Non-subungual melanomas of the hand.

The non-subungual area of the hand is a rare anatomical site for malignant melanoma, lesions in this site comprising only 0.37% of 8,584 cutaneous melanomas in the Sydney Melanoma Unit database. This is approximately the same frequency of melanoma as is found on the subungual region of the hand, which represents a much smaller surface area. Not only is the sub-site distribution on the hand unusual but in addition the histogenetic types of melanoma found on the dorsum of the hand are not those commonly encountered on sun exposed skin. In this study, comparison is made between melanomas occurring on the non-subungual areas of the hand and those on the foot, an anatomically similar surface area. Comparison is also made between melanomas arising on the dorsal non-subungual surface of the hand and those on the face, a region with an equivalent surface area and similar sun exposure. The results of surgical treatment of 31 melanomas of the non-subungual region of the hand are reviewed.

Plasma and urinary luteinizing hormone levels in the diagnosis of endocrine disease.

The diagnostic value of measurements of plasma and urinary luteinizing hormone (LH) has been studied in 209 patients with endocrine disease. In 44 patients puberty was either delayed or had failed to occur. In those with chromosomal abnormalities the LH levels were often within the normal range, whereas those with a pituitary cause usually had low levels. In boys with delayed puberty plasma LH levels rose before physical changes occurred and had prognostic value. In patients with later gonadal failure, men with impotence or infertility, and women with secondary amenorrhoea LH assays proved of little value, although in one case a premature menopause was suspected and six patients with anorexia nervosa had low LH levels.Sixty patients with disorders of the hypothalamicpituitary area were studied. Levels of LH were measured and considered in relation to the other anterior pituitary hormones. Impairment of LH secretion was one of the first effects on hormone production of disease affecting this area, and this was, of course, most readily detected in postmenopausal women.The normal ranges of both plasma and urine LH are wide and there seems to be considerable day-to-day variation, especially of urinary output. Several samples should, therefore, be measured if therapeutic decisions are involved.