ABSTRACT
Prolonged exposure to sun for long periods during most of the year has led to an increase in the frequency of malignant melanoma in Israel, especially for head and neck (H&N) melanoma. H & N melanoma is found in males more than in females and diagnosed when already locally advanced. The disease-free interval between treatment of the primary lesion and recurrence of the disease correlated with the patient's age and the depth of invasion according to Breslow. A higher recurrence rate correlated with male gender, location in the scalp, and the stage of the disease. Metastatic disease involved the lungs, liver, and brain and responded poorly to systemic therapy. Improved survival was related to female gender, early stage of the disease, low Breslow thickness, and location of the primary lesion elsewhere than the scalp. Immunologically, we found that the titers of antimelanoma antibodies in patients with metastatic disease originating in the area of the head and neck were higher than the titer in disease-free H & N melanoma patients (p = 0.05). Moreover, patients with metastatic H & N melanoma had a higher titer of antityrosinase antibodies compared with healthy subjects. These two types of antibodies might be used as markers for disease progression in H & N melanoma. The more aggressive character of H & N melanoma was not reflected by different titers of antimelanoma antibodies nor by antityrosinase antibodies in patients with H & N versus non-H & N melanoma.
Subject(s)
Antibodies, Neoplasm/blood , Head and Neck Neoplasms/pathology , Melanoma/pathology , Skin Neoplasms/pathology , Adult , Age Factors , Aged , Aged, 80 and over , Biomarkers, Tumor/blood , Disease Progression , Disease-Free Survival , Female , Head and Neck Neoplasms/immunology , Humans , Israel , Male , Melanoma/immunology , Melanoma/secondary , Middle Aged , Neoplasm Invasiveness , Neoplasm Recurrence, Local , Neoplasm Staging , Scalp , Sex Factors , Skin Neoplasms/immunology , Sunlight/adverse effects , Tyrosine/immunologyABSTRACT
Nine young patients with cholinergic urticaria reported that the occurrence of the disease was restricted to winter. They were examined in a climatic room in winter and summer under three climatic conditions in each season (cold, comfort, and severe heat). All subjects experienced severe phenomena of cholinergic urticaria during the winter season when tested under comfortable climate and under severe heat load. No phenomena were elicited in the summer under any of the three climatic conditions or under cold climatic condition in the winter. This finding led to the assumption that symptoms appear in the sufferers only when exposed to heat or heat-producing exercise while unacclimatized to heat. Artificial heat acclimatization is winter resulted in disappearance of all clinical phenomena of cholinergic urticaria, lasting from a few days to two weeks.
