Malignant melanoma of the skin in black South Africans: a 15-year experience.

AIM: To document the anatomical distribution of melanoma, extent of disease, results of treatment and survival among black patients in the north-eastern part of South Africa. METHODS: All available histological material was reviewed. All available addresses of patients were consulted to establish the status of patients treated in the drainage areas of, or referred to, Kalafong Hospital or Pretoria Academic Hospital retrospectively and prospectively for the 15-year period 1969 - 1983. RESULTS: Of the 185 patients with melanoma who were documented, 10 were eliminated for various reasons. Among the remaining 175 patients there were 128 documented deaths, 35 patients having died of melanoma within 1 year of presentation. Thirty patients survived for more than 3 years. Because of late presentation and the nature of the disease, malignant melanoma has a very poor prognosis in black patients in South Africa.

Venous bullet embolism. A case report.

Venous missile embolism to the pulmonary artery is a rare occurrence and controversy persists about the need to remove such a foreign body. This report describes a case of bullet embolism from the right common iliac vein to the left pulmonary artery. In this case the bullet was not removed.

Actinomycosis of urachal remnants.

A case of actinomycosis of the urachus is described. A 25-year-old woman presented with a midline mass below the umbilicus. The differential diagnosis included an inflammatory or a neoplastic lesion. Diagnosis was made by histologic examination, after complete excision of the tumour. Post-operative penicillin was given and the patient's recovery was uneventful. A review of the literature is presented with special reference to the pathogenesis and treatment.

Thermal injury in pregnancy--the neglected tragedy.

Thermal injury sustained during pregnancy presents special management problems for the gravid woman and her unborn child. Because of the reported high morbidity and mortality and lack of available data in South Africa, a multicentre retrospective review was undertaken by five burn centres. Thirty-three patients (average age 25,7 years) with mean 30% (range 1-80%) total body surface area burn were assessed. A review of the clinical material led to the following observations and conclusions. Pregnancy does not influence maternal outcome after thermal injury and maternal survival is usually accompanied by fetal survival in the absence of significant maternal complications. Maternal survival is less likely if the burn wound exceeds 50% total body surface area. Thermal injury does increase the risk of spontaneous abortion and premature labour, and fetal survival depends on fetal maturity. Early obstetric intervention is only indicated in the gravely ill patient where complications (hypoxia, hypotension, sepsis) jeopardize the life of a viable fetus. The mode of delivery should be determined by obstetric considerations.

Pseudoxanthoma elasticum in South African black patients. A report on 7 cases.

Pseudoxanthoma elasticum in 7 South African black patients is reported. All demonstrated cutaneous lesions of varying severity and extent. Gastro-intestinal bleeding requiring surgical intervention was found in 1 patient.