; and 2)evaluation of test-retest reliability in 39 individuals.Results: The pilot study demonstrated the content validity of both questionnaires. Principalcomponent analysis revealed that 2 components in each of the dimensions studied accountedfor over 50% of the variance. A good correlation was found between the items studied. Validitywas demonstrated in the first phase of the analysis with a Cronbach of between 0.45 and 0.8for all components except knowledge (0.335). In the second phase, test-retest reliability wasdemonstrated (absolute agreement > 60%).Conclusions: The psychometric properties of the questionnaire make it a valid and reliable toolfor the study of knowledge, attitudes, and habits with respect to sun exposure in the youngadult school population.

Resumen Introduccion La exposicion solar en la infancia es el principal factor de riesgo para el desarrollo de cancer de piel en la vida adulta. Las intervenciones basadas en programas y politicas de fotoproteccion escolar han demostrado ser las estrategias mas eficaces y coste-efectivas para la prevencion del cancer de piel. Objetivos Elaborar un modelo de certificacion que permita identificar de forma objetiva aquellos centros escolares que promueven activamente la fotoproteccion. Metodos Se empleo metodologia de consenso basada en panel de expertos, recurriendo al metodo Delphi en 2 rondas. Se analizaron las medianas de las valoraciones de la importancia y factibilidad de cada una de las recomendaciones, y el porcentaje de respuestas positivas para los niveles de cada una de ellas. Resultados Se obtuvo un modelo integrado por 14 recomendaciones junto a sus criterios de evaluacion, relativas a 7 dimensiones: 1) liderazgo organizacional (5 recomendaciones), 2) comunicacion efectiva (2 recomendaciones), 3) elementos estructurales (2 recomendaciones), 4) formacion de profesionales (una recomendacion), 5) curriculum escolar (una recomendacion), 6) modelos de conducta (2 recomendaciones) y 7) habitos del alumnado (una recomendacion). Todas las recomendaciones mostraron un alto nivel de acuerdo, tanto en la valoracion de la importancia y factibilidad como en la categorizacion de los niveles de complejidad. Conclusion Se trata del primer distintivo de fotoproteccion escolar que se desarrolla en nuestro pais. Se necesitan estudios que evaluen el grado de aceptacion de la estrategia y su impacto en los habitos de fotoproteccion de los escolares.

Introduction Sun exposure during childhood is the main risk factor for skin cancer in later life. School-based sun protection policies and practices have proven to be the most effective and cost-effective strategies for preventing skin cancer. Objective To develop a sun protection accreditation program known as «Soludable» (a play on the Spanish words sol [sun] and saludable [healthy]) to objectively identify schools that actively promote sun protection behaviors among students. Methods The consensus method used was a 2-round Delphi technique with input from a panel of experts. We then calculated the median scores for the importance and feasibility of each of the recommendations proposed and the level of complexity assigned to each recommendation by counting the percentage of experts who chose each difficulty category. Results The resulting accreditation model consists of 14 recommendations with corresponding evaluation criteria divided into 7 domains: 1) organizational leadership (5 recommendations), 2) effective communication (2 recommendations), 3) structural elements (2 recommendations), 4) training of professionals (1 recommendation), 5) school curriculum (1 recommendation),6) behavioral models (2 recommendations), and 7) student habits (1 recommendation). A high level of agreement among experts was observed for all recommendations, in terms of both their perceived importance and feasibility and their categorization by levels of complexity. Conclusions This is the first sun protection accreditation program developed for Spanish schools. Studies are needed to evaluate how this program is received and how it affects students’ sun protection behaviors.

Background: Transplant recipients are particularly prone to the development of skin cancer, and overexposure to UV radiation during outdoor activities increases the risk of carcinogenesis. Objective: The aim of this study was to analyze sun-related behaviors and knowledge in transplant athletes, examine the equency of sunburns, and explore associations with a history of skin cancer. Materials and methods: Cross-sectional descriptive study. Participants (n = 170) in the XXI World Transplant Games from >50 countries completed a questionnaire on sun protection habits and knowledge, type of transplant, immunosuppressive therapy, and personal history of skin cancer. Results: The most common transplanted organs were the kidney (n = 79), the liver (n = 33), and the heart (n = 31). Overall, 61.3% of athletes had been doing sport for >15 years and 79.5% spent >1–2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes aged

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The objective of this study was to analyse the sun exposure habits of elite aquatics athletes, together with their sunburn history and skin examination habits, taking into account differences by sex and between sports. A cross-sectional health survey was conducted at world championship events during which elite surfers, windsurfers and Olympic sailors from 30 different countries were invited to participate. The athletes were asked to complete a self-administered questionnaire focused on sun protection habits, sun exposure and sports practices. The survey was completed by 240 athletes, 171 men (71.3%) and 69 women (28.8%), with a mean age of 22 years (SD 5.86) and skin phototypes I (6.3%), II (3.3%), III (22.0%), IV (32.5%), V (9.2%) and VI (1.7%). There were significant differences between male and female athletes in skin self-examination (p

Skin cancer prevention campaigns in schools have been shown to be both effective and cost-effective. The success of such programs depends on the use of an appropriate design informed by a prior survey of the target population (pupils, teachers, and parents). There are, however, very few validated Spanish-language questionnaires designed to study the habits and knowledge of this population with respect to sun exposure in childhood and none designed for use with a young adult population.To construct and validate a questionnaire designed to explore sun exposure behaviors in a young adult population.Two questionnaires were developed, one for adults (18+) and the other for young adults (11-17); both included demographic information, skin color, Fitzpatrick skin type, and history of sunburn as well as questions on knowledge, attitudes and practices related to sun exposure. The content was then piloted and its validity analyzed. The subsequent validation study was divided into 2 phases as follows: 1) analysis of the validity and internal consistency of the items in a cross-sectional study of 1,482 adults and adolescents, using exploratory factor analysis to test construct validity and Cronbach α to measure internal consistency; and 2) evaluation of test-retest reliability in 39 individuals.The pilot study demonstrated the content validity of both questionnaires. Principal component analysis revealed that 2 components in each of the dimensions studied accounted for over 50% of the variance. A good correlation was found between the items studied. Validity was demonstrated in the first phase of the analysis with a Cronbach α of between 0.45 and 0.8 for all components except knowledge (0.335). In the second phase, test-retest reliability was demonstrated (absolute agreement60%).The psychometric properties of the questionnaire make it a valid and reliable tool for the study of knowledge, attitudes, and habits with respect to sun exposure in the young adult school population.

Background Overexposure to sunlight is the main cause of skin cancer. Outdoor sports increased sun exposure times. Sun protection behaviors and attitudes are utmost importance to reduce sun exposure. Aims To evaluate sun exposure habits, sun protection practices, and sun-related attitudes and knowledge among paralympic sailors. Methods This descriptive observational study analysed the answers of a validated self-reported questionnaire of habits, attitudes and knowledge related to sun exposure and skin cancer completed by 56 elite sailors with disabilities from 19 countries which taking part in 2019 Para World Sailing Championships. Results Three in four (76.8%) participants reported a history of sunburn in the previous season. Overall, participants showed an average for sport practice per week of 8.0 h (SD: 4.9). Participants reported a low adherence to sun protection practice, with the exception of using sunglasses (85.7%), sunscreen (83.9%) and hat (75%), having a very low rate (28.6%) of avoidance of midday sun and an inadequate sunscreen reapplication (33.9% reported “do not reapply” and 16.1% “reapply every one or 2 h”). Although 82.1% of participants reported to be worried about can get skin cancer out of the sun, they also presented excessive sun tanning attitudes (42.9% likes sunbathing and 57.1% sunbathing makes them feel well). The average score for sun-related knowledge was low (62.1 out 100 points; SD: 13.6). Conclusions Awareness campaigns on sun risk are needed specifically directed at this target group, in order to improve their sun protection habits and reduce the rates of sunburn associated with sports practice.

Introduction Incisional biopsy may not always provide a correct classification of histologic subtypes of basal cell carcinoma (BCC). High-frequency ultrasound (HFUS) imaging of the skin is useful for the diagnosis and management of this tumor. Objectives The main aim of this study was to compare the diagnostic value of HFUS compared with punch biopsy for the correct classification of histologic subtypes of primary BCC. We also analyzed the influence of tumor size and histologic subtype (single subtype vs. mixed) on the diagnostic yield of HFUS and punch biopsy. Methods Retrospective observational study of primary BCCs treated by the Dermatology Department of Hospital Costa del Sol in Marbella, Spain, between october 2013 and may 2014. Surgical excision was preceded by HFUS imaging (Dermascan C©, 20-MHz linear probe) and a punch biopsy in all cases. We compared the overall diagnostic yield and accuracy (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) of HFUS and punch biopsy against the gold standard (excisional biopsy with serial sections) for overall and subgroup results. Results We studied 156 cases. The overall diagnostic yield was 73.7% for HFUS (sensitivity, 74.5%; specificity, 73%) and 79.9% for punch biopsy (sensitivity, 76%; specificity, 82%). In the subgroup analyses, HFUS had a PPV of 93.3% for superficial BCC (vs. 92% for punch biopsy). In the analysis by tumor size, HFUS achieved an overall diagnostic yield of 70.4% for tumors measuring 40 mm2 or less and 77.3% for larger tumors; the NPV was 82% in both size groups. Punch biopsy performed better in the diagnosis of small lesions (overall diagnostic yield of 86.4% for lesions ≤ 40 mm2 vs. 72.6% for lesions > 40 mm2). Conclusions HFUS imaging was particularly useful for ruling out infiltrating BCCs, diagnosing simple, superficial BCCs, and correctly classifying BCCs larger than 40 mm2.

Resumen Introduccion La biopsia incisional puede fallar en la correcta catalogacion de subtipos histologicos de carcinoma basocelular (CBC). La ecografia (ECO) cutanea es una herramienta diagnostica util en el diagnostico y manejo de este tumor. Objetivos El objetivo principal fue evaluar la utilidad diagnostica de la ECO frente a la biopsia punch en la correcta clasificacion del patron histologico de infiltracion de los CBC primarios. Los objetivos secundarios fueron: evaluar si el rendimiento diagnostico de la ECO frente a la biopsia incisional guardaba relacion con el tamano tumoral y con formas de CBC simples frente a formas mixtas. Metodos Estudio observacional prospectivo de los casos de CBC primarios atendidos en el Servicio de Dermatologia del Hospital Costa del Sol (Marbella) entre octubre de 2013 y mayo de 2014. Previamente a la extirpacion quirurgica se realizo una ECO cutanea (Dermascan C © , sonda lineal, 20 Mhz) y una biopsia punch. Se valoro el porcentaje de acuerdo absoluto y rendimiento diagnostico (sensibilidad, especificidad, valor predictivo positivo [VPP] y valor predictivo negativo [VPN]) para resultados globales y parciales entre ECO y punch frente al gold estandar (biopsia escisional por cortes seriados). Resultados Se incluyeron 156 casos. La tasa de concordancia diagnostica global de la ECO fue del 73,7% (sensibilidad: 74,5%, especificidad: 73%) vs. 79,9% (sensibilidad: 76%, especificidad: 82%) para el punch. En el analisis individual destaca para el CBC superficial un VPP para la ECO del 93,3% frente al 92% para el punch. En el analisis por tamano tumoral la ECO incremento el porcentaje de acuerdo absoluto del 70,4 al 77,3% (area ≤ 40 mm 2 vs. area > 40 mm 2 ) manteniendo el VPN constante para ambos subgrupos (82%). Para la biopsia punch, el porcentaje de acuerdo absoluto paso del 86,4 al 72,6%. Conclusiones La ECO cutanea muestra una especial utilidad para descartar la presencia de invasividad, para el diagnostico de formas superficiales simples y para la correcta catalogacion de CBC de area mayor a 40 mm 2 .

Subcutaneous lesions may be detected during follow-up of patients with melanoma. The main entities that should be contemplated in the differential diagnosis in such cases are in-transit and regional lymph node metastases. We describe 2 cases of women with breast implants who developed palpable subcutaneous lesions in the axillary region during follow-up of melanoma. In both cases, the ultrasound study showed diffuse hyperechoic signals forming the characteristic snowstorm sign in the subcutaneous tissue. Ultrasound proved to be a key diagnostic tool for ruling out melanoma-related disease, such as in-transit metastases and regional lymph node metastases.

Resumen Introduccion La piramide nasal, area de dificil reconstruccion quirurgica, constituye una localizacion predilecta del cancer cutaneo no melanoma. La cirugia oncologica a menudo origina defectos cutaneos extensos, con la participacion ocasional del cartilago subyacente y de la mucosa nasal. Nuestro objetivo es describir nuestra experiencia en el uso del colgajo paramediofrontal en la reconstruccion de defectos nasales. Metodologia Estudio retrospectivo de pacientes consecutivos en los que se empleo un colgajo paramediofrontal para la reconstruccion de defectos quirurgicos nasales (julio de 2004-marzo de 2011). Se describen aspectos clinicoepidemiologicos, caracteristicas de la tecnica quirurgica, complicaciones, procedimientos secundarios y resultados cosmeticos. Resultados Se incluyen 41 pacientes, con edad media de 67 anos (SD: 10,36) y de predominio masculino (2,4:1). Los factores de riesgo asociados fueron diabetes (27%), factores de riesgo cardiovascular (49%) y habitos toxicos (19,5%). Los defectos de sustancia eran mayoritariamente distales (80%) y no penetrantes (78%), con un tamano medio de 21,6 mm (SD: 6,78). Un 14,6% de los pacientes presentaron complicaciones posquirurgicas precoces y un 31,7% secuelas tardias (22% abultamiento del colgajo y 19% transposicion de pelo), requiriendose tecnicas de refinamiento secundario en el 19,5% de los pacientes. Los resultados cosmeticos se consideraron mayoritariamente aceptables/excelentes (90,2%). Discusion El colgajo paramediofrontal es un colgajo versatil, que proporciona caracteristicas similares en color y textura a la piel de la piramide nasal. Su pediculo vascular seguro garantiza su viabilidad, asi como la de otros tejidos, cuando se utiliza en combinacion con injertos condromucosos o condrocutaneos. Para la obtencion de resultados optimos pueden requerirse procedimientos de revision secundarios.

Introduction Surgical reconstruction of the external nose, a common site for nonmelanoma skin cancer, is difficult. Oncologic surgery often leaves large skin defects, occasionally involving the underlying cartilage and nasal mucosa. We describe our experience with the paramedian forehead flap for reconstruction of nasal defects. Methodology We performed a retrospective study of consecutive patients in whom a paramedian forehead flap was used to repair surgical defects of the nose between July 2004 and March 2011. We describe the clinical and epidemiologic characteristics, the surgical technique, complications, secondary procedures, and cosmetic results. Results The series comprised 41 patients with a mean (SD) age of 67 (10.36) years. The majority were men (male to female ratio, 2.4:1). Associated risk factors included diabetes in 27% of patients, cardiovascular risk factors in 49%, and smoking or drinking in 19.5%. The tissue defects were distal in 80% of cases and nonpenetrating in 78%. The mean (SD) diameter was 21.6 (6.78) mm. Early postoperative complications occurred in 14.6% of patients and late complications in 31.7% (trap door effect in 22% and hair transposition in 19%), with a need for Readjustment in a second operation was needed in 19.5% of patients. The cosmetic results were considered acceptable or excellent in 90.2% of cases. Discussion The paramedian forehead flap is versatile and provides skin of a similar color and texture to that of the external nose. It has a reliable vascular pedicle that guarantees the viability not only of the flap but also of other tissues that may be used in combination, such as chondromucosal or chondrocutaneous grafts. Revision of the technique in a second operation may sometimes be required to achieve an optimal result.

Sun exposure during childhood is the main risk factor for skin cancer in later life. School-based sun protection policies and practices have proven to be the most effective and cost-effective strategies for preventing skin cancer.To develop a sun protection accreditation program known as «Soludable» (a play on the Spanish words sol [sun] and saludable [healthy]) to objectively identify schools that actively promote sun protection behaviors among students.The consensus method used was a 2-round Delphi technique with input from a panel of experts. We then calculated the median scores for the importance and feasibility of each of the recommendations proposed and the level of complexity assigned to each recommendation by counting the percentage of experts who chose each difficulty category.The resulting accreditation model consists of 14 recommendations with corresponding evaluation criteria divided into 7 domains: 1) organizational leadership (5 recommendations), 2) effective communication (2 recommendations), 3) structural elements (2 recommendations), 4) training of professionals (1 recommendation), 5) school curriculum (1 recommendation), 6) behavioral models (2 recommendations), and 7) student habits (1 recommendation). A high level of agreement among experts was observed for all recommendations, in terms of both their perceived importance and feasibility and their categorization by levels of complexity.This is the first sun protection accreditation program developed for Spanish schools. Studies are needed to evaluate how this program is received and how it affects students' sun protection behaviors.

The objective of this study was to analyse the sun exposure habits of elite aquatics athletes, together with their sunburn history and skin examination habits, taking into account differences by sex and between sports. A cross-sectional health survey was conducted at world championship events during which elite surfers, windsurfers and Olympic sailors from 30 different countries were invited to participate. The athletes were asked to complete a self-administered questionnaire focused on sun protection habits, sun exposure and sports practices. The survey was completed by 240 athletes, 171 men (71.3%) and 69 women (28.8%), with a mean age of 22 years (SD 5.86) and skin phototypes I (6.3%), II (3.3%), III (22.0%), IV (32.5%), V (9.2%) and VI (1.7%). There were significant differences between male and female athletes in skin self-examination (p 0.001) and in the use of sunglasses (p 0.001). In sunburn history during the last season, there were significant differences (p 0.001) among the three sports analysed, in both sexes. The mean rate of sunburn during the previous season was 76.7%, and 27.5% of participants reported having experienced three or more sunburns that lasted at least 1 day. This type of athlete is at high risk of sunburn and hence of future skin cancer. However, there is a general lack of awareness of this risk. This study highlights the need to inform such athletes and to raise awareness of the dangers, through educational interventions on the importance of protecting against sunburn in order to reduce the future incidence of skin cancer.

In the last few decades, the role of cutaneous ultrasound has increased in dermatology. This technique currently has multiple applications, both in inflammatory and tumoural disease. Indeed, melanoma is one of the tumours benefitting most from technological advances in ultrasound, both for initial diagnosis and for follow-up. Today, cutaneous ultrasound is a noninvasive diagnostic technique, whose main applications in melanoma are to determine tumoural thickness and analyse intratumoural vascularisation. This allows prognostic factors to be determined in real time and contributes to the diagnosis of subcutaneous and nodal metastases during initial staging and follow-up with a view to reducing morbidity and mortality.

Cutaneous ultrasound plays an important role in the study and management of non-melanoma skin cancer. Among other factors, this technique contributes to the diagnosis and differential diagnosis of these tumours, the establishment of their size and relation to neighbouring structures, the delimitation of surgical margins, and the detection of subclinical and recurrent lesions. The present article analyses the role of cutaneous ultrasound in the field of non-melanoma skin cancer (basal and squamous cell carcinomas, lymphomas and dermatofibrosarcoma) through a literature review.

Resumen Objetivo Estudiar las diferencias clinico-patologicas del melanoma entre grupos de poblacion espanola y centro-norte europea en el area sanitaria publica de la Costa del Sol occidental. Metodos Se realizo un estudio descriptivo, transversal, que incluyo todos los casos de melanoma cutaneo primario confirmados histologicamente durante el periodo 2005-2011 en el area sanitaria del Hospital Costa del Sol. Se analizaron las caracteristicas clinicas y patologicas. Se realizo un analisis descriptivo y un analisis univariado tomando como variable de comparacion de subgrupos el pais de nacimiento (Espana vs norte y centro de Europa). Resultados En comparacion con los espanoles, los pacientes centro-norte europeos presentaron una edad al diagnostico 10 anos superior (66,2 vs 56,2; p i o ii 90,3% vs. 67,1%; p Conclusion Las diferencias fenotipicas y en los estilos de vida entre la poblacion espanola y la centro-norte europea parecen determinar patrones diferentes de presentacion del melanoma. Conocer estas diferencias permitira orientar mas adecuadamente las estrategias de prevencion, asi como el seguimiento de los pacientes con melanoma en poblaciones multiculturales como la de la Costa del Sol.

Objective To compare clinical and pathological features of melanoma in Spanish patients with those of patients from Central or Northern Europe living in the health district of Costa del Sol Occidental in southern Spain. Methods We conducted a descriptive cross-sectional study of all cases of primary cutaneous melanoma histologically confirmed between 2005 and 2011 in the health care district covered by Hospital Costa del Sol in Marbella. We analyzed clinical and pathological features and performed a descriptive analysis of the 2 populations, in addition to univariate analysis with place of birth (Spain vs Central or Northern Europe) as the independent variable. Results Compared with Spaniards, patients from Central or Northern Europe were 10 years older at the time of melanoma diagnosis (66.2 vs 56.2 years, P P P P = .001), nonmelanoma skin cancer (47.2% vs 15.7%, P . 001), and a family history of melanoma (9.5% vs 2.3%, P = .01) were more common in these patients. Central and Northern Europeans also had a higher overall frequency of melanoma on the trunk (46.3% vs 38.7%) and melanoma in situ (54.7% vs 41.8%, P = .03). Conclusion Differences in melanoma presentation between Spanish patients and patients from Central or Northern Europe appear to be linked to phenotypic and lifestyle factors. A better understanding of these differences will help to tailor melanoma prevention and follow-up programs for multicultural populations, such as those on Spain's Costa del Sol.

Background and objectives Skin cancer prevention and detection campaigns targeting specific groups are necessary and have proven to be more effective than those aimed at the general population. Interventions in outdoor tourist spots have proven successful, although none have specifically targeted golf courses. The aims of this study were to describe the risk profile of golfers and golf course workers and evaluate the impact of a skin cancer prevention and early detection intervention. Material and methods This was a cross-sectional descriptive study conducted at 6 golf courses. The intervention included a skin examination and completion of a questionnaire about demographic details, risk factors, and sun exposure and sun protection habits. Participants were also given advice on sun protection measures, self-examination, and use of sunscreens, and were asked about their satisfaction with the intervention and their intention to change their current behaviors. The effect was measured in terms of the diagnoses made, satisfaction with the intervention, reported intention to change, and potential effect in terms of existing risk factors. Results Of the 351 participants (57% golfers and 43% golf course workers), 70.4% had fair skin, 11.7% had a family history of skin cancer, and 8.5% had a personal history of skin cancer. Skin cancer and actinic keratoses were diagnosed in 10.7% and 40% of the golfers, respectively. The session was rated positively by 99.4% of the participants; 93.9% stated that they intended to improve their sun exposure habits and 93.4% said that they planned to examine their skin more frequently. Conclusions Our findings confirm that golf course workers and, in particular, golfers are an important target for skin cancer prevention campaigns. This is the first intervention to specifically target golf courses, and it proved to be both feasible and useful. Its success appears to be attributable to numerous factors: it was conducted at golf courses, had multiple components, and was preceded by a motivational campaign.

Resumen Introduccion y objetivos El desarrollo de programas de prevencion y deteccion de cancer cutaneo especificamente dirigidos a grupos diana -de mayor rentabilidad que aquellos desarrollados sobre la poblacion general- es necesario. Intervenciones en enclaves turisticos al aire libre ya demostraron eficacia, aunque no existen campanas especificas en campos de golf. Nuestros objetivos fueron describir el perfil de riesgo de los trabajadores y jugadores de golf y evaluar el impacto de una intervencion. Material y metodos Estudio transversal descriptivo desarrollado en 6 campos de golf, realizandose cuestionarios sobre datos demograficos, factores de riesgo y habitos de exposicion solar y fotoproteccion, examen cutaneo. Se impartio consejo sanitario en fotoproteccion, autoexamen y cremas fotoprotectoras, y finalmente se completaron encuestas de satisfaccion e intencion de cambio. Se midio el efecto en terminos de: diagnosticos realizados, satisfaccion con la intervencion e intencion expresada de cambio y efecto potencial en terminos de factores de riesgo presentes. Resultados De 351 participantes (el 57% golfistas, el resto trabajadores) el 70,4% tenian piel clara, el 11,7% tenian antecedentes familiares y el 8,5% personales de cancer de piel. Entre los golfistas se diagnostico cancer cutaneo en el 10,7% y queratosis actinicas en el 40%. El 99,4% de los participantes valoro las jornadas positivamente, el 93,9% refirio intencion de mejorar sus habitos de fotoexposicion y el 93,4% intencion de examinarse la piel mas frecuentemente. Conclusiones Trabajadores de campos de golf y especialmente golfistas se confirman como una importante diana para la prevencion del cancer cutaneo. Esta es la primera campana dirigida a estos grupos, resultando factible y util el desarrollo de las mismas; su exito parece relacionado con el desarrollo en el propio escenario, la intervencion multicomponente y su estrategia publicitaria motivacional.

Background and objectives Chlamydia trachomatis genital infection is common in our setting and early treatment can prevent complications. The aim of this study was to report on patients diagnosed with C trachomatis genital infection in a sexually transmitted disease (STD) clinic. Material and methods This was a descriptive, cross-sectional, observational study of patients diagnosed with C trachomatis infection between 2010 and 2011. We recorded demographic data and information on sexual habits, concomitant sexually transmitted infections (STIs), and various aspects of treatment. Results In total, 12.3% of the samples analyzed were positive for C trachomatis genital infection. Sixty-two patients (43 men) with a mean age of 31 years were studied; 75% were heterosexual and 87% had had a sexual partner in the previous 2 months. Condom use was inconsistent in 81%, 79%, and 65% of patients who practiced vaginal, oral, and anal sex, respectively. Thirteen percent of the patients had symptoms and anogenital warts were the most common associated STI. The most widely used treatment was doxycycline. Conclusions A high prevalence of genital C trachomatis infection was detected in our STD clinic, and the majority of cases were found in young men. We observed a high rate of asymptomatic infection in patients who do not engage in high-risk sexual behavior and who had come to the clinic for another reason. Systematic screening of C trachomatis infection should be implemented in STD units to enable the early treatment of patients and their recent sexual partners.