Obstructive cholecystitis due to metastatic melanoma.
(25/10127)
A patient with isolated metastases from cutaneous melanoma to the gall-bladder is reported. The patient presented clinically with obstructive cholecystitis. The course of melanoma is unpredictable and the possibility that an apparently unassociated condition is due to metastases should always be considered. Isolated metastases may respond well to radical surgery and reward the surgeon's efforts. (+info)
Effects of photographs and written descriptors on melanoma detection.
(26/10127)
Two studies are reported on the effects of photographic and written information on performance in an experimental melanoma detection task. Subjects were shown slides of four types of skin lesions, including melanoma, and were asked what they would do if the lesion was on their skin. Four response options were provided from seeing a doctor immediately to doing nothing. In Experiment 1, no clear differences in performance were found as a function of prior instruction using four, eight or 16 photographs of each of the four lesion types. In Experiment 2, the effects of written and photographic instructional material were compared. The written material contained descriptions of each lesion type and details of the ABCD criteria for melanoma detection. Eight photographs were provided for each lesion type. Photographic information resulted in superior performance (P < 0.001) for seborrhoeic keratoses and a combination of both types of information was superior (P < 0.05) for melanoma. The two kinds of instructional material produced different effects, suggesting that a brochure offering a combination of photographs and written information is likely to be most useful in helping members of the public identify early melanoma as suspicious. (+info)
The rationale for skin cancer screening and prevention.
(27/10127)
Skin cancer, the most common malignancy in the United States, accounts for considerable morbidity and mortality. Efforts at lessening the burden of this disease are possible through both primary and secondary prevention, although some barriers may detract from the ability of primary care physicians to perform skin cancer screening. Public education combined with increased vigilance by physicians and other health professionals may significantly alter the morbidity and mortality associated with this disease entity. (+info)
Optimum porphyrin accumulation in epithelial skin tumours and psoriatic lesions after topical application of delta-aminolaevulinic acid.
(28/10127)
Photodynamic therapy with topically applied delta-aminolaevulinic acid is used to treat skin tumours by employing endogenously formed porphyrins as photosensitizers. This study examines the time course of porphyrin metabolite formation after topical application of delta-aminolaevulinic acid. Porphyrin biosynthesis in human skin tumours (basal cell carcinoma, squamous cell carcinoma), in psoriatic lesions, and in normal skin was investigated. Skin areas were treated with delta-aminolaevulinic acid, and levels of total porphyrins, porphyrin metabolites and proteins were measured in samples excised after 1, 2, 4, 6, 9, 12 and 24 h. There was an increase in porphyrin biosynthesis in all tissues with maximum porphyrin levels in tumours between 2 and 6 h and in psoriatic lesions 6 h after treatment. The pattern of porphyrins showed no significant difference between normal and neoplastic skin, protoporphyrin being the predominant metabolite. The results suggest that optimum irradiation time for superficial epithelial skin tumours may be as soon as 2 h after application of delta-aminolaevulinic acid, whereas for treatment of psoriatic lesions an application time of 6 h is more suitable. (+info)
Inducible nitric oxide synthase (iNOS) expression may predict distant metastasis in human melanoma.
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Expression of inducible nitric oxide synthase (iNOS) and its cellular localization was investigated in subcutaneous or lymph node metastases of human melanoma. Immunohistochemistry revealed that iNOS expression was limited to melanoma cells. In samples of patients without distant metastases, the number of iNOS+ tumour cells/total tumour cells was 55% +/- 17% (n = 12) compared with 9% +/- 8% when distant metastases of lung, liver or brain occurred within an observation period of 3 years (n = 10) (P < 0.001). Western blotting confirmed the expression of iNOS protein in select cases. Notably, iNOS is expressed in regional melanoma metastases and its expression is inversely related to the tumour's metastatic potential. Thus, iNOS expression may have predictive value for the development of distant metastases of human melanoma. (+info)
Histochemical investigation into the molecular mechanisms of malignant transformation in a benign glomus tumour.
(30/10127)
A glomangiosarcoma arose in a benign glomus tumour. The histological and immunohistochemical characteristics of the tumour were investigated. Apoptotic cells were identified by terminal deoxynucleotidyl transferase (TdT) mediated dUTP-biotin nick end labelling (TUNEL). The proportion of apoptotic cells was found to be low and TUNEL positive nuclei were present in the benign part of the tumour. Bcl-2 protein, an inhibitor of apoptosis, was strongly expressed in the glomangiosarcoma with only weak staining in the benign area. The proliferation index of the glomangiosarcoma was almost 10-fold higher than that of the benign glomus tumour. Numerous nuclei in the glomangiosarcoma were intensely stained for the tumour suppressor protein p53. The results of the this study may contribute to an understanding of the molecular basis of malignant transformation in benign glomus tumours. (+info)
Trends in mortality from cutaneous malignant melanoma in Belgium.
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BACKGROUND AND METHODS: Changes over time of mortality rates from cutaneous malignant melanoma (CMM) in Belgium were analysed, based on people (n = 3695) aged 25-84 years, who died of CMM from 1954 to 1992. All data were collected from the Belgian National Institute of Statistics. For the log-linear analysis and calculation of the average annual change, only the data from 1973 to 1992 were considered. RESULTS: The age-adjusted mortality rates (per 10(5)) for the age group 25-84 years old increased from 0.5 in 1954 to 3.0 in 1992 in men, and from 0.8 in 1954 to 2.2 in 1992 in women. The average annual percentage change in men (-0.003%) was stable over the period 1973-1982, and increased to 4.4% over the period 1983-1992. In women, the average annual increase was 4.6% over the period 1973-1982, and continued to increase to 6.8% over the period 1983-1992. Log-linear analysis showed that the change in rates for both men and women was mainly due to an age-'drift' effect, contrary to the results of the average annual percentage change in men. CONCLUSION: The risk of dying from CMM increased in men and women continuously over the whole period, irrespective of birth cohort. In both men and women, there was approximately a 20% increase in CMM mortality per 5-year period. (+info)
Neurology and the skin.
(32/10127)
As knowledge of pathophysiology grows, so does the refinement of diagnoses. Sometimes increased knowledge permits consolidation and unification. Unfortunately, at our present level of understanding, it usually demands proliferation of diagnostic categories. As tedious as this diagnostic splintering may seem, such is the price currently exacted of both the investigator and the clinician who seek to optimise management. Increased diagnostic refinement often requires inquiry into matters outside the bounds of one's specialty. Most often we turn to the radiologist or to the laboratory to narrow the differential diagnosis generated from the history and neurological examination. As we have shown, a useful intermediate step is extension of the physical examination to organs such as the skin, which are not the traditional preserve of the neurologist. That any text could confer the sophistication required for expert dermatological diagnosis is an unrealistic expectation. However, we hope that this review will encourage careful examination of the skin, hair, and nails by the neurological practitioner, with consideration of referral to a dermatologist when greater expertise is required. (+info)