Gordon H. Burgess

Treatment of kaposi's sarcoma with vinblastine

Fourteen patients with Kaposis sarcoma (KS) were treated systemically with vinblastine sulfate in a low‐dose regimen and compared with 23 patients reported in the medical literature. The therapeutic results in our series were excellent in terms of regression of cutaneous lesions. Vinblastine appears to be a drug that is well suited for the management of KS in an outpatient setting. Intravenous therapy may be supplemented with intralesional or intraarterial vinblastine.

Xeroderma Pigmentosum: A Rapid Sensitive Method for Prenatal Diagnosis

When normal human cells, capable of repairing ultraviolet-induced lesions in their DNA, are incubated in the thymidine analog 5-bromodeoxyuridine after ultraviolet irradiation, the analog is incorporated into the repaired regions. When such repaired cells are subsequently irradiated with 313-nanometer radiation and placed in alkali, breaks appear in the DNA at sites of incorporation of 5bromodeoxyuridine, inducing a dramatic downward shift in the sedimentation constant of the DNA. Cells from patients with the disease xeroderma pigmentosum, which causes sensitivity to ultraviolet, are incapable or only minimally capable of repair; such cells incorporate little 5-bromodeoxyuridine into their DNA under these conditions and, upon 313-nanometer irradiation and sedimentation in alkali, exhibit only minor shifts in DNA sedimentation constants. When fibroblasts developed from biopsies of normal skin and of skin from patients with xeroderma pigmentosum, as well as cells cultured from midtrimester amniotic fluid, were assayed in this fashion unequivocal differences between normal and xeroderma pigmentosum cells were shown. Xeroderma pigmentosum heterozygotes are clearly distinguishable from homozygous mutants, and results are available 12 hours after irradiation.

Squamous cell carcinoma in dominant type epidermolysis bullosa dystrophica.

The unusual genetic disorder epidermolysis bullosa dystrophica has been reported in several patients in whom the chronic cutaneous scars led to the development of cutaneous squamous cell carcinoma. However, only one of these previously reported cases involved the autosomal dominant form of the disease; the remainder occurred in its recessive counterpart. We report the second and third patients with squamous cell carcinoma associated with the dominant form of epidermolysis bullosa dystrophica. In addition, we not only observed the previous electron microscopic findings of decreased numbers of anchoring fibrils beneath the basal lamina but have also noted marked disruption of the basal lamina itself.

Breast carcinoma and basal cell epithelia after X-ray therapy for hirsutism

We report a 60‐year‐old woman with a history of x‐ray therapy for generalized hirsutism at 20 years of age who at the age of 37 years developed the first of numerous basal cell epitheliomas on her trunk, including chest, on a background of radiation damaged skin. At the age of 51 years one of the basal cell epitheliomas was biopsied and an incidental histologic finding was a breast carcinoma. The basal cell epithelioma is clearly linked with x‐ray exposure; breast cancer is less so although there is impressive epidemiologic evidence supporting an association between human breast cancer and radiation exposure. In view of an association between thyroid cancer and dermatologic x‐ray therapy, further investigation of such an association with breast cancer should be considered. It may be wise to evaluate patients who received dermatologic x‐ray exposure to their breasts for possible breast cancer and to consider radiation induced skin damage on or near the skin overlying the thyroid or breasts as a cutaneous marker of internal malignancy or potential internal malignancy.

Patch stage Kaposi's sarcoma

The patch stage of Kaposis sarcoma (KS) has been recently recognized as histologically distinct from that seen in well-developed violaceous nodules of KS. We report a patient with patch stage KS and its angioendothelioma-like histology. The presence of glomerulus-like vascular structures is a newly described feature.

Effect of topical tubercidin on basal cell carcinomas and actinic keratoses

The nucleoside Tubercidin was applied topically in a 0.5% concentration to solitary basal cell carcinomas in eight patients and widespread actinic keratoses in five patients for periods of 2–6 weeks. The treatment resulted in complete resolution of all eight basal cell carcinomas. All patients have been followed for 1 1/2 years. No recurrences have been observed. The treatment of the actinic keratoses was unsuccessful in four of five patients treated. These results are in contrast to those produced by topical 5‐fluorouracil, which is less active in basal cell carcinomas and more active against actinic keratoses than Tubercidin.