PubMed Health⌕ Search

Biomedical subjects

Matthias Moehrle

Publications and source records attributed to Matthias Moehrle.

6 recordsLinked to original sources
PubMed2006

Melanoma of the nose: prognostic factors, three-dimensional histology, and surgical strategies.

OBJECTIVES: The prominent position of the nose in the face accounts for its constant exposure to sunlight and thus its high incidence of malignant involvement. The aim of this prospective study was to define prognostic factors for nasal melanomas and to evaluate surgical strategies. METHODS: Forty-five patients with stage I/II melanoma were included. Malignant melanomas of the nose represented 0.8% of stage I/II cutaneous melanoma and 5.3% of head and neck melanoma (1983-2004). The median tumor thickness was 0.75 mm. Twenty-two of 33 Lentigo maligna melanomas (LMM) underwent three-dimensional (3D) histology in paraffin technique (i.e., micrographic surgery). RESULTS: The 5 year disease-specific survival rate was 96%, and the 5 year recurrence-free survival rate was 93%. There were no statistically significant risk factors in the univariate analysis. LMMs that were removed with accompanying 3D histology were thinner than other histologic types (median 0.75 vs. 1.55 mm). Compared with conventional histology, using 3D histology made it possible to reduce the excision margins (median 5 vs. 10 mm). There was one lymph node recurrence after LMM with 3D histology. Of five sentinel lymph node biopsies (SLNB) there was no positive SLNB and no recurrence. CONCLUSION: This is the largest study of nasal melanomas so far. Excision of LMM using 3D histology allowed the reduction of excision margins for better cosmesis and function. Our results do not permit conclusions regarding the prognostic impact of SLNB.

Aged↗
PubMed2003

Continuous long-term monitoring of UV radiation in professional mountain guides reveals extremely high exposure.

Ultraviolet radiation (UVR) is estimated to be one of the most important risk factors for nonmelanoma and melanoma skin cancers. High occupational UV exposure is assumed to be associated with skin cancer. Mountain guides receive considerable UV doses due to altitude-related increase of UVR and reflection from snow- and ice-covered surfaces. The aim of our study was to assess the annual occupational UV exposure of mountain guides. Spore film test chambers containing spores of Bacillus subtilis (VioSpor) were used as UV dosimeters with a spectral sensitivity profile similar to erythema-weighted data calculated from spectroradiometric measurements. Nine mountain guide instructors carried dosimeters on the sides of their heads on a total of 1,406 working days during one year (July 1999-June 2000). Dosimeters were changed monthly. Measurements of 92 months could be evaluated (4-12 months/mountain guide). The mean individual monthly UV exposure was 107 standard erythema doses (SED) (median 71 SED; range 10-505 SED). The mean annual cumulative UV exposure was 1,097 SED (median 1,273 SED; range 312-1,770 SED) per mountain guide. The mean UV dose per day (4-10 hr) was 6.6 SED (median 5.7 SED; range 0.6-24.2 SED). This is the second study of continuous annual UV dosimetry in a cohort of outdoor workers. Our study showed that it is not sufficient to interpolate annual UV exposure from a few days' measurements. Only long-term dosimetry can give reliable yearly information of UVR load. Median daily UV exposure exceeded limits for UV radiation (e.g., ACGIH effective dose 30 J/m(2) per 8 hr period corresponding to 1.08 SED/day) 6-fold; maximal exposure exceeded these limits 23-fold. These extremely high exposure values are suggestive for an increased risk of skin cancer and thorough epidemiologic studies in the collectives of professional and recreational mountaineering are required.

Germany↗
PubMed2003

UV exposure in cars.

BACKGROUND: There is increasing knowledge about the hazards of solar and ultraviolet (UV) radiation to humans. Although people spend a significant time in cars, data on UV exposure during traveling are lacking. The aim of this study was to obtain basic information on personal UV exposure in cars. METHODS: UV transmission of car glass samples, windscreen, side and back windows and sunroof, was determined. UV exposure of passengers was evaluated in seven German middle-class cars, fitted with three different types of car windows. UV doses were measured with open or closed windows/sunroof of Mercedes-Benz E 220 T, E 320, and S 500, and in an open convertible car (Mercedes-Benz CLK). Bacillus subtilis spore film dosimeters (Viospor) were attached to the front, vertex, cheeks, upper arms, forearms and thighs of 'adult' and 'child' dummies. RESULTS: UV wavelengths longer than >335 nm were transmitted through car windows, and UV irradiation >380 nm was transmitted through compound glass windscreens. There was some variation in the spectral transmission of side windows according to the type of glass. On the arms, UV exposure was 3-4% of ambient radiation when the car windows were shut, and 25-31% of ambient radiation when the windows were open. In the open convertible car, the relative personal doses reached 62% of ambient radiation. CONCLUSIONS: The car glass types examined offer substantial protection against short-wave UV radiation. Professional drivers should keep car windows closed on sunny days to reduce occupational UV exposure. In individuals with polymorphic light eruption, produced by long-wave UVA, additional protection by plastic films, clothes or sunscreens appears necessary.

Automobiles↗
PubMed2003

"Functional" surgery in subungual melanoma.

BACKGROUND: Subungual melanomas represent approximately 2% to 3% of cutaneous melanomas in White populations. Complete or partial amputation proximal to the distal interphalangeal joint of the digits has been suggested. Recently, we introduced for acral melanomas, similar to lentigo maligna melanoma, limited excision and complete histology of excisional margins (three-dimensional histology). OBJECTIVE: To evaluate the prognostic relevance of clinical parameters and different surgical management in patients with subungual melanoma. STUDY DESIGN: From 1980 to 1999, subungual melanoma was diagnosed in 62 of 3,960 stage I and II melanoma patients (1.6%) of the melanoma registry of the Department of Dermatology (University of Tuebingen). A retrospective comparative analysis of two treatment groups was performed: Thirty-one patients had an amputation in or proximal to the distal interphalangeal joint (median follow-up of 55 months), and 31 patients had "functional" surgery with local excision of the tumor and only partial resection of the distal phalanx (median follow-up of 54 months). RESULTS: In the univariate analysis, the level of invasion (P=0.0059), ulceration (P=0.0024), and tumor thickness (P=0.0004) were significant prognostic factors for recurrence-free survival but not for survival. In a multivariate analysis, only lower tumor thickness and a reduced level of amputation were independent significant prognostic parameters for recurrence-free survival (P=0.035 and P=0.0069). Patients with an amputation in or proximal to the distal interphalangeal joint did not fare better than patients with less radical "functional" surgery. CONCLUSION: Limited excision with partial resection of the distal phalanx only and three-dimensional histology to assure tumor-free resection margins give better cosmetic and functional results and do not negatively affect the prognosis of patients with subungual melanoma.

Adult↗
PubMed2002

Cerebriform giant melanocytic nevus of the scalp: report of two cases with different surgical approaches.

Cerebriform giant melanocytic nevus of the scalp is an extremely rare malformation. Clinical appearance with maceration and fetor within the crypts and the risk of malignant transformation may require surgical therapy. We report two cases with different methods of surgical management. A 27-year-old woman noticed a swelling of the parietal scalp that developed over a period of 4 years into a gyrus-like tumor measuring 12 cm x 18 cm. The crypts between the gyri could not be inspected. Serial excisions under subcutaneous infusion anesthesia were performed to reduce the size of the nevus and to flatten the surface of the scalp. The second patient, a 26-year-old man, demonstrated a giant 10 cm x 10 cm cerebriform nevus on the occiput. The nevus also contained areas of fetid maceration. After implanting a tissue expander under general anesthesia the nevus was excised. The defect was closed using a rotation flap.

Adult↗