ABSTRACT
Patron saints have been adopted to protect against disease and disability in the Christian world since the Middle Ages. A patron saint most often has a morbid connection to their affiliated ailment, although patronage may stem from physical attributes or a miracle performed. The purpose of this study is to identify and describe patron saints associated with injury, musculoskeletal disease and orthopaedic pathology. Saints were identified by a systematic review of multiple reference texts. Additional searches were performed in online academic databases, alongside biographic research of primary and secondary archives. Seven patron saints associated with trauma and orthopaedic conditions were identified. These include St. Ignatius, who pioneered deformity-correction surgery on himself and St. Kostka, patron saint of broken bones who was the victim of his infamously cruel brother Paul. St. Alphonsus Liguori, patron saint of spinal conditions, suffered such a severe cervical kyphosis that his chin eroded his chest. Further saints identified include St. Cosmas and St. Damian as patrons of musculoskeletal oncology, and St. Amalberga and St. Roch as patrons of upper and lower limb injuries, respectively. Over the centuries, patron saints have provided hope for patients in the absence of effective treatments, and as role models for physicians with few resources. Their lives and legends provide valuable insight into an important historical aspect of medical culture.
ABSTRACT
AIMS: Because the term 'naevoid melanoma' has variable clinical and pathological interpretations, we aimed to clarify the features of melanomas referred to as naevoid. METHODS AND RESULTS: A review was undertaken of 102 melanomas diagnosed histopathologically as naevoid melanomas and ascertained by European Organization for Research and Treatment of Cancer Melanoma Group Subcommittee pathologists from their records. We found these could be classified morphologically into three groups. Thirteen melanomas were overlying genuine naevi and were therefore excluded. Of the 89 melanomas considered to be naevoid, 11 presented clinically as exophytic papillomatous nodules with little junctional component and composed of small atypical cells showing numerous mitoses and no change with depth; we termed these 'papillomatous naevoid' melanomas. The other 78 were flat or only slightly raised, and had a superficial spreading melanoma-like component with maturation to a small cell, but still an atypical, dermal component; we termed these 'maturing naevoid' melanomas. We showed that papillomatous and maturing naevoid melanomas also have differing immunochemical profiles. Preliminary clinical follow-up suggested different outcomes for these two naevoid melanoma types. CONCLUSIONS: Melanomas that have been classified as naevoid melanomas comprise two types with distinct clinical, histopathological and immunohistochemical features that may also be prognostically significant.
