Graeme L. Beardmore

Home treatment of skin cancer and solar keratoses

Participants in a community survey of skin cancer and solar keratoses were asked about their use of home remedies for these lesions. There were 164 persons aged between 20 and 69 years at high risk who said they treated these lesions themselves (7.8% of those surveyed). Half of the agents used were naturopathic and of these Euphorbia peplus was unanimously considered an effective treatment. Aloe vera was the most popular remedy and paw paw and creams such as lanolin were also popular despite their generally perceived lack of efficacy. Most of the self‐treaters were at high risk of skin cancer and thus the danger of this home treatment is the likely failure to recognize invasive disease. Close medical supervision of the treatment of actinic lesions remains essential.

Malignant melanoma in Queensland: a study of 219 deaths.

A series of 219 patients who died within five years of histological diagnosis of their melanoma is reported. One hundred and fifty‐eight died of melanoma and in three melanoma contributed to death. Male to female ratio was about 2:1 There was a progressive increase of deaths in each cohort in males with aging, but in females only after 60 years of age. Fatal melanomas arose most commonly on the back. Face and thigh lesions were responsible for an approximately equal number of deaths and thigh lesions were shown to have a worse outlook than melanoma of the leg. This series contained a large proportion of patients with melanomas bigger than 2 cm. and of the 13 patients with lesions larger than 3 cm., 10 had metastases on registration with the Queensland Melanoma Project. The presence of only three flat melanomas would indicate a generally better outlook for this type of lesion. Ulceration and bleeding suggested a poor prognosis. The large number of patients (78) who had microscopic evidence of metastases on registration contributed to the poor survival in this series. Of the 78, 30 patients presented with metastatic disease and no primary melanoma was found. The findings from 29 autopsies indicated the ability of melanoma to disseminate widely. Fifty‐one patients died from causes other than melanoma, the more common being cardio‐vascular and cerebro‐vascular disease.

Malignant melanoma in Queensland: Pathology of 105 fatal cutaneous melanomas

&NA; The pathology of 105 primary cutaneous melanomas from 103 patients (70 males, 33 females) dead from melanoma is reported. Features of a melanoma adversely affecting prognosis were: presence of pedunculation and of a spherical shape (suggested by a low width/height ratio), increasing depth of dermal invasion, and ulceration. Pedunculated stage‐2 melanomas were placed in a separate category because they appeared to have a more malignant behaviour. We did not find that pleomorphism, mitotic rate, pigmentation or inflammation helped in assessing prognosis although further study may prove otherwise. It is desirable that comparison of results of different treatments are made on the same type of melanoma, from the same site and in the same sex. We should like to see a standard method of staging melanomas.

CHROMOBLASTOMYCOSIS IN QUEENSLAND: A RETROSPECTIVE STUDY OF 13 CASES AT THE ROYAL BRISBANE HOSPITAL*

Since 1965 13 cases of chromoblastomycosis have been seen at the Royal Brisbane Hospital. These cases have been reviewed. All were men who presented with localized, chronic, verrucous and cicatrizing plaques on the distal of the distal part of the upper limb. Fungal culture demonstrated the presence of Cladosporium carrionii in 8 of 10 cases and was negative in the remainder. No evidence of spread following invasive techniques was found. Treatments employed included oral potassium iodide, surgery, cryotherapy, and oval 5‐fluorocytosine.

RECALCITRANT SPOROTRICHOSIS: A REPORT OF A PATIENT TREATED WITH VARIOUS THERAPIES INCLUDING ORAL MICONAZOLE AND 5-FLUOKOCYTOSINE

A Sporotrichum schenckii infection of the forearm and hand of a 41‐year‐old man was treated over a period of 11 years with oral potassium iodide, griseofulvin, miconazole, 5‐fluorocytosine, curettage and cauterization, intra‐lesional injections of amphotericin B and cryotherapy.

CUTANEOUS MELANOCYTES IN QUEENSLAND PATIENTS

A study of cutaneous melanocytes and dermal changes around non‐melanoma lesions and malignant melanomas in Queensland patients has been undertaken. The findings from the non‐melanoma group are reported in this paper. The aim of the study was to see if a melanoma affected the melanocytes in the surrounding epidermis. To do this, a base‐line for changes in the melanocytes in Queensland patients with non‐melanoma tumours was sought. The features studied were number, morphology and activity of melanocytes, epidermal pigmentation and solar‐induced dermal changes.

A clinically invisible melanoma

We report a case of an amelanotic lentigo maligna incidentally found on a shave biopsy in an 87‐year‐old woman. Amelanotic lentigo maligna is a rare variant of lentigo maligna. It is often reported as presenting as erythematous scaly macules and is usually confused as benign dermatoses. Here were present a case of amelanotic lentigo maligna with no visible or palpable features.