Our population-based study establishes epidemiological data on age-specific incidence rates, clinical presentation, Breslow microstaging, treatment and survival of nail apparatus melanoma (NAM) patients in England. Four cancer registries, covering a population of 10.6 million, recorded 105 cases of NAM during the period 1984-93. During the same decade there was a total of 7585 patients with cutaneous melanoma and NAM represents 1.4% of all cutaneous melanoma. The incidence rate of NAM in English patients is 0.1 per 100,000 of the population per annum. Amelanotic melanoma was the clinical presentation in 24 of our NAM cases. The overall prognosis is poor with an observed 5 year survival of only 51%. Patients with NAM less than 2.5 mm Breslow depth have a 5 year survival of 88% and are twice as likely to survive compared with those with tumours greater or equal to 2.5 mm in thickness (P < 0. 05). NAM patients are best managed by a multidisciplinary team approach in a few key skin cancer centres.

Frontal fibrosing alopecia (FFA) is a recently described inflammatory and scarring type of hair loss affecting almost exclusively women. Despite a dramatic recent increase in incidence the aetiopathogenesis of FFA remains unknown. We undertake genome-wide association studies in females from a UK cohort, comprising 844 cases and 3,760 controls, a Spanish cohort of 172 cases and 385 controls, and perform statistical meta-analysis. We observe genome-wide significant association with FFA at four genomic loci: 2p22.2, 6p21.1, 8q24.22 and 15q2.1. Within the 6p21.1 locus, fine-mapping indicates that the association is driven by the HLA-B*07: 02 allele. At 2p22.1, we implicate a putative causal missense variant in CYP1B1 , encoding the homonymous xenobiotic- and hormone-processing enzyme. Transcriptomic analysis of affected scalp tissue highlights overrepresentation of transcripts encoding components of innate and adaptive immune response pathways. These findings provide insight into disease pathogenesis and characterise FFA as a genetically predisposed immuno-inflammatory disorder driven by HLA-B*07: 02.

In this review, the current state of knowledge concerning nail melanoma is summarized. The pathogenesis, histological findings, clinical presentation, treatment and prognosis of this rare form of cutaneous melanoma are discussed. Important clinical clues to the early diagnosis of nail melanoma are highlighted and recommendations to improve the management of patients are suggested.

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An eight-month-old, male domestic shorthair kitten developed progressive abdominal distension over a six-week period. Abdominocentesis revealed a fluid with high protein (3.8 g/dl) and moderate cellularity. Infectious, cardiovascular, and neoplastic causes of posthepatic obstruction were ruled out. Partial obstruction and stenosis of the caudal vena cava (CVC) at the level of the diaphragm were detected on a contrast venogram. Exploratory surgery revealed a fibrous, web-like membrane at the site of obstruction. Resection of the stenotic segment of the CVC was not possible because of the junction of the left hepatic veins and CVC just caudal to the lesion. A 3 by 6-mm, oval Dacron patch graft was sutured into the venotomy site. Postoperative complications included fever and leukocytosis, eosinophilic pleural effusion, and transient congestive heart failure associated with volume overload. The cat is normal 16 months after surgery, with no recurrence of ascites. This is the first reported case of Budd-Chiari syndrome (BCS) in a domestic kitten. Documented herein is the first successful treatment of BCS in a small animal using a vascular, prosthetic patch graft.