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Biomedical subjects

L Scerri

Publications and source records attributed to L Scerri.

At least 19 recordsLinked to original sources
PubMed2006

A profile of invasive cutaneous malignant melanoma in Malta: 1993-2002.

BACKGROUND: The incidence of malignant melanoma of the skin has risen in every part of the world where reliable cancer registration data are found. OBJECTIVE: Our study aims to describe the changing incidence of and survival from invasive cutaneous malignant melanoma in Malta, by analysing the data from the 211 cases that were registered at the Malta National Cancer Registry between 1993 and 2002. RESULTS: The age standardized incidence rates for invasive cutaneous malignant melanoma rose from 3.7 per 100,000 population per year for males and 5.1 for females in the first 5-year period, to 8.0 per 100,000 population per year for males and 5.9 for females in the second 5-year period. In both sexes, numbers of thin (< or = 1.0 mm) invasive melanomas increased significantly between 1993 and 2002; males also registered a significant increase in intermediate-thickness (1.01-4.0 mm) melanomas. The increase in numbers of thin and intermediate-thickness melanomas between the two 5-year periods was greatest in patients aged 60 years and over. The overall absolute 5-year survival rate for the first period was 74% and for the second period 92%. CONCLUSION: Numbers of reported cases of invasive cutaneous malignant melanoma in Malta have more than doubled during the 10-year study period. This is mostly due to a marked rise in the diagnosis of thin melanomas in both sexes, occurring mainly in patients aged 60 years and over. As thin melanomas are of low metastasizing potential, this has resulted in an increase in survival between the two 5-year study periods.

Female↗
PubMed2004

Sun awareness in Maltese secondary school students.

BACKGROUND: Studies indicate that reducing exposure to ultraviolet light during childhood and adolescence decreases the risk of skin cancer. From a young age, children need to be educated about the sun's harmful effects on the skin and how best to protect themselves. OBJECTIVE: To help in the design of school-based interventions to raise sun awareness, a school survey was carried out to identify students' stereotypes and misconceptions. STUDY DESIGN: A total of 965 students attending Maltese secondary schools in forms 1, 2 and 3 were surveyed in May 2002, using a structured questionnaire designed to examine students' sun-related attitudes and knowledge. RESULTS: A high level of sun awareness among students was demonstrated, with high scores on knowledge of the effects of the sun on the skin, knowledge of skin cancer and knowledge of sun protection. Girls were clearly more knowledgeable than boys. However, of all the students surveyed, 55% thought that a suntan made them look better and 70% thought that their friends would desire a tan. These views were commoner among the older students. Skin type and hair or eye colour had no bearing on attitudes towards tanning or sun-related knowledge. The commonest misconceptions were that 'the sun is bad for your skin only when you get sunburnt' and that 'you cannot get too much sun on a cloudy day'. Deliberate suntanning was more frequently reported by girls than by boys and by students in the higher forms. CONCLUSION: Attitude change lags behind knowledge. Future school sun awareness interventions need to take into account gender and age differences in students' attitudes and perspectives. They should aim at motivating attitude change and preventive behaviour through consistent and repeated sun-education messages that are supported by a sun-conscious school environment.

Adolescent↗
PubMed2002

Sun awareness and sun protection practices in Malta.

BACKGROUND: Concern regarding the rising incidence of melanoma and non-melanoma skin cancers in Malta has led to the organization of annual campaigns since the early 1990s. These aim to inform the public of the dangers of sun exposure and to promote sun protection. OBJECTIVE: To help guide future campaigns, a survey was carried out to evaluate current sun protection measures among the Maltese people and to assess their level of knowledge regarding harmful effects of the sun on the skin. STUDY DESIGN: A total of 559 pedestrians were interviewed in the main street of the capital city of Malta in the summer of 1999. RESULTS: Self-reported rates of regular sunscreen and hat use in adults exposed to the spring/summer sun between 10.00 h and 15.00 h were 51% and 32%, respectively, for leisure activities, and 25% and 37%, respectively, for outdoor work. Men reported using sunscreen less often than women during both leisure and work. The fairer-skinned outdoor workers actually reported making less use of a sunscreen and/or hat than their darker counterparts, and rates of sunscreen and/or hat use during leisure and work were not found to increase with the amount of time spent in the sun. Almost 75% of sunscreen users were using a sun protection factor of at least 15. Parents reported much higher rates of regular sunscreen and hat use by their young children than by themselves, with 87% of children under 12 years of age reported to be using sunscreen and 78% reported to be wearing a hat. The great majority knew that injudicious sun exposure is associated with skin cancer and skin ageing, but 48% were still regarding a suntan achieved without skin burning as 'healthy' The mass media was by far considered to be the main source of information for the general public regarding effects of the sun on the skin. CONCLUSIONS: The positive impact of past campaigns can be seen in the high reported rates of sun protection in children. However, much remains to be done with adults in order to change their attitude about a 'healthy suntan' and to convince them that it is worthwhile to protect themselves from the sun.

Adolescent↗
PubMed2000

Teaching non-specialist health care professionals how to identify the atypical mole syndrome phenotype: a multinational study.

The atypical mole syndrome (AMS) phenotype is the strongest known risk factor for cutaneous melanoma but recognition of the phenotype has been claimed to be problematic and to require specialist assessment. This study determined the ability of previously unskilled doctors and nurses in five countries to recognize the phenotype after brief training. The system used was the AMS scoring system. This incorporates melanocytic naevus counts, clinical atypia of naevi and distribution of naevi. The agreement in scoring between the dermatologist and trained personnel was determined in 986 patients; overall agreement in diagnosis was 94.5% (kappa 0.70, P < 0.0001). The kappa scores in different countries ranged from 0.65 to 0.77 for individual naevus characteristics, indicative of good agreement. Accurate diagnosis of the atypical mole syndrome phenotype is possible by non-specialists. This has implications for collaborative studies of naevi, for screening and for both primary and secondary prevention of melanoma.

Adolescent↗
PubMed1999

Azathioprine in dermatological practice. An overview with special emphasis on its use in non-bullous inflammatory dermatoses.

Azathioprine is employed for its immunosuppressive properties, as a steroid-sparing agent or as monotherapy. Its most traditional clinical indications are connective tissue diseases, vasculitis, post-transplant, and immunobullous dermatoses. The main disadvantages of azathioprine therapy are a delayed onset of action (6-8 weeks), and rare profound bone marrow toxicity. Susceptibility to bone marrow toxicity is due to a genetically determined metabolic defect (1 in 300). Patients at risk of such toxicity may be identified by a Thiopurine methyltransferase enzyme assay. We have undertaken a retrospective study, looking at the use of azathioprine as monotherapy for non-bullous inflammatory dermatoses. We studied a total of 24 patients (10 male, 14 female). The dermatoses comprised: atopic eczema (10), pompholyx (6), plaque psoriasis (6), and chronic actinic dermatitis (2). All patients had severe refractory disease warranting systemic second line therapy. The mean age was 49.4 years (range 17-86 years). The starting dose of azathioprine was 100-150 mg/day, and the maintenance dose 50-100 mg/day. The mean duration of treatment was 33.5 months(range 1-132 months). Eighteen patients (75%) showed a good to excellent sustained clinical response to azathioprine. This response rate was evenly represented in the 4 dermatoses studied. The adverse reactions encountered were raised MCV (6), leucopenia (2), raised hepatic enzymes (6), and dyspepsia (4). Azathioprine had to be discontinued due to adverse reactions in 2 patients (dyspepsia, raised hepatic enzymes) followed by normalization. Other factors that potentially contributed to the observed adverse events were present in 5 patients: alcoholism (2), erythromycin toxicity (1), and malabsorption (2). Our study demonstrates the efficacy of azathioprine monotherapy for severe atopic eczema, pompholyx, plaque psoriasis, and chronic actinic dermatitis. Furthermore, azathioprine is a low cost and generally well tolerated drug.

Adolescent↗
PubMed1996

Occupational contact sensitization to the stabilized chlorinated paraffin fraction in neat cutting oil.

Twelve men developed contact sensitization to a neat cutting oil to which they were occupationally exposed in the same factory. Serial patch testing ultimately showed strong positive reactions to the chlorinated paraffin fraction of the oil in all 12 patients, whereas negative results were obtained in all 25 controls. Patch testing to pure chlorinated paraffin, on the other hand, gave negative results. Unexplained positive patch test reactions to epoxy resin from the standard series were elicited in half of the cases, suggesting that an epoxy stabilizer within the chlorinated paraffin fraction was the most likely sensitizer responsible for the outbreak of dermatitis. Because of insufficient manufacturer cooperation, we were not able to specifically identify the sensitizer. A number of deficiencies in the work practice, which accounted for the relatively large size of the sensitized group, were identified.

Adult↗
PubMed1996

Familial juvenile systemic granulomatosis (Blau's syndrome).

Blau's syndrome refers to the rare familial presentation of a sarcoid-like granulomatous disease classically involving the skin, uveal tract and joints, in the absence of pulmonary manifestations. The onset is in childhood, and the mode of inheritance is thought to be autosomal dominant. We report a 15-year-old female and her 22-month-old daughter who presented with clinical features similar to those of Blau's syndrome. In addition to the skin, eye and joint disease, the mother also developed neurological involvement. In both patients long-term systemic corticosteroids were required to control the disease.

Adolescent↗
PubMed1996

Dissecting cellulitis of the scalp: response to isotretinoin.

We report three patients with dissecting cellulitis of the scalp. Prolonged treatment with oral isotretinoin was highly effective in all three patients. Furthermore, long-term post-treatment follow-up in two of the patients has shown a sustained therapeutic benefit.

Adult↗
PubMed1995

Acute graft-versus-host disease with unusual cutaneous intracellular vacuolation in an infant with severe combined immunodeficiency.

We report an infant with severe combined immunodeficiency (SCID) who had cutaneous manifestations of acute graft-versus-host disease (GVHD) due to maternofetal lymphocyte engraftment. Histologic and ultrastructural examinations of the skin revealed intracellular vacuoles resembling lipid droplets in the epidermis and dermis, which is not a recognized feature of acute GVHD or SCID.

Acute Disease↗
PubMed1994

Dermatomyositis associated with malignant melanoma--case report and review of the literature.

Dermatomyositis (DM) is a connective tissue disorder characterized by cutaneous and muscle involvement. It is a well recognized paraneoplastic syndrome and has been linked with malignancy in 15-34% of adult patients. The course of DM in such patients usually correlates closely with the activity of the underlying malignancy. We report a patient who developed DM 4 years after excision of a malignant melanoma (MM) from the back and 1 year before the diagnosis of metastatic disease. A literature review revealed that the association of dermatomyositis with MM is rare and consistent with a dismal prognosis.

Dermatomyositis↗
PubMed1994

Primary anetoderma: phagocytosis of elastic fibres by macrophages.

We report a 22-year-old female with a 2-year history of increasingly numerous well-circumscribed, asymptomatic skin lesions. The clinical and histological features were consistent with anetoderma and investigations failed to reveal any associated underlying disorders. Electron microscopy of abnormal skin showed phagocytosis of elastic fibres by macrophages. Although the aetiology of primary anetoderma remains unknown, this finding suggests that phagocytic destruction of elastic fibres plays a major role in its pathogenesis.

Adult↗
PubMed1994

Split skin grafting on severely damaged skin. A technique using absorbable tissue adhesive.

BACKGROUND: Patients with severely damaged skin are more likely to develop skin malignancies. However, suturing following excision of tumors is difficult due to their fragile skin. OBJECTIVE: To evaluate the effectiveness of a technique using butyl-2-cyanoacrylate tissue adhesive in split skin grafts in patients with severely damaged skin. METHOD: The technique was used in 19 patients with 24 skin tumors. Two patients also had multiple skin biopsies to assess the biodegradability of the adhesive. RESULTS: Split skin grafts were applied successfully in all patients. The adhesive was completely absorbed without a foreign body reaction within 6 months. CONCLUSION: We recommend the use of butyl-2-cyanoacrylate in split skin grafting patients with severely damaged skin.

Absorption↗