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Malignant melanoma of the skin in Black Africans.

Malignant melanoma of the skin in Blacks in formidable and sinister tumour. This study is concerned with the epidemiology of malignant melanoma, as seen in both urban and rural Black Africans. A smaller series in which follow-up on the patients was available is included. To our knowledge, this is the first study of its kind in which follow-up, and hence survival figures, can be quoted. Although the numbers are relatively small, they provide a valuable indication of the behaviour of melanomas in this group. The difficulties of follow-up cannot be overemphasised, and follow-up on 79 cases out of 100 could be obtained only by the employment of an able and enthusiastic Black social worker for 3 years. The first recorded survival figures in a Black population show a 3-year survival rate of only 28,4%. Prognosis is related to the size and extent of the tumour with larger and more widespread tumours faring worse than others. The incidence of malignant melanoma in Johannesburg Black was 1,2 per 100 000 and accounted for 2% of all cancers. The largest number of cases occurred in the 50- 70-year age group and there was a female preponderance. As in previous studies, the sites predominantly affected were the foot and the hand, mainly on the plantar and palmar surfaces.

Adolescent↗

Concomitant granuloma annulare and necrobiosis lipoidica. Report of a case and review of the literature.

A case of concomitant granuloma annulare (GA) and necrobiosis lipoidica (NL) is presented. The etiology of these two disorders remains obscure. The similarity of the histopathology in GA and NL might suggest a common origin. However, a review of the 5 previous cases of concomitant GA and NL and recent biochemical, immunological and immunohistochemical studies comparing GA to NL indicates an independent etiology for these two histologically related disorders. Some evidence points toward a closer relationship of NL with diabetes than GA, while GA may be related to delayed-type hypersensitivity reactions.

Arm↗

[Annular granuloma in HIV positive patients].

Pathogenesis of Granuloma Annulare is not resolved. In some Authors' opinion it is caused by an allergic granulomatous reaction to an unknown dermal antigen. Presence of Granuloma Annulare in patients with Human Immunodeficiency Virus (HIV) infection questions this hypothesis. We present two cases of such association and review eleven patients previously described in the literature. Clinical and histological findings suggest that the cell mediate immune response is not the dominant pathogenetic event, especially in cases of altered cell-mediated immunity.

Adult↗

[Papulonecrotic tuberculide. Presentation of 4 cases].

Four young patients simultaneously affected by morphological variations of papulonecrotic tuberculid and lymphnode and pulmonary tuberculosis (three cases) are reported. The clinical, therapeutic, histological and immunological aspects of papulous tuberculid are discussed and the different diagnostic approaches to this rare disease are evaluated.

Adult↗

Dermatology flow sheet.

This article presents an organized and relatively easy mechanism for the diagnosis of dermatologic problems by using an algorithmic flow sheet. Once this technique is understood, the practitioner may find it much easier to categorize, diagnose, and manage skin conditions of the lower extremities.

Foot Dermatoses↗