The maximum tumour thickness is the most important prognostic factor in malignant melanomas of the skin. However, the clinical outcome of thick nodular melanomas remains unpredictable. Therefore, we investigated possible prognostic markers in this subset of melanomas. From a melanoma data base, 12 patients with thick (> 3 mm) stage I nodular melanomas of the skin were identified, who were still without signs of progression after five years of follow-up. These tumours were compared to randomly selected series of 12 cases, who did not survive the first five years after removal of the tumours. We performed immunostaining for the p53-protein and the proliferation associated Ki-67-antigen. For quantification of immunostaining the tumours were entirely scanned. In addition, all tumours were investigated for any differences with conventionally applied prognostic features: the tumour thickness: the level of invasion; the prognostic index (tumour thickness multiplied by mitotic count); and the mean volume-weighted mean nuclear volume. We demonstrated significant differences between survivors and non-survivors exclusively in respect of the staining indices for p53 and Ki-67 (P < 0.03 and 0.02, respectively). With both antibodies the tumours of survivors showed lower counts as compared to non-survivors survivors. However, within both groups we found no significant correlations between the p53- and Ki-67-staining results. We conclude that immunostaining for p53-protein and Ki-67-antigen is helpful to identify individuals with thick nodular melanomas who are at risk of metastatic disease.

Inflammatory nodules due to adverse reactions to permanent fillers containing microparticles with a hydrophobic surface were treated with good results with a regimen of allopurinol and intralesional injections with a mixture of fluorouracil and low-dose triamcinolon.

We report a case of recalcitrant pruritus after infusion therapy with hydroxyethyl starch (HES) for sudden deafness. The diagnosis was confirmed by detection of typical HES storage vacuoles within dermal macrophages and perineural cells. Treatment with antihistamines and antipruritic agents, UVB irradiation, and neuroleptic drugs, was ineffective. Topical capsaicin (0.05%) twice daily produced excellent symptomatic relief, without side-effects.

Patients who overcome melanoma do not necessarily have a reduced QoL. Strategies used by these melanoma patients resulted in similar levels of coping as previous studies in comparable general populations. Nevertheless, doctor-patient communication was correlated with emotional and social functioning and should be emphasised in treatment and care of melanoma patients.

Variations in the length of simple repetitive tandem repeats (microsatellite instability, MIN) between constitutive and tumour DNA, which is characteristic of tumours in patients affected with hereditary nonpolyposis colon cancer (HNPCC), have been found to be very important in the carcinogenesis of a variety of human neoplasms. Recently, MIN has been found in sebaceous and colorectal tumours as well as in keratoacanthomas of Muir-Torre syndrome. In order to elucidate the significance of both MIN and loss of heterozygosity (LOH) in the pathogenesis of sporadic keratoacanthomas, the presence of MIN and LOH at five loci [chromosome 5q21 (D5S346, APC), 9p21 (D9S171, p16), 10pter (D10S89, Mfd28), 11p (D11S904) and 17p12 (D17S520, p53)] was evaluated. MIN was found at only one locus (p53) in 1 of 12 keratoacanthomas and no evidence for the presence of LOH could be detected. Our results suggest that, in contrast to keratoacanthomas associated with Muir-Torre syndrome, neither MIN nor LOH appear to be significant in the induction of sporadic keratoacanthomas.