[Cutaneous melanomas, a spectrum of emerging cancers in women of Wallonia. Outlook by the Mosan Study Group of Pigmented Neoplasms]. / Les mélanomes cutanés, un spectre de cancers émergents chez la femme en région Wallonne. Un regard porté par le Groupe Mosan d'Etude des Tumeurs Pigmentaires.

The Mosan Study Group of Pigmented Neoplasms was founded about 15 years ago. It has collected more than 20,000 cutaneous malignancies including melanomas and basal and squamous cell carcinomas. The incidence of these cancers is on the rise in Wallonia. In particular, malignant melanomas represent a spectrum of emerging cancers characterized by a proteiform biological outcome. They mostly affect young women. The major risk factor appears to be iterative and unwise ultraviolet exposures. The prevention of melanomas is basically founded on such a dogma and accordingly relies on sunscreens. However, controversies about their beneficial effects are rife and fueled by axiomas and contradictory sophisms. At the exception of surgery, the therapeutic options for the diverse types of melanomas do not yet fulfill the scope of evidence-based medicine.

[Dermatologic diseases of the nipple and areola]. / Maladies dermatologiques du mamelon et de son aréole.

Several diseases of the nipple and areola have a specific dermatological presentation. They may be classified into five main categories including dysembryoplasias, mastalgia, inflammatory dermatoses, hyperkeratoses and neoplasms.

Cyanoacrylate skin surface stripping: an improved approach for distinguishing dysplastic nevi from malignant melanomas.

We present a novel approach for improving the management of patients with pigmented neoplasms including malignant melanomas and dysplastic nevi. A cohort of 215 dysplastic nevi and malignant melanomas was studied by cyanoacrylate skin surface stripping (CSSS) and conventional histology. Presence of atypical melanocytes was found in the stratum corneum in more than 95% of malignant melanomas and was always absent in dysplastic nevi. We conclude that this non-invasive technique is rapid, easy to perform, and inexpensive. Its specificity and sensitivity are high enough to be considered by clinicians as an aid for distinguishing dysplastic nevi from malignant melanomas. We recommend this ancillary technique as a screening procedure though not as a substitute for conservative excisional biopsy, when doubt persists in the diagnosis of atypical pigmented neoplasms.

The fate of hypodermis after liposuction surgery.

Liposuction surgery can be viewed as a trauma to the hypodermis. With histologic, morphometric, and autoradiographic examination and the use of tritiated thymidine, uridine, and proline, we have studied the fate of adipose tissue at various intervals after liposuction; however, we have never seen a reparative proliferation of the residual lipocytes. Moreover, the metabolic activity of adipocytes apparently is not increased. Inflammatory reaction is minimal in the early weeks, but fibrosis takes place in some lobules of the hypodermis. Our data support the view that liposuction has a long-term effect on the structure of the hypodermis, without any stimulation in the proliferative and biosynthetic activity of residual adipocytes.

Episodic progression and regression of basal cell carcinomas.

Metabolic activity and structure of the stroma adjacent to basel cell carcinomas are closely related to cytological aspects and proliferative activity of the neoplastic cells. Basal cell carcinomas without clear evidence for regression compress or infiltrate an apparently normal dermis where cellular replication is low. Conversely regressing zones of basal cell carcinomas are surrounded by a remodelled stroma where fibroblasts and endothelial cells show signs of proliferation. When regression affects the palisaded array of cells, clefts occur between the basal cell carcinoma and the adjacent stroma. Progression of most types of basal carcinomas may proceed by successive extension and partial regression. More than one type of stroma reaction may be present ina single basal cell carcinoma and the overall pattern may be regarded as the result of successive phases of growth and regression of the neoplasm.

The histological structure of Kveim tests parallels the evolution of pulmonary sarcoidosis.

The histopathology of the granulomas induced by Kveim antigen varies in patients with sarcoidosis. Eighty skin sites of Kveim tests were biopsied 4 and 5 weeks after the antigen was injected into the skin of patients with pulmonary sarcoidosis. The histological features in the skin of Kveim tests differed according to the stage of evolution of sarcoidosis and seem to parallel the pathological changes in the lung.

[Diagnosis and follow-up of syphilis by serological tests (author's transl)]. / Diagnostic et surveillance de l'évolutivité de la syphilis par les tests sérologiques.

Sensitivity and specificity of TPHA, TPI, RPCF, Kline's and Kolmer's tests are compared in a retrospective study carried out on 2,500 sera. The interest of these tests differs as far as diagnosis and survey of syphilis are concerned and the association of TPHA with a quantitative test as Kline's test appears optimal. TPHA is highly sensitive and specific. Its positivity, which usually remains after treatment, is particularly valuable in the diagnosis of cases of late syphilis. Its association with a quantitative test brings a better evaluation of the evolutivity of the disease.