Our results confirm early radical excision as the treatment of choice for hidradenitis suppurativa. Using intraoperative color-marking of sinus tracts, the recurrence rate is minimal. The method of reconstruction has no influence on recurrence and should be chosen with respect to the size and location of the excised area.

Background: The indication for surgical treatment of congenital nevocellular nevi results from aesthetic-cosmetic consideration as well as from the increased risk of melanomatous transformation. Objective: We evaluated the outcome after dermabrasion of congenital nevi of different sizes and treated at different ages. Methods: 215 patients treated by dermabrasion during the years 1979–1995 were examined at a median interval of 24 months postoperatively. Results: No postoperative development of malignant melanoma arising from the congenital nevus was seen in any of the patients during the time of follow-up. No serious long-term complications were seen. Hypertrophic scars were seen within parts of the operation field in 14.6%, but in those the cosmetic result was still satisfactory. Permanent reduction of pigmentation to 0–20% as compared with the preoperative status was achieved if treatment was performed within the newborn period. In case of large and giant nevi, permanent removal of pigmentation was better than in small or medium-sized nevi. Conclusion: Dermabrasion proved to be an adequate modality for removal of pigmentation in the therapy of large and giant congenital nevocellular nevi when assessed within 2 years following the procedure. Early treatment is crucial for permanent removal of pigmentation. Long-term effects remain to be adequately monitored.

Chromosome analysis of lymphocytes from patients who had been exposed to arsenic showed frequent structural and numerical aberrations, even with an interval of decades since the last exposure. The in vitro addition of sodium arsenate induced the same chromosome changes--even to extreme of chromosome pulverizations--upon lymphocyte cultures from healthy subjects. Radioactive incorporation studies showed that arsenate was able to inhibit dose-dependently the incorporation of radioactively labeled nucleotide in RNA and DNA. Beyond that, arsenic blocked the cells in the S- and G2-phase. A general explanation for the inhibitory effect of inorganic arsenic on cell metabolism is the known strong affinity of arsenic to enzymes, especially to those containing sulfhydryl groups.ImagesFIGURE 2. aFIGURE 2. bFIGURE 2. cFIGURE 3. aFIGURE 3. bFIGURE 4.

Congenital melanocytic nevi are benign skin tumours with a population-based prevalence of 1-6%. They run an increased life-time risk of transformation into malignant melanoma. Additionally, they can be associated with an involvement of the leptomeninges (neurocutaneous melanosis), and may cause considerable cosmetic and psychic problems. In contrast to the past, the risk of congenital melanocytic nevi developing into melanoma is now regarded as well-established. Thus, excision is recommended whenever possible. Large lesions which do not allow complete excision should be treated by dermabrasion within the first weeks of life.

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Background: Previous investigators noted an association of multiple basal cell carcinomas (BCC) with certain HLA antigens; however, these findings were contradictory, and the associations were only weak. Objective: The aim of the study was to objectify the previously found associations. Methods: Serologic HLA typing for class I and class II antigens was performed in 49 unrelated patients with 5 or more BCCs. Results: HLA-DR4 showed decreased frequencies in the patient group as compared with healthy controls (n = 716). Cw7 was found to be increased in the total group of patients as well as in a subgroup with multiple BCCs of the face (n = 24), while a subgroup with BCCs mainly on the trunk (n = 25) revealed increased frequencies of HLA-A11, -B17, -B22 and -Cw3. However, none of these deviations appeared significant after correction of p values. Conclusion: We conclude that, if at all, the HLA system plays only a minor role in the development of multiple BCCs.

Chromosomenaberrationen an menschlichen Lymphozyten bei chronischen ArsenschädenBei einer Gruppe arsenexponierter Patienten wurden Chromosomenanalysen an Lymphozyten durchgeführt und die Ergebnisse mit den Befunden an einer Kontrollgruppe verglichen. Nach der teilweise Jahrzehnte zurückliegenden Arsenexposition fand sich ein gehäuf tes Auftreten -von strukturellen Aberrationen vom Chromosomen-und Chromatidtyp. Auch numerische Aberrationen ließen sich in Form erhöhter Aneuploidieraten bei der Arsengruppe nachweisen. Als Ursachen werden Einflüsse auf den Enzymstoffwechsel diskutiert, besonders auf solche Enzyme, die an der Nucleinsäuresynthese beteiligt sind. Die Befunde erlauben den Schluß, daß Arsen auch das lymphopoetische System irreversibel schädigt. Es erscheint möglich, daß die Chromosomenaberrationen in einem ursächlichen Zusammenhang mit atypischen Zelipopulationen stehen, wie sie sich klinisch in Form von Neoplasien der Haut und verschiedener innerer Organe manifestieren.

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