[Axillary recurrence after lymph node excision in malignant melanoma]. / Das axilläre Rezidiv nach Lymphadenektomie beim malignen Melanom.

In a retrospective study 143 patients with 155 axillary lymphadenectomies were observed with a maximum of 8 years of follow-up (mean 51.9 +/- 25.8 months). At the time of their lymphadenectomies, 39 patients had histologically negative nodes (stage I), 85 patients lymph-node metastases (stage II), 19 patients axillary node involvement and distant metastases (stage III). The estimated 5-year survival rates were 77.5% in stage I and 28.6% in stage II. Axillary recurrence after dissection of tumor-free lymph nodes rarely happened, but in stage II the probability of recurrence was as high as 30.7%. All axillary recurrences occurred in the first 20 months after lymphadenectomy. In a multivariate analysis (Cox model), the only prognostic factor of probability of recurrence in stage II was the development of regional in-transit cutaneous metastases (p = 0.048). Factors that did not affect the appearance of recurrent metastases in the node dissection field were: epidermal ulceration, vascular invasion, tumor thickness, degree of lymph-node involvement, age, sex, and adjuvant chemotherapy. Median survival after axillary recurrence following therapeutic lymph-node excision (5 months) was comparable with survival after lymphadenectomy in stage III (7 months). There was a high incidence (> 30%) of regional in-transit cutaneous metastases in both groups. Regardless of the poor prognosis, we found 15% axillary recurrences after lymph-node clearance in stage III.

[Results of a randomized polychemotherapy study in malignant melanoma]. / Ergebnisse einer randomisierten Polychemotherapiestudie beim malignen Melanom.

A polychemotherapy (DTIC, vincristine, ftorafur, hydroxycarbamide) devised with reference to the results of short-term sensitivity tests in cell culture is compared with single-agent chemotherapy with DTIC in malignant melanoma. Effectiveness was investigated in a randomized prospective study in cases of high-risk melanoma in clinical stage I, in clinical stage II after lymphadenectomy and in clinical stage III after tumour debulking. The results recorded allow no positive effects of either form of chemotherapy in stage I disease compared with surgical treatment only in a control group. In contrast, a statistically significant advantage of the polychemotherapy was noted in stage II compared with a control group. There was no significant difference in the results of treatment between the two forms of chemotherapy in stage III. No complete remissions of long duration have been achieved.

[Syphilitic skeletal manifestations in infancy--a case report]. / Syphilitische Skelettmanifestation im Säuglingsalter--Ein Fallbericht.

Radiological and morphological findings in the bones in the limbs of a one-and-a-half-month-old infant led us to suspect syphilis connata praecox. In this child typical bone changes were present which are otherwise only rarely detected nowadays. The serological findings could not be clearly interpreted. The necessity of therapy is discussed.

[Staphylogenic Lyell's syndrome in adults]. / Das staphylogene Lyell-Syndrom des Erwachsenen.

In the staphylogenically caused Lyell-syndrome - in most cases a disease in childhood - toxins of Staphylococcus aureus lead to epidermolysis. It should always be treated with antibiotics resistant to penicillinase, in no case with corticosteroids. Therefore, the correct diagnosis must be made in time. This is possible by the different histological picture of the two forms.