Squamous cell carcinoma and basal cell carcinoma within the clinical picture of a chronic venous insufficiency in the third stage.

Two cases of neoplastic ulcers of the leg will be described which presented themselves within the clinical picture of a chronic venous insufficiency in its third stage. Both cases had a phlebological anamnesis. The transformation of chronic ulcers of the leg into spinal cell carcinomas is well known. With the presence of an ulcus cruris, however, basal cell carcinomas are rarely considered in a differentiated diagnosis. Yet both of these (by and large common) skin tumors can occur in the clinical picture of an ulcus cruris. The role of the dermatologist in the early diagnosis and treatment such neoplastic ulcers is therefore an important one.

[Have new noninvasive study methods replaced invasive venous pressure measurement in dermatophlebology?]. / Haben neue nicht-invasive Untersuchungsmethoden die blutige Venendruckmessung in der Dermatophlebologie ersetzt?

Preliminary answers are given to the question as to whether or not new, non-invasive methods, such as light reflection rheography or infrared-photoplethysmography, have replaced invasive venous pressure measurements (peripheral phlebodynamometry). The results of a recent study by the author are compared with opinions found in the literature. A detailed statistical analysis has confirmed the close relationship between phlebodynamometry and indirectly observed parameters. However, it has been shown that the prediction error can be important for the diagnosis and for the prognosis as to whether or not a chronic venous insufficiency can be improved by epifascial venous therapy. Therefore it may be advisable to confirm the results obtained with non-invasive methods by phlebodynamometry in complicated cases. Both non-invasive methods are certainly very useful for quick screening of the venous function.

Unusual cutaneous dissemination of a tropical fish tank granuloma.

A patient with an unusual disseminated tropical fish tank granuloma is presented. The infection manifested first as red, subcutaneous nodules of the right hand and forearm. During subsequent days and weeks, nodules appeared on the left arm, on the ventral and dorsal thorax, on one leg, and the face. The diagnosis was based on, in addition to the history and the clinical aspects, a positive reaction to intracutaneous testing with a specific Mycobacterium marinum antigen and on the histologic examination of biopsy specimens. The larger nodules were treated with excision. Smaller nodules disappeared spontaneously after the larger ones had been surgically removed.

Soft-X-ray therapy in Bowen's disease and erythroplasia of Queyrat.

The therapeutic results obtained with soft-X-ray irradiation on 77 lesions in 52 patients are reported. 35 males (67.3%) and 17 females (32.7%) were treated. Clinical and histological features revealed Bowen's disease in 73 cases (94.8%) and erythroplasia of Queyrat in 4 cases (5.2%). The primary healing was rated as 100% in all cases up to 6 months after a cumulative dosage of 3,200-5,000 R. 2 cases with a genital localization (2.6% of all sites and 11.1% of anogenital localizations) relapsed after 8 and 16 months, respectively. The follow-up period ranged from 1 to 11 years with a mean of 3 years. In order not to miss the late recurrences, the oncologic follow-up is taken care of by the Dermatology Department of the Zurich University Hospital during 10 years, or longer in some cases. Association with a malignant internal tumour (larynx, bronchi, anus) was found in 3 patients (5.8%).

[Palliative surgery and computer-assisted-tomography of lymphangiokeratoma circumscriptum naeviforme (author's transl)]. / Palliative chirurgie und computertomographie bei Lymphangiokeratoma Circumscriptum Naeviforme.

More than 50 percent of classified lymphangioma circumscriptum naeviforme are combined with subcutaneous lymphangioma. Therefore an exact examination before surgical operation is necessary. The computer-assisted-tomography is a new way to clarify the exact dimension of such a lymphangioma. Classification, clinical manifestations and problems in treatment of lymphangiomas are discussed.

[Pigment spot polyposis (Peutz-Jeghers syndrome)]. / Pigmentfleckenpolypose (Peutz-Jeghers-Syndrom).

Clinical findings in Peutz-Jeghers-Syndrome in a 14-year-old female patient are presented. In addition differential diagnosis and therapeutic possibilities are discussed. Furthermore, the authors assume that ultrastructural characteristics of this pigment disorder are described for the first time.