Sex differences in survival from cutaneous melanoma.
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Biomedical subjects
Publications and source records attributed to F H Rampen.
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A questionnaire was sent to all consultant dermatologists in The Netherlands, Belgium and Scotland regarding their management of suspected melanomas. The 343 evaluable responses showed that 29.7% of the dermatologists regularly prefer to 'wait and see' or carry out incisional biopsies in the early management of suspected melanoma, especially if the risk is thought low. The main arguments advanced by the proponents of incision were doubts about whether incisional biopsy provokes metastatic spread, and the belief that a pathologist can make reliable diagnosis on a partial specimen of the tumour. These arguments are questioned and excision biopsy, provided it is feasible without being disfiguring, is strongly recommended in the initial treatment of a suspected melanoma.
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Fifteen out of twenty-three female patients (65%) receiving PUVA therapy showed signs of moderate to severe hypertrichosis. Only two out of fourteen patients (14%) on UV-A therapy without systemic psoralens developed hypertrichosis. We conclude that hypertrichosis may develop in many patients treated with photochemotherapy.
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From studying cell kinetic parameters it is demonstrated that both males and females with metastatic melanoma respond favourably to various chemotherapy schedules. Male patients have a shorter doubling time (DT) of pulmonary secondaries prior to chemotherapy compared to females, which seems to give them a less favorable starting point. Also, the DT of lung metastases of males after chemotherapy is less favourable than that of females. However, a significant difference in DT is noticed between measurements prior to and after the institution of chemotherapy in both sexes. It is concluded that the alleged sex differences in response to chemotherapy may be an artifact due to differences in tumor growth kinetics between males and females.
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A 24-year-old female patient with congenital ichthyosiform erythroderma, deafness and vascularizing keratitis yet also examining normal sweating and tear production when tested is reported. This unique finding indicates that a certain subgroup of patients with this generalized ectodermal disturbance may benefit from treatment with the aromatic retinoids.
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