Five years of sucsessful prevention of malignant epidermal tumors: data from the Referral Center of Dermatologic Oncology, Ministry of Health and Social Welfare, Croatia.

The main goals of the Referral Center of Dermatologic Oncology, Ministry of Health and Social Welfare, Republic of Croatia, set in 2006 included collection and processing of epidemiological data on malignant epidermal tumors in Croatia, improved diagnosis and treatment of malignant epidermal tumors, promotion of diagnosis and treatment of primary skin lymphomas, prevention of malignant skin tumors, education of dermatovenereologists in the field of dermatologic oncology, and collaboration and team approach in the field of dermatologic oncology. In line with the conditions stated by the Ministry Rule Book, the Referral Center had successfully performed the tasks and achieved good scientific and professional results in upgrading prevention of various skin tumors. A total of 8174 minor surgical procedures were performed, including operative removal of various pigment lesions, epidermal malignant tumors and deep biopsy for inflammatory dermatoses. Superficial radiotherapy was performed in 820 patients. Photodynamic therapy with aminolevulinic acid (5-ALA) was used in 171 patients with actinic keratoses, Bowen disease and broad superficial basal cell carcinomas. The diagnosis of skin lymphoma was made in 114 patients. T-cell primary skin lymphoma accounted for the majority of cases (77.5%), whereas the diagnosis of B-cell primary skin lymphoma was made in ten (12.5%) patients. Mycosis fungoides was the most common primary skin lymphoma, diagnosed in 94 patients, i.e. 90% of all T immunophenotype primary skin lymphomas. Excellent collaboration and team approach has been established with pathologists, hematologists and oncologists as necessary. Primary prevention included education of the population at large, young people in particular, on the measures of protection from excessive sun exposure. In the scope of secondary prevention, we invested all our knowledge and efforts in early diagnosis and early therapy of malignant skin tumors, which is closely related to better prognosis and lower treatment cost. Members of the Referral Center have regularly participated in the project of skin tumor prevention, Euromelanoma Day Croatia since 2008, when the Croatian Dermatovenereological Society joined this project launched by the European Academy of Dermatology and Venereology.