International Foundation for Dermatology. A challenge to meet the dermatologic needs of developing countries.

The primary goal of the IFD, which serves under the aegis of the International Committee of Dermatology (the governing body of the International League of Dermatological Societies), is to improve dermatology and dermatologic care in rural areas and developing countries. The principal mission of the IFD is to create regional dermatology training centers in geographic areas of greatest need. The first such center, serving the 12 countries of the African Regional Health Community, is located in Moshi, Tanzania.

What is early melanoma?

One of the goals of the National Institutes of Health Consensus Development Conference on Diagnosis and Treatment of Early Melanoma is to facilitate communication between experts in a variety of disciplines. Toward that end, this paper explores the definition of "early" melanoma from a number of perspectives, including experimental, clinical, epidemiological, and legal.

Risk of another basal cell carcinoma developing after treatment of a basal cell carcinoma.

Background: There is an increased risk of new basal cell carcinomas (BCCs) developing in a person who has had a BCC.

Objective: This study attempts to define the magnitude of this increased risk.

Methods: The charts of 260 white patients with a histologically proven BCC were reviewed for the occurrence of new BCCs.

Pachydermodactyly: first report in a woman.

Pachydermodactyly is a rare form of digital fibromatosis that is characterized by acquired, asymptomatic, protracted connective tissue swellings on the back and sides of a few proximal phalanges or proximal interphalangeal joints. This is the tenth reported case of pachydermodactyly. It has previously been reported only in men; to the best of our knowledge, this is the first woman described with this condition.

Verification of a formula for determination of preexcision surgical margins from fixed-tissue melanoma specimens.

Background: Recently our group reported on the shrinkage of 199 malignant melanoma surgical-excision specimens. In that report, a multivariate analysis revealed that the age of the patient was the only factor that significantly affected the percentage shrinkage of a surgical specimen. In addition, a formula was presented that extrapolates the actual surgical margins (in vivo) from the (contracted) fixed-tissue pathology report measurement and the reported in vivo lesion diameter.

Recurrence rates of treated basal cell carcinomas. Part 4: X-ray therapy.

This is the fourth report in a series that reviews the experience in the Skin and Cancer Unit, from 1955 through 1982, with the treatment of basal cell carcinomas (BCCs). It concerns 862 primary (previously untreated) BCCs irradiated by a "standardized" x-ray therapy schedule. The overall 5-year recurrence rate for these lesions, as determined by the modified life-table method, was 7.

Recurrence rates of treated basal cell carcinomas. Part 3: Surgical excision.

This is the third report in a series that reviews the experience in the Skin and Cancer Unit, from 1955 through 1982, with the treatment of basal cell carcinomas (BCCs). It concerns 588 previously untreated (primary) BCCs removed by surgical excision. The cumulative 5-year recurrence rate was 4.

Influence of gender on survival in patients with stage I malignant melanoma.

Background: Women with stage I malignant melanoma (MM) have a survival advantage over men as judged by univariate analysis. However, on multivariate analysis, gender was found to be an independent predictor of survival in only 8 of 14 published studies.

Objective: This study attempts to explain the disparate findings for gender as a prognostic factor in different multivariate analyses.

Level of education and the risk of malignant melanoma.

Background: The risk for the development of malignant melanoma has been reported to be higher in persons with more formal education than in individuals with less.

Objective: To study whether those with more formal education are indeed at more risk for malignant melanoma than those with less formal education.

Methods: This case-control study explores the relation between education and melanoma risk by analyzing data collected by the American Cancer Society.

Determination of preexcision surgical margins of melanomas from fixed-tissue specimens.

The shrinkage of cutaneous surgical specimens of 199 malignant melanomas was analyzed. A formula was derived that makes it possible to calculate the in vivo (preexcision) specimen diameter from the in vitro (fixed-tissue) specimen diameter. The age of the patient was found to significantly influence specimen shrinkage and was incorporated into this shrinkage formula.

Clinical features of dysplastic nevi.

The clinical features of 100 dysplastic nevi were tabulated. Although certain characteristics were present in most or all of these melanocytic nevi, there was a marked heterogeneity of other clinical features. The preponderant type of large (greater than or equal to 8 mm) melanocytic nevus in patients with classic dysplastic nevi is a papule or plaque with the following characteristics: multicoloration (various shades of tans, browns, reds, or black); slightly raised height for its broad diameter; mamillated surface; and lack of hypertrichosis.

Distinguishing benign and malignant melanocytic lesions with the AgNOR method.

A silver staining technique has recently been devised to aid in the differentiation between benign and malignant melanocytic lesions. This study showed a statistically significant difference between the staining of silver-nucleolar organizer regions (AgNORs) in melanocytic nevi and that of AgNORs in malignant melanomas.

Volume of malignant melanoma is superior to thickness as a prognostic indicator. Preliminary observation.

There are many clinical and histologic factors that are known to be valuable in predicting survival rates for patients with cutaneous malignant melanomas. Breslow thickness is considered to be the most reliable prognostic factor; however, thickness is a unidimensional measurement. A more accurate mensuration to predict biologic behavior might be one that takes into account the three-dimensional volume of the neoplasm.

Factors influencing survival in melanoma.

Multiple factors appear to influence survival of patients with MM. As computer and mathematic analysis techniques advance, the specific effects of these variables, in terms of their impact on survival rates, will be delineated better.

Recurrence rates of treated basal cell carcinomas. Part 1: Overview.

This is the first article in a series reviewing the extensive experience of the Oncology Section of the Skin and Cancer Unit, from 1955 through 1982, with 5755 basal cell carcinomas (BCCs) treated by curettage-electrodesiccation, surgical excision, or x-ray therapy. Recurrence rates were calculated by three methods for each of the treatment modalities: 1) by the raw recurrence rate method; 2) by the "strict" 5-year recurrence rate method; and 3) by modification of the life-table method. Our analyses show that the last method best approximates the true recurrence rate.

Recurrence rates of treated basal cell carcinomas. Part 2: Curettage-electrodesiccation.

This is the second article in a series that reviews the experience in the Skin and Cancer Unit, from 1955 through 1982, with the treatment of basal cell carcinomas (BCCs). This report deals with 2314 previously untreated (primary) BCCs removed by curettage-electrodesiccation. Multivariate analysis showed that increasing lesion diameter (P less than .

Malignant melanoma in the 1990s: the continued importance of early detection and the role of physician examination and self-examination of the skin.

Despite the exciting new techniques being developed to help diagnose early malignant melanoma, the current standard of care remains periodic examination of the skin. The combination of routine physician examination coupled with self-examination of the skin provides an opportunity for the identification of early malignant melanoma. Removal of such thin lesions can significantly reduce the ever-increasing mortality rate from this potentially serious form of cutaneous cancer.

Late recurrence of malignant melanoma: a report of five cases, a review of the literature and a study of associated factors.

This is a study of factors associated with late recurrence (i.e. 10 or more years after definitive surgery) of cutaneous malignant melanoma (MM).

Prospective follow-up for malignant melanoma in patients with atypical-mole (dysplastic-nevus) syndrome.

A total of 357 white patients who had melanocytic nevi that fulfilled the clinical criteria for the "classic" atypical-mole (dysplastic-nevus) syndrome (100 or more melanocytic nevi; one or more melanocytic nevi 8 mm or larger in diameter; and, one or more melanocytic nevi with atypical features) were followed for the development of cutaneous malignant melanomas. Seventeen patients (4.8%) developed malignant melanomas during an average follow-up period of 49 months.

Familial multiple desmoplastic trichoepitheliomas.

A kindred with familial multiple desmoplastic trichoepitheliomas is described. Desmoplastic trichoepitheliomas should be added to the group of lesions that indicate an inherited pattern when they occur as multiple primary tumors. The implications for nosologic status and treatment of desmoplastic trichoepitheliomas are considered.

Does a history of melanoma correlate with the clinical presentation of dysplastic nevi?

In order to determine the prevalence of key features concerning nevocytic nevi (NN) in 150 consecutive Caucasian patients with dysplastic nevi (DN), total-body photographs were reviewed that revealed the following: 74% had greater than or equal to 100 NN, 73% had NN 8 mm or more in diameter, and 81% had atypical NN. The patients were then divided into two subsets, those with a personal and/or family history of malignant melanoma (MM) and those without, to see if the proportion of these three features differed in these two groups. There were no statistically significant differences between the MM-history-positive and MM-history-negative subsets.

Accuracy in the clinical diagnosis of malignant melanoma.

The computerized database (1955 through 1982) of the Oncology Section of the Skin and Cancer Unit of New York (NY) University Medical Center includes data on 13,878 lesions. Of these lesions, 214 were diagnosed clinically and histologically as malignant melanoma (MM). An additional 51 lesions, diagnosed clinically as other than MMs, were found histologically to be MM.