Frequency of skin cancer and other ultraviolet radiation provoked skin lesions of eyelid and periocular region in the 1981-1992 period.

It is well known that the region of eyelids and periocular skin is exposed to ultraviolet radiation (UV rays), so it is the location of skin changes associated with the effects of this radiation. The analysis of basal cell carcinomas, keratoses, keratoacanthomas and cornu cutaneum of this regions covered a 12-year period. In the total of 1,398 skin biopsies from the Department of Ophthalmology, Sestre Milosrdnice University Hospital from Zagreb, the above mentioned lesions were found in 498 cases. Most frequent were basal cell carcinomas (BCC), found in 377 cases, followed by squamous cell carcinoma (SCC) in 64, keratoses in 37, cornu cutaneum in 8 and keratoacanthoma in 12 cases. As BCC was the most frequent finding in the bioptic material from this clinic, special emphasis was put on this tumor, its age and sex distribution, and localization. In the discussion and material analysis, particular reference is given to the causative relation with the effects of UV radiation. As a special contribution to the discussion on the connection of these changes with UV radiation, 3 cases with the occurrence of BCC and seborrheic keratoses in the same lesion and a patient with senile elastosis and BCC in the same segment of the skin of an eyelid are described.

Local interferon therapy for melanoma patients.

BACKGROUND: Melanoma, once considered a rare form of cancer, is increasing in incidence throughout the world. The prognosis of malignant melanoma is inversely related to the depth of tumor invasion. METHODS: Twenty-seven patients were treated with r.IFN alpha 2c. Four patients were treated with human natural leukocyte interferon (HNLI). Interferon was applied locally. Historical control groups were used for comparison in the statistical analysis. The data were evaluated taking into account the single risk factor Clark levels III and IV. In the control group there were 10 patients with Clark levels III and IV; in the group of r.IFN apha 2c-treated patients there were 20 patients. The data were analyzed by using the Kaplan-Meier and Cox methods. RESULTS: The percentage of survivals was higher in the interferon-treated groups with Clark levels III and IV, than in the control group, that is 60% compared to 25%, and 40% compared to 33%, respectively. The results of the statistical analysis after 60 months of follow-up are significantly better in the interferon group (P = 0.0175). CONCLUSIONS: The control group was not selected at random. Therefore, on the basis of our results, one can say that the treatment of the melanoma patients, Clark levels III and IV, with the r.IFN alpha 2c is promising and that further investigation is justified.

Pyoderma gangrenosum.

The authors summarize recent data on the etiopathogenesis and therapy of pyoderma gangrenosum and report on a 72-year-old patient for years suffering from recurring nodose lesions on his forelegs. The ulcerations first appeared a month before the patient's admission to author's Department. The course of the disease, patient's history and comprehensive clinical and laboratory findings pointed to the diagnosis of pyoderma gangrenosum. The patient was treated with systemic application of corticosteroids, and this therapy proved very effective.

Interferon reduces recurrences of basal cell and squamous cell cancers.

BACKGROUND: Interferon is considered to be an important curative agent for dermatologic diseases. We report the follow-up experience of patients with basal cell or squamous cell carcinomas treated with human natural leukocyte interferon (HNLI). RESULTS: Among 52 patients with basal cell carcinoma (BCC) treated with HNLI more than 10 years ago, and among 58 treated more than 5 years ago, only 2 recurrences were observed. There were no recurrences in 75 patients who had a complete response to HNLI treatment, nor were there any in 20 patients with either a partial or complete response to r.IFM alpha 2c treatment. Of 52 patients with squamous cell carcinoma (SCC), 31 had been treated more than 10 years earlier, two recurrences of the disease at the site of the original lesion were observed. CONCLUSION: Interferon treatment makes it possible to achieve a persistent cure in patients with BCC and SCC in a high proportion of cases. The potential advantage of nonsurgical treatment are an enhancement of cosmetic results through the prevention of destruction of important anatomic structures.

[Interferon in the treatment of solid tumors]. / Interferon u lijecenju solidnih tumora.

Discovered almost four decades ago, interferons were being investigated as potential anticancer agents from early sixties, because of their antiviral antiproliferative and immunomodulating properties and their relatively modest toxicity. Unlike very good effects on some lymphoproliferative disorders where complete durable remissions were observed, results of their application in solid tumors are not so unambiguous. Among large number of tumors investigated so far, the best, reproducible, although modest, activity was found against melanoma, renal cell carcinoma and Kaposi's sarcoma. There are still many doubts concerning their optimal doses, sequencing and schedules, most probably in combination with other biological response modifiers and/or cytotoxic agents, which have to be clarified in further clinical trials, together with investigation of more reliable biological indicators of response to interferons in vivo.

Langerhans cells in the immunopathology of contact allergic dermatitis.

The functional morphology, topography and frequency of Langerhans cells (LCs), which are significant factors in the pathogenesis of contact allergic dermatitis (CAD), were studied by histoenzymatic methods (adenosine triphosphatase (ATP-ase), acid phosphatase (AF) and alpha naphtylacetate esterase (ANAE), immunohistochemical methods (indirect immunoperoxidase (IPO) with the monoclonal antibody OKT 6), and the peroxidase-antiperoxidase (PAP) method with the polyclonal S-100 antibody in skin biopsies of 24 patients with CAD, as well in skin biopsies in experimental models in guinea pigs. The results confirmed the significant role of LCs in the pathogenesis of contact allergic dermatitis.

Influence of emulsoid vehicle on the release and activity of allantoin.

Samples which contain 2% (w/w) of allantoin in various emulsified vehicles were prepared and characterized. The influence of vehicle on releasing and diffusion of allantoin through semipermeable membrane into an aqueous medium was examined and the quantity of released allantoin was estimated spectrophotometrically. The best results were achieved with ambiphilic vehicle emulsified with complex Tagat S-Tegin M which in the aqueous phase contained propylene glycol (sample A2). On the contrary, with both lanacolic vehicles, the poorest results were achieved in vitro. On the basis of the results for clinical evaluation, the best preparation was chosen (A2) and the preparation with lanacolic vehicle which contains propylene glycol (B2). Before the application of samples, each patient was tested for irritation and sensitization. All test were negative. During further clinical examinations on patients suffering from psoriasis an open double trial for the duration of 14 d was performed. For the evaluation of the efficacy of the examined preparations, objective parameters of the clinical picture were observed (the state of hyperkeratosis, of erythema and infiltration) as well as subjective parameters which were evaluated by the patients themselves. When the in vitro results are compared with clinical estimation, it is evident that they correspond only when characteristics of the preparation are estimated by patients (smearing, absorption and feeling on the skin), because the best preparation was in these cases A2. Both preparations are equally good when regression of subjective symptoms is evaluated (itching and burning). In the objective evaluation of the regression of visible symptoms, such as hyperkeratosis and erythema, results of the clinical experiment do not correspond with results in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

Interferon therapy for basal cell carcinoma and squamous cell carcinoma.

Totally 161 basal cell and squamous cell carcinoma (BCC, SCC) patients were treated with human natural leucocytic interferon (HNLI) and recombinant IFN alpha 2c. After HNLI treatment, 61 out of 86 BCC patients and 29 out of 45 SCC patients were cured according to histopathologic and clinical findings. In 13 BCC and 13 SCC patients, the cancer lesion was reduced 25%-90%. After recombinant IFN alpha 2c treatment, 14 of 20 BCC patients and 4 of 10 SCC patients were cured according to histopathologic and clinical findings. In 6 BCC patients and 5 SCC patients the cancer lesion was reduced 25% to 90%. Both types of interferons are effective in the treatment of BCC and SCC patients. Local application of interferon stimulates immune reaction at the site of the tumor. There is a marked difference between the spontaneous macrophage activity and that induced by interferon. The interferon activated macrophages are significantly larger, the number of lysosomes and the density of macrophages is increased. In difficult locations intralesional therapy can be considered to avoid disfigurement of the patients with or without surgery.