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Biomedical subjects

A du Vivier

Publications and source records attributed to A du Vivier.

At least 19 recordsLinked to original sources

Problems with registration of cutaneous malignant melanoma in England.

The aim of the study was to assess the completeness and accuracy of cancer registration for cutaneous malignant melanoma. The study was conducted in seven health districts in England and one health board in Scotland from 1987 to 1989 with a total resident population of 3.6 million. Records from pigmented lesion clinics and pathology laboratories collected during the Cancer Research Campaign's health education programme to promote the early detection of melanoma were matched with cancer registrations from a total of five regional cancer registries. In England 74% out of a total of 642 cases of invasive malignant melanomas (ICD 172) and 44% out of a total of 155 in situ melanomas (ICD 232) had been registered compared with 96% and 100% respectively in Scotland. A significantly higher proportion of late-stage cases was found among registered than among non-registered cases in England (P < 0.001). In all registries the majority of superficial spreading in situ melanomas were miscoded as invasive cases. The annual incidence of invasive malignant melanoma in the English study areas was found to be seven per 100,000 in men and 11 per 100,000 in women, similar to that reported in Scotland. The registries are best at recording thick or late-stage melanomas. As the skin cancer target for Health of the Nation depends on monitoring trends in the incidence of malignant melanoma, future improved ascertainment of cases and changes in the type of cases being registered must be taken into account.

England

Melanoma. Differences observed by general surgeons and dermatologists.

A retrospective review of 182 cutaneous melanomas seen at King's College Hospital from 1970 to 1987 showed that surgeons saw much thicker melanomas (median 3.64 mm) when compared to dermatologists (median 1.14 mm). Surgeons saw a greater proportion of nodular melanomas, less superficial spreading melanomas, were less likely to make the correct clinical diagnosis, and were more likely to perform wide excisions for thin melanomas (less than 2 mm) when compared to dermatologists. General surgeons see a different group of melanoma patients compared to dermatologists and manage them differently from dermatologists working with plastic surgeons. There is a need for a combined approach for the diagnosis and management of cutaneous melanoma between specialists.

Dermatology

Malignant melanoma--a review: early diagnosis is the key.

The face of malignant melanoma is changing. The incidence is rising, and the disease is tending to affect a younger age group. Publicity about the disease is intense, and the trend is towards earlier diagnosis. Early diagnosis is essential, as the only effective treatment remains surgical excision, which is curative for thin lesions.

Adult

Successful use of topical vitamin E solution in the treatment of nail changes in yellow nail syndrome.

A double-blind controlled study was performed on a patient with long-standing yellow nail syndrome to investigate the potential beneficial role of topical vitamin E solution for the nail changes seen in this disorder. Three nails received active solution containing DL-alpha-tocopherol in dimethyl sulfoxide; three nails received dimethyl sulfoxide only; and the remainder were untreated. After 6 months of therapy, the three nails treated with active solution showed marked clinical improvement and a corresponding increase in nail growth rates. Dimethyl sulfoxide alone produced a small increase in nail growth rate and slight clinical improvement. Active solution was then applied to all of the nails for a further 6 months, resulting in clinical improvement and increased nail growth rates in the remaining nails. These beneficial effects require further study.

Administration, Topical

Cutaneous malignant melanoma: a potentially curable disease.

Theoretically no-one should die of cutaneous malignant melanoma for it is a unique cancer in that it is visible and can therefore be spotted early and excised before it has invaded to a significant depth. Cure depends on an informed general public and on doctors who can distinguish the sinister from the banal.

Humans

Familial malignant melanoma.

A case is reported of a 28-year-old man with three separate primary cutaneous malignant melanomas. The patient denied any family history of melanoma, but screening of the first degree relatives resulted in the early diagnosis of two malignant melanomas in his brother and the recognition of a strong family history of melanoma.

Adult

Anthralin-corticosteroid combination therapy in the treatment of chronic plaque psoriasis.

A prospective randomized trial of anthralin in Lassar's paste compared with anthralin in 0.0125% clobetasol propionate in the treatment of chronic plaque psoriasis was undertaken. The psoriatic skin of patients treated with the corticosteroid-anthralin combination cleared significantly more quickly than those treated with anthralin alone, with a mean time to clearance of 14.9 days compared with 18.5 days, and with lower concentrations of anthralin. No significant difference was found in the rate of relapse of the two treatment groups, with relapse occurring in over 80% of patients within one year. Anthralin in 0.0125% clobetasol propionate was found to be an effective agent in the treatment of chronic plaque psoriasis, and one that was cosmetically acceptable to patients and nursing staff. An important disadvantage, however, was the development of a staphylococcal folliculitis in four of the 35 patients in which it was used. Because of this, anthralin in Lassar's paste remains our standard inpatient therapy, although the ease of use and cosmetic acceptability of anthralin in clobetasol propionate make it a useful remedy for outpatient use.

Adolescent