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D J Elpern

Publications and source records attributed to D J Elpern.

At least 19 recordsLinked to original sources
PubMed1995

Nonmelanoma skin cancer in Japanese ethnic Hawaiians in Kauai, Hawaii: an incidence report.

BACKGROUND: Incidence reports of nonmelanoma skin cancer (NMSC) in Japanese persons are limited. Most studies have relied primarily on hospital records or voluntary reporting systems. OBJECTIVE: Our purpose was to determine the incidence of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and Bowen's disease (BD) in a defined Japanese population. METHODS: A prospective 5-year population-based incidence study was conducted on the island of Kauai, Hawaii from 1983 through 1987. RESULTS: Thirty Japanese Kauai residents, 12 men and 18 women, developed BCC during the 5-year study period. At the same time, 24 Japanese, 6 men and 18 women, were identified with SCC, and 11 had BD, three men and eight women. When standardized to the Japanese population in Japan, the annual BCC incidence rate was 30 per 100,000 Japanese Kauai residents with an average patient age of 75 years. More than 80% of these BCCs were localized to the head and neck. New BCCs developed in four patients with BCC, but none was a recurrence of a previously treated lesion. Five patients with BCC had SCC or BD concurrently or at other times. The SCC incidence was 23 per 100,000 Japanese Kauai residents with an average patient age of 80 years. The head and neck were again the most common anatomic sites. New SCCs subsequently occurred in two patients, in one of whom a localized recurrence also developed. Five patients with SCC had BCC simultaneously or at other times. The incidence of BD was 13 per 100,000 Japanese Kauai residents with an average patient age of 74 years. The extremities were the most common anatomic sites. One patient later had a new BD lesion and a recurrent BD lesion. Two patients had BCC or SCC at other times. CONCLUSION: We report incidence rates of BCC, SCC, and BD at least 45 times higher in the Japanese population in Kauai, Hawaii than rates for the Japanese population in Japan. Kauai's intense UV radiation and emphasis on outdoor activities may contribute. More Japanese women had NMSC than men, a sex difference not observed in Japan.

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PubMed1995

Keratoacanthoma in Japanese Hawaiians in Kauai, Hawaii.

BACKGROUND: This is the first incidence report of keratoacanthoma (KA) in a Japanese ethnic population. METHODS: The study was designed as a 5-year prospective incidence study using an island-wide survey of Japanese residents in Kauai, Hawaii, during the years 1983 through 1987. RESULTS: Eleven Japanese residents of Kauai, three men and eight women, had KA. The crude incidence is 22.1 per 100,000 Japanese Kauaiian population. Two thirds of the lesions were on the extremities. No recurrence was noted, but a nonmelanoma skin cancer developed in some patients. CONCLUSIONS: The incidence of KA in a Japanese ethnic population is not low. Ultraviolet light exposure must, in part, contribute to the development of KA. This is supported by fact that the incidence of KA in Japanese residents in Kauai is much higher than in Japan and that most of the KAS appear on exposed skin.

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PubMed1995

Squamous cell carcinoma in Kauai, Hawaii.

BACKGROUND: It is estimated that over 100,000 new cases of squamous cell carcinoma are diagnosed in the United States annually. This number is compounded by an increasing concern over the ozone layer depletion and the continued sunbathing behavior of many individuals. This could be particularly acute in Hawaii, which may have the highest rates of skin cancer in the country. We believe the updated information on skin cancer is essential to address the magnitude of the problem. METHODS: A prospective 5-year population-based incidence study was conducted on Kauai, Hawaii, between 1983 and 1987 to investigate the frequency of squamous cell carcinomas in resident Caucasians. RESULTS: A total of 58 residents, 37 men and 21 women, were identified with an initial episode of squamous cell carcinoma during the 5-year period. The average annual incidence rate per 100,000 Kauai Caucasian residents, standardized to the 1980 U.S. white population, was 153 for men and 92 for women with a combined rate of 118. The average patient age was 66.4 years. The head and neck was the most common anatomic site, with the extremities second. Subsequent new squamous cell carcinoma occurred in 13.8% of patients. Only one patient (2%) developed a recurrence after treatment. Twenty-five patients (43%) had basal cell carcinoma simultaneously or at other earlier times. CONCLUSIONS: In Kauai the incidence rate of squamous cell carcinoma is the highest yet documented in the United States. No consistent trend in incidence rates was appreciated during this 5-year period.

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PubMed1995

Junk!

Each day, the US Postal Service delivers millions of pieces of unsolicited mail to our country's 500,000 physicians. This onslaught includes brochures for meetings in places both exotic and pedestrian, solicitations from financial institutions, newsletters, magazines, and elaborately packaged pharmaceutical promotions that may include such inducements as candy, flashlights, pens, and even golf tees! Our mailboxes groan under masses of unsolicited letters, periodicals, packets, brochures, booklets, and boxes.

Advertising↗
PubMed1994

Bowen's disease (squamous cell carcinoma in situ) in Kauai, Hawaii. A population-based incidence report.

BACKGROUND: The incidence of Bowen's disease (squamous cell carcinoma in situ) is rarely investigated. OBJECTIVE: Our purpose was to report the incidence of Bowen's disease in a defined Caucasian population in Kauai, Hawaii. METHODS: We conducted a prospective 5-year population study. RESULTS: We found 71 Caucasian residents, 44 men and 27 women, who had an initial episode of Bowen's disease during the 5-year period. The average annual incidence rate per 100,000 Caucasian residents of Kauai, standardized to the 1980 U.S. Caucasian population, was 174 for men and 115 for women, with a combined rate of 142. The incidence increased in older age groups. The mean age of the patients was 65.2 years. The most common anatomic site was the extremities. Subsequent Bowen's disease occurred in eight patients (11.3%). Recurrence after treatment developed in only one patient (1.4%). Twenty-six patients (36.6%) had concurrent skin cancers, either basal cell carcinoma or squamous cell carcinoma, or both. There was no increased incidence of internal malignancy. CONCLUSION: The incidence of Bowen's disease is high in Caucasian residents of Kauai and is 10 times higher than that reported from a northern Midwestern community. Kauai's intense ambient UV light and greater opportunity for year-round outdoor activities likely contributes to this higher rate.

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PubMed1993

Basal cell carcinoma in Kauai, Hawaii: the highest documented incidence in the United States.

BACKGROUND: In Kauai, Hawaii, we observed an exceedingly high incidence of basal cell carcinoma in an earlier 1-year study. OBJECTIVE: Our purpose was to report the incidence of basal cell carcinoma in a defined population in Hawaii. METHODS: A prospective 5-year population-based incidence study was conducted on Kauai, Hawaii, between 1983 and 1987 to investigate the frequency of basal cell carcinomas in Caucasian residents. A total of 242 residents, 161 men and 81 women, were identified with an initial episode of basal cell carcinoma during the 5-year period. RESULTS: The average annual incidence per 100,000 Kauai Caucasian residents standardized to the 1980 U.S. white population was 576 for men and 298 for women with a combined incidence of 422. The average patient age was 56.5 years, and men had a significantly higher incidence of cancer than women (p < 0.000001). The head and neck was the most common site. The trunk was the second most common site, representing one third of lesions. Subsequent new basal cell carcinomas occurred in 16.9% of patients. Only 3.3% of patients had recurrent carcinomas after treatment. CONCLUSION: Kauai's incidence rates of basal cell carcinoma are the highest yet documented in the United States. As an unexpected finding, a decreasing incidence trend was noted in the study's later years and may warrant further investigation. Finally, a significant number of basal cell carcinomas developed on the trunk, suggesting and reinforcing the expectation that sun exposure is not limited to the face and neck in this Hawaiian population.

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PubMed1993

Non-melanoma skin cancer and keratoacanthoma in Filipinos: an incidence report from Kauai, Hawaii.

BACKGROUND: Non-melanoma skin cancer is the most common malignancy in the white population of the United States with an estimated 700,000 new cases each year. Regrettably, data on minority racial groups are either scarce or lacking entirely. METHODS: This study was designed as a 5-year prospective incidence study of non-melanoma skin cancer and keratoacanthoma by using an island-wide survey of Kauai's Filipino residents and covers the years of 1983 to 1987. RESULTS: Seven basal cell carcinoma (incidence: 12.3/100,000), one squamous cell carcinoma (incidence: 1.8/100,000) and four keratoacanthoma (incidence: 7/100,000) patients are reported. CONCLUSIONS: To the best of our knowledge, this is the first population-based incidence report on non-melanoma skin cancer and keratoacanthoma in this population.

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PubMed1993

Keratoacanthoma in Kauai, Hawaii. The first documented incidence in a defined population.

BACKGROUND AND DESIGN: A prospective 5-year population-based incidence study was conducted on the island of Kauai, Hawaii, from 1983 through 1987 to investigate the frequency of keratoacanthoma in white residents. RESULTS: A total of 53 residents, 36 men and 17 women, were identified with an initial episode of keratoacanthoma during the 5-year study. The average annual incidence rate per 100,000 Kauai residents, standardized to the US white population, was 144 for men and 73 for women, with a combined rate of 104. The average patient age was 63.5 years. The limbs, particularly the hands and arms, were the most common anatomic site, with the trunk second. Only one patient developed a new subsequent keratoacanthoma, and no recurrent lesions were observed. Three patients had two keratoacanthomas when they first presented, and 13 patients had concurrent skin cancer. Sixty percent (32) of our patients developed skin cancer at one time or another. CONCLUSIONS: We report the first population-based keratoacanthoma incidence rates documented in the United States, which are almost equal to those of squamous cell carcinoma. Keratoacanthoma also shares many common epidemiological features with squamous cell carcinoma, such as increasing incidence in progressively older age groups.

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PubMed1992

Acral lentiginous melanoma: case studies from Kauai.

Cutaneous malignant is generally regarded as a skin cancer of Caucasians. However, one subtype, acral lentiginous melanoma (ALM), has an equal distribution among all ethnic groups and is the variant most common in non-Caucasians. In its early stage it is difficult to recognize and, unless diagnosed early, has a very poor prognosis. Herein, we present 3 cases of ALM seen on Kauai in 1990.

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PubMed1991

Sarcoidosis: a Hawaii rarity.

Sarcoidosis is so rarely seen in residents of Hawaii that it may not be considered as a diagnostic possibility. The differential diagnosis is more complex in Hawaii due to the presence of granulomatous diseases such as tuberculosis and leprosy. We present the first known case of sarcoidosis in a Hawaii resident together with an overview of the disorder.

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