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Biomedical subjects

F H Rampen

Publications and source records attributed to F H Rampen.

At least 55 records · Page 3Linked to original sources
PubMed1989

Racial differences in mole proneness.

Mole counts were studied in relation to skin complexion in various racial groups. White children had a median total number of naevocytic naevi of 17.0, versus 2.5 in non-white children (p less than 0.001). Young white adults showed a similar mole proneness to that of coloured subjects (61.0 versus 16.0; p less than 0.001). With regard to moles greater than 2 mm diameter in the young-adult group, white subjects again exhibited a higher median count than non-white subjects (5.5 versus 1.0; p less than 0.001). There was an inverse gradient of mole counts in young adults from subjects of white complexion through those of mixed ancestry, Oriental ancestry, to those of Negroid descent. This study indicates that there is a strong racial background predisposing to the development of naevocytic naevi.

Adolescent↗
PubMed1989

Patients' and doctors' delay in the diagnosis and treatment of cutaneous melanoma.

Factors involved in patients' and doctors' delay in the diagnosis and treatment of primary or metastatic cutaneous melanoma were studied in an inquiry of 284 patients in 12 hospitals. The most important patients' delay factors were: unawareness of the danger of the earliest and to a lesser extent the late signs and symptoms in the evolution of melanoma. Age and socio-economic status were of negligible importance in this respect. When the primary melanoma was easily visible, patients noticed the first signs of the developing melanoma significantly earlier than when the primary was not visible; nevertheless visibility had no impact on tumor thickness. This again shows that the early signs were not experienced as signs that required a visit to a doctor. Patients who showed their melanoma as a secondary complaint while they visited the doctor for another condition, had a more favorable tumor thickness than those who only came for their melanoma. The most important factors in doctors' delay were lack of suspicion (often due to amelanosis), and the performance of an incisional or punch biopsy and treatment without histopathology. Melanomas discovered by chance during a physical examination while the patient was totally unaware of the lesion had a most favorable tumor thickness. These observations indicate that a better education of the general public and of the medical profession is warranted, in order to improve the prognosis of cutaneous melanoma.

Aged↗
PubMed1988

Naevocytic naevi as an atavism; their relationship to melanoma risk.

Common "acquired" naevocytic naevi (moles) are often regarded as caused by ultraviolet radiation although no proof of this assumption exists. An alternative view is presented herein, describing moles as atavistic relics. When the remote ancestors of Homo sapiens lost their fur, coat colour patterns also disappeared, leaving behind small rudimentary defects of the pigmentary system. These remnants are known to us as naevocytic naevi.

Animals↗
PubMed1988

Prevalence of common "acquired" nevocytic nevi and dysplastic nevi is not related to ultraviolet exposure.

The precise role of ultraviolet radiation in the induction of nevocytic nevi is unsettled. We studied mole counts in relation to the attitude toward ultraviolet exposure in 508 students 18 to 30 years of age. Moles were counted on the chest, back, and legs. Lesions measuring 2 mm or less in diameter and those measuring more than 2 mm were recorded separately. Dysplastic nevi were also recorded separately. The attitude toward sun worship was related to the average periods of sunbathing, the frequency of holidays in sunny climates, and the use of artificial ultraviolet sources. The frequency of pigmented nevi showed no correlation with sun behavior, irrespective of sex, mole size, or burning and tanning propensities. This lack of correlation between ultraviolet exposure and mole counts held true for all solar parameters: periods of sunbathing, sunny holidays, and sunlamp usage. Contrary to expectation, there was a clear, although not statistically significant, excess of dysplastic nevi in subjects with short periods of ultraviolet exposure during leisure. From these data insufficient evidence emerges to support the hypothesis of a correlation between the occurrence of common nevocytic nevi and dysplastic nevi and the degree of insolation by natural or artificial ultraviolet radiation.

Adolescent↗
PubMed1988

Nevocytic nevi and skin complexion.

There exists a large body of evidence that the occurrence of nevocytic nevi is closely related to skin complexion. Nevi are more frequent in Caucasians with a light skin than in those with a dark phenotype. In Orientals and Negroids nevocytic nevi are uncommon. Within a black population subjects with a relatively light complexion have greater total counts than those with a very dark skin. It is concluded that literature data dealing with mole proneness in relation to skin complexion strongly point to an association of high nevus counts with light complexion. This applies to differences between racial groups as well as to differences between complexion phenotypes within a given racial group.

Humans↗
PubMed1988

Referral pattern and accuracy of clinical diagnosis of cutaneous melanoma.

Between 1981 and 1983, 329 patients with cutaneous melanoma registered in Amsterdam and Rotterdam, The Netherlands, were analysed with respect to the referral pattern and accuracy of clinical diagnosis. With increasing Breslow thickness, a greater proportion of the patients were referred to the surgeon than to the dermatologist (p less than 0.01). The overall clinical suspicion rate was 61.6%. Suspicion of melanoma was greater for lesions less than or equal to 2 mm thick vis-à-vis the greater than 2 mm thickness group (p less than 0.01). Accuracy of clinical diagnosis was better for dermatologists than for surgeons (p less than 0.01, after adjustment for microstage). Differential diagnoses were more often considered by dermatologists than by surgeons (p less than 0.01). Vague descriptions such as 'tumour' without specification were less frequently used by dermatologists than by surgeons (p less than 0.01). Amelanotic melanomas were often missed clinically by both disciplines (overall diagnostic accuracy 28.6%). It is emphasized that close cooperation between dermatologists and surgeons in the clinical management of melanoma is highly desirable.

Diagnosis, Differential↗
PubMed1988

Eruptive seborrheic keratoses associated with erythrodermic pityriasis rubra pilaris. Possible role of retinoid therapy.

A 74-year-old female patient with an erythrodermic pityriasis rubra pilaris developed multiple seborrheic keratoses during the early stage of the skin disorder. There was no evidence of an underlying internal malignancy. Initially, the patient was treated with etretinate. The seborrheic keratoses all faded away during the next 3-4 months without any specific treatment. The possible role of retinoid treatment in the resolution of seborrheic keratoses is discussed.

Aged↗
PubMed1988

Unreliability of self-reported burning tendency and tanning ability.

Burning and tanning histories were studied in 790 white students 18 to 30 years of age by means of a self-administered questionnaire. Only 325 cases (41.1%) were classifiable according to the Fitzpatrick scheme (skin types I to IV). Skin type I (always burn, never tan) was recorded only twice (0.3%). The minimal erythemal dose was measured in a subgroup of 197 students; these results showed no significant correlation with the self-reported burning tendency. In 508 students the burning-tanning histories were compared with eye and hair color, freckling tendency, and number of moles. The tanning ability showed a better correlation with skin complexion characteristics than the burning tendency. It is concluded that self-reported burning-tanning histories form an unreliable means of skin typing.

Adult↗
PubMed1987

Melanoma of the skin is not caused by ultraviolet radiation but by a chemical xenobiotic.

The putative ultraviolet (u.v.) carcinogenesis of cutaneous melanoma bears sufficient inconsistencies as to seriously challenge this theory. A more attractive hypothesis is the incrimination of a hitherto unknown chemical xenobiotic. This hypothesis explains the dramatic increase in incidence rates in most affluent countries during the last two or three decades. It also explains the particular risk of populations of high socio-economic status and the increased risk of indoor workers. It finally explains the urban-rural and coastal-inland trends observed in many countries with high incidence rates.

Carcinogens↗