Dermatofibrosarcoma protuberans: an early non-protuberant phase of the tumour.

A 40-year-old female patient presented with a flat scar like plaque on the upper chest. The patient's perception of subtle change in the lesion was of paramount importance in the decision to biopsy this lesion of innocuous clinical appearance. Histopathological findings were those of dermatofibrosarcoma protuberans. This case illustrates the early clinical features of the tumour and a recommendation for taking a biopsy of any scar-like plaque where there is no clear history of preceding trauma.

Cutaneous nerve hypertrophy.

We present a case of cutaneous nerve hypertrophy possibly secondary to scratching or other trauma. The patient was symptomatic and sought surgical treatment, despite no clinical lesion being evident. This type of change has not been previously reported in this clinical setting. There was no clinical evidence of multiple endocrine neoplasia-type 2b (MEN-2b). Awareness of this entity may avoid unnecessary surgery.

Acute streptococcal necrotising fasciitis.

Two cases of acute streptococcal necrotising fasciitis are reported. Both patients were taking nonsteroidal antiinflammatory drugs when they developed this infection. Urgent surgical debridement was undertaken and resulted in a successful outcome in both patients. The clinical and histopathological features of this condition are reviewed.

Halo dermatitis around a melanocytic naevus: Meyerson's naevus.

A case of halo dermatitis (eczema) around a pigmented naevus is reported. This appears to be a not uncommon condition which is not described in major dermatology textbooks. The relevant literature is reviewed, and the eponym 'Meyerson's naevus' is suggested.

Pathology medical manpower planning in New Zealand results of 1977 survey.

As part of Medical Manpower Planning in New Zealand, a survey conducted by the New Zealand Society of Pathologists in association with the Royal College of Pathologists of Australia shows that at present there are 116 pathologists practising in New Zealand, a ratio of one to 27 000 population. This is far short of the requirement of 1:20 000, for which an additional 40 pathologists is required now, with an average annual requirement of 11 additional pathologists over the next nine years.

Perinatal infections by group B beta-haemolytic streptococci.

Since 1970 there has been an increase in isolations of Group B beta-haemolytic streptococci from infants and mothers at the National Women's Hospital and the organism has become the major cause of fatal perinatal infection. Forty-three of 60 stillborn and liveborn infants with postmortem isolations of Group B streptococci had pneumonia and of these a minority also had meningitis and/or septicaemia. Amnionitis was found in 15 of 20 placentae examined from these patients and an ascending infection from the maternal genital tract, often through intact membranes, was considered likely in the majority. However, a review of the prenatal histories of 33 infants showed that only a minority had premonitory features such as prolonged rupture of membranes, prolonged labour or maternal fever. Thirteen of 26 liveborn infants had a birth weight less than 2500 g. The majority presented within one hour of birth with respiratory distress or apnoea and died within 48 hours of birth. Early diagnosis of Group B infection is possible if bacteriological and radiological evidence is sought in infants of low birth weight, with low Apgar scores and with early onset of respiratory distress syndrome or apnoea in addition to those having the more usual indications of intrauterine infection. Group B streptococci were carried vaginally in 9 per cent of women attending an antenatal clinic and this high carrier rate is considered to preclude prophylactic treatment.