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FC110 Role of copper in the pathogenesis of vitiligo
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pigmented, indented, irregular lesion of 2 x 2 and also irregularity of colour within the tumour itself, localizated on the nose near the first lesion mentioned above. The diagnose was again a superficial spreading melanoma (Clark III) with vertical growth phase, and treated with surgery and nasolabial flap.
1FC109 1 Dysplastic naevi and risk for melanoma: 1997 patient care guidelines in The Netherlands P.C. van Voorst Vader’, W. Bergman’, ’ University Hospital, Leiden; 3Vniversity
D.J. Ruiter3.
Groningen; 2 University Hospital, Hospital, Nijrnegen, The Netherlands
In 1987 the Dutch Melanoma Working Group, a multidisciplinary group (29 members in 1997) was founded and published the 1st edition of the Dutch Guidelines for Melanoma in 1990. The 2nd edition was published in 1997 and contains not only the revised text of the chapter on precursor lesions, but also a supplement offering guidelines for assessing melanoma risk and management of patients with dysplastic naevi (DN). These guidelines on DN and melanoma risk as agreed upon by the Dutch Melanoma Working Group contain: 1. The clinical and histological definiton of DN; 2. The indications for excision of a DN; 3. The definitions of the sporadic and the familial Dysplastic Naevus Syndrome; 4. The indications for family-screening; 5. The follow-up management strategy based on risk-level (low, moderate, high risk); 6. Genera1 risk-factors for melanoma. These guidelines on DN and melanoma risk will be presented and illuminated. FCll 0
I
Role of copper in the pathogenesis of vitiligo
A. Vaisov, S. Arifov, A. Rahmatov, K. Alimhanov, J. Hasanov. Institute
of Dermatology
and Venerology,
Tashkent,
Uzbekistan
In recent years copper deficiency as an etiologic factor in vitiligo patients has been discussed again. The aim of this study was to determine the role of copper in the pathogenesis of vitiligo. 60 patients (34 male and 26 female) and 50 healthy control subjects were included in this study. Copper levels in the depigmented skin were significantly decreased (P < 0.001) in comparison with the normal pigmented skin. However, patients with vitiligo had high levels of copper in their serum (P < 0.001) and urine (P < 0.05) in comparison with control subjects. We recommend that PUVA + Cupir (medicine contains copper) as the best method of vitiligo treatment. FCl 11 The incidence of aggressive-growth
basal
cell carcinoma in young adults: A retrospective study on 964 patients A. Garcovich, F. Catamo, A. Zampetti, G. Olivetti, L.M. Larocca ’ , M. Alotto, C. Corradini2. Department
of Dermatology; ‘Department of Histopathology; 2Department Otorhinolaryngology Catholic University of Rome, Italy
Aggressive-Growth
Basal Cell Carcinoma (AG-BCC)
of
defines a
-
Sl41
Photobiology
group of basal cell cancers that are histologically and clinically aggressive. Since recent studies have demonstrated a high frequency of AG-BCCs among patients under 35 years of age we reviewed the pathologic findings of 964 patients (521 M, 433 F), aged 19-100 y. o. (Mean age: 61.6 y. o.), diagnosed with sporadic BCC in our hystopatologic laboratory from 1991 to 1995. Thirty-three of these patients (3.42%) were aged 19-35 years (mean age: 31.01 y. 0.). There was a small excess of females in the young-age group (19 F, 14 M). 18 tumours were located on the cervical-facial district, 14 on the trunk and only one case was located on the arm. 14 patients presented the infiltrating variant of BCC; 12 patients presented the morpheaform type of BCC; 7 pts. presented the superficial multifocal variant of BCC. Aggressive-growth BCC is frequently noted in the head and neck of young adults, as confirmed by our observation. Results of this study show that AG-BCC has a high incidence in younger populations (~35 years); in fact in this group it accounted for 78% of all BCCs. These data seem to confirm the relationship between age and aggressivity suggested by other reports. Failure to diagnose this type of BCC may lead to improper treatment and to an inadequate follow-up. FCl12
Elastic fibres in differentiation of Spitz nevus from malignant melanoma
K. Pizinger, P. Cetkovska. Department of Medicine,
Charles
University,
Pilsen,
of Dermatology, Czech Republic
Faculty
The differentiation of Spitz nevus from malignant melanoma can be very difficult even with using immunohistochemistry. The changes of the elastic fibres are helpful in distinguishing these melanocytic lesions. In 30 Spitz nevi, of which 5 were of the junctional type, 17 compound type, and 8 intradermal, specimens were stained for detection of elastic fibres. In 29 cases (96.6%) elastic fibres were present between the nests of melanocytes in the dermal component of nevi. In junctional type of Spitz nevus the fine and thin elastic fibres were found just below the melanocytes in the upper part of the dermis. In one compound type, the elastic fibres between the melanocytes were totally absent, and even their number in normal surrounding dermis was also extremely small. Nevertheless, the amount and pattern of the elastic fibres varied in all the other cases, although they were always present. In our clinical and histological experience with 1.920 malignant melanomas of all types, almost all showed complete absence of elastic fibres. Only in some suddenly appearing metastases of malignant melanoma, can the elastic fibres be found. In conclusion, the presence or absence of elastic fibres is helpful in differentiation of Spitz nevi from malignant melanoma. In Spitz nevi the elastic fibres are present, whereas in malignant melanomas the elastic fibres are always absent.
pigmented, indented, irregular lesion of 2 x 2 and also irregularity of colour within the tumour itself, localizated on the nose near the first lesion mentioned above. The diagnose was again a superficial spreading melanoma (Clark III) with vertical growth phase, and treated with surgery and nasolabial flap.
1FC109 1 Dysplastic naevi and risk for melanoma: 1997 patient care guidelines in The Netherlands P.C. van Voorst Vader’, W. Bergman’, ’ University Hospital, Leiden; 3Vniversity
D.J. Ruiter3.
Groningen; 2 University Hospital, Hospital, Nijrnegen, The Netherlands
In 1987 the Dutch Melanoma Working Group, a multidisciplinary group (29 members in 1997) was founded and published the 1st edition of the Dutch Guidelines for Melanoma in 1990. The 2nd edition was published in 1997 and contains not only the revised text of the chapter on precursor lesions, but also a supplement offering guidelines for assessing melanoma risk and management of patients with dysplastic naevi (DN). These guidelines on DN and melanoma risk as agreed upon by the Dutch Melanoma Working Group contain: 1. The clinical and histological definiton of DN; 2. The indications for excision of a DN; 3. The definitions of the sporadic and the familial Dysplastic Naevus Syndrome; 4. The indications for family-screening; 5. The follow-up management strategy based on risk-level (low, moderate, high risk); 6. Genera1 risk-factors for melanoma. These guidelines on DN and melanoma risk will be presented and illuminated. FCll 0
I
Role of copper in the pathogenesis of vitiligo
A. Vaisov, S. Arifov, A. Rahmatov, K. Alimhanov, J. Hasanov. Institute
of Dermatology
and Venerology,
Tashkent,
Uzbekistan
In recent years copper deficiency as an etiologic factor in vitiligo patients has been discussed again. The aim of this study was to determine the role of copper in the pathogenesis of vitiligo. 60 patients (34 male and 26 female) and 50 healthy control subjects were included in this study. Copper levels in the depigmented skin were significantly decreased (P < 0.001) in comparison with the normal pigmented skin. However, patients with vitiligo had high levels of copper in their serum (P < 0.001) and urine (P < 0.05) in comparison with control subjects. We recommend that PUVA + Cupir (medicine contains copper) as the best method of vitiligo treatment. FCl 11 The incidence of aggressive-growth
basal
cell carcinoma in young adults: A retrospective study on 964 patients A. Garcovich, F. Catamo, A. Zampetti, G. Olivetti, L.M. Larocca ’ , M. Alotto, C. Corradini2. Department
of Dermatology; ‘Department of Histopathology; 2Department Otorhinolaryngology Catholic University of Rome, Italy
Aggressive-Growth
Basal Cell Carcinoma (AG-BCC)
of
defines a
-
Sl41
Photobiology
group of basal cell cancers that are histologically and clinically aggressive. Since recent studies have demonstrated a high frequency of AG-BCCs among patients under 35 years of age we reviewed the pathologic findings of 964 patients (521 M, 433 F), aged 19-100 y. o. (Mean age: 61.6 y. o.), diagnosed with sporadic BCC in our hystopatologic laboratory from 1991 to 1995. Thirty-three of these patients (3.42%) were aged 19-35 years (mean age: 31.01 y. 0.). There was a small excess of females in the young-age group (19 F, 14 M). 18 tumours were located on the cervical-facial district, 14 on the trunk and only one case was located on the arm. 14 patients presented the infiltrating variant of BCC; 12 patients presented the morpheaform type of BCC; 7 pts. presented the superficial multifocal variant of BCC. Aggressive-growth BCC is frequently noted in the head and neck of young adults, as confirmed by our observation. Results of this study show that AG-BCC has a high incidence in younger populations (~35 years); in fact in this group it accounted for 78% of all BCCs. These data seem to confirm the relationship between age and aggressivity suggested by other reports. Failure to diagnose this type of BCC may lead to improper treatment and to an inadequate follow-up. FCl12
Elastic fibres in differentiation of Spitz nevus from malignant melanoma
K. Pizinger, P. Cetkovska. Department of Medicine,
Charles
University,
Pilsen,
of Dermatology, Czech Republic
Faculty
The differentiation of Spitz nevus from malignant melanoma can be very difficult even with using immunohistochemistry. The changes of the elastic fibres are helpful in distinguishing these melanocytic lesions. In 30 Spitz nevi, of which 5 were of the junctional type, 17 compound type, and 8 intradermal, specimens were stained for detection of elastic fibres. In 29 cases (96.6%) elastic fibres were present between the nests of melanocytes in the dermal component of nevi. In junctional type of Spitz nevus the fine and thin elastic fibres were found just below the melanocytes in the upper part of the dermis. In one compound type, the elastic fibres between the melanocytes were totally absent, and even their number in normal surrounding dermis was also extremely small. Nevertheless, the amount and pattern of the elastic fibres varied in all the other cases, although they were always present. In our clinical and histological experience with 1.920 malignant melanomas of all types, almost all showed complete absence of elastic fibres. Only in some suddenly appearing metastases of malignant melanoma, can the elastic fibres be found. In conclusion, the presence or absence of elastic fibres is helpful in differentiation of Spitz nevi from malignant melanoma. In Spitz nevi the elastic fibres are present, whereas in malignant melanomas the elastic fibres are always absent.