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Biomedical subjects

B Lindelöf

Publications and source records attributed to B Lindelöf.

At least 37 records · Page 2Linked to original sources
PubMed1994

Risk of lymphoma in patients with dermatitis herpetiformis.

OBJECTIVE: To provide accurate estimates of the risk of lymphoma in patients with dermatitis herpetiformis. DESIGN: Comparison of observed and expected incidence of cancer in patients with dermatitis herpetiformis. SUBJECTS: 976 patients aged 4 to 97 years with no clinical signs of coeliac disease who were admitted to hospital between 1963 and 1983. SETTING: Data from Swedish Cancer Registry. MAIN OUTCOME MEASURES: Incidence and type of cancer. RESULTS: 106 cancers were diagnosed in 94 patients. The relative risk was 1.4 (95% confidence interval 1.1 to 1.7) in male patients and 1.2 (0.8 to 1.7) in female patients. When the individual cancer sites were analysed a significant risk was found only for malignant, non-Hodgkin's lymphoma in male patients, with a relative risk of 5.4 (2.2 to 11.1). CONCLUSIONS: The risk of lymphoma is greater in male patients with dermatitis herpetiformis, and this calls for increased surveillance in these patients.

Adolescent↗
PubMed1994

Accuracy in the clinical diagnosis and pattern of malignant melanoma at a dermatological clinic.

The diagnostic pattern of malignant melanoma and clinical suspicion rate has been investigated at a dermatological university clinic. Of 174 histologically proven malignant melanomas, 60 (34%) were not clinically suspected as melanomas. The accuracy of clinical diagnosis increased with level of experience. Physicians with < 1 year experience in dermatology were able to detect malignant melanoma as the first diagnosis in 31% of the cases in contrast to 63% for those with > 10 years experience. Of 50 patients immediately referred from the dermatologic clinic to surgery departments, 12 did not have melanoma.

Dermatology↗
PubMed1994

DMSA administration to patients with alleged mercury poisoning from dental amalgams: a placebo-controlled study.

The present investigation was performed to determine the effect of 14-day oral administration of meso-2.3-dimercaptosuccinic acid (DMSA) on the urinary mercury excretion and the potential reduction of blood and plasma mercury concentrations, and also to relate these effects to possible decrease of symptoms, allegedly associated with amalgam fillings. Twenty subjects, relating their symptoms to mercury from amalgam fillings, received 20 mg/kg DMSA or placebo for 14 days. Their symptoms and mood states were recorded during the study and at a check-up 3 months later. Interpretation was based on intra-individual differences. DMSA-treatment resulted in an average increase in urinary mercury excretion by 65% and a decrease in blood mercury levels of 0.04 microgram/L/day. At the check-up after 3 months, urinary mercury excretion had returned to the pre-treatment level. No treatment effect of DMSA was apparent on subjective symptoms and mood state. One statistically significant treatment effect was noted-a decrease in fatigue-inertia in the DMSA-group-but there was no demonstrable correlation with increased urinary excretion or decreased blood concentration of mercury. Three subjects showed hypersensitive reactions, probably DMSA-specific, at the end of the treatment period. This placebo-controlled study provides no scientific support for diagnostic or therapeutic administration of DMSA for symptoms allegedly associated with chronic mercury exposition from dental amalgam fillings.

Administration, Oral↗
PubMed1993

PUVA and cancer: a case-control study.

A detailed case-control study was carried out on 24 PUVA-treated patients with squamous cell cancer of the skin, and on an accurately matched control population of 96 PUVA-treated patients. Possible co-carcinogens, such as prior therapy with tar, ultraviolet-B, ionizing radiation, methotrexate and arsenic, were investigated. The only statistically significant association to emerge was that of prior therapy with methotrexate: relative risk 3.5; 95% confidence interval 1.2-9.9. Our data suggest that prior therapy with methotrexate might be a risk factor for skin cancer in PUVA-treated patients.

Adult↗
PubMed1993

Leg ulcers and squamous cell carcinoma. An epidemiological study and a review of the literature.

There has been concern about the possible risk of malignification of venous leg ulcers. To investigate the incidence of squamous cell carcinoma in venous ulcers, data on 1,170 patients with venous leg ulcers and 511 patients with other types of non-traumatic ulcers were matched with corresponding data from the Swedish Cancer Registry to determine the incidence of squamous cell carcinoma in these patients. Mean follow-up time was 8.3 years. Seven cases of squamous cell cancer were observed, while the expected number was 10.56 (relative risk = 0.66; 95% confidence interval = 0.27 to 1.36). However, four of the observed cancers were located on the lower leg in venous ulcers, the expected number being 0.68 (relative risk = 5.89; 95% confidence interval = 1.60 to 15.08). This indicates that a certain alertness is necessary when treating this common disease. The literature on cancer in venous ulcers, where 152 cases of squamous cell carcinoma in venous ulcers are reported, is reviewed.

Aged↗
PubMed1992

Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study.

BACKGROUND: An association between polymyositis and cancer was first proposed in 1916, but the existence of the association has been disputed. An association between dermatomyositis and cancer is better accepted, but its magnitude is not known. METHODS: We undertook a study to provide accurate estimates of the risk of cancer in patients with dermatomyositis or polymyositis. We studied the incidence of cancer and the rate of mortality from cancer in a population-based cohort of 788 patients with dermatomyositis or polymyositis in Sweden from 1963 through 1983. The results were compared with those for the general population. RESULTS: Among the 396 patients with polymyositis, 42 cancers were diagnosed at the same time or after polymyositis was diagnosed in 37 patients (9 percent). The relative risk of cancer was 1.8 (95 percent confidence interval, 1.1 to 2.7) in the male patients and 1.7 (95 percent confidence interval, 1.0 to 2.5) in the female patients. Eighty-four males and 85 females died, and in 24 of these cases (14 percent) cancer was the principal cause of death. The mortality ratio (the rate of mortality from cancer in these patients as compared with that in the general population) was 0.90 (95 percent confidence interval, 0.6 to 1.4). Among the 392 patients with dermatomyositis, 61 cancers were diagnosed at the same time or after dermatomyositis was diagnosed in 59 patients (15 percent). The relative risk of cancer was 2.4 (95 percent confidence interval, 1.6 to 3.6) in the male patients and 3.4 (95 percent confidence interval, 2.4 to 4.7) in the female patients. Fifty-seven males and 110 females died, and in 67 of these cases (40 percent) cancer was the principal cause of death (mortality ratio, 3.8; 95 percent confidence interval, 2.9 to 4.8). CONCLUSIONS: The risk of cancer is increased in patients with polymyositis or dermatomyositis. In patients with dermatomyositis there is also a higher rate of mortality from cancer.

Confidence Intervals↗
PubMed1992

Comparison of the carcinogenic potential of trioxsalen bath PUVA and oral methoxsalen PUVA. A preliminary report.

BACKGROUND AND DESIGN: There is an increasing concern about the long-term carcinogenic effect of oral psoralen with long-wave UV radiation in the A range (PUVA). Most follow-up investigations indicate a definite risk of squamous cell carcinoma of the skin with long-term PUVA treatment. In a recently published study of 4799 Swedish patients who had received PUVA, it was noted that 833 patients who had received trioxsalen bath or oral trioxsalen did not show any increased risk of skin cancer in contrast to oral methoxsalen. This finding has been further investigated in this study. We compared four dermatologic university clinics in Sweden with regard to the carcinogenic potential of the PUVA regimen used. One clinic used trioxsalen bath PUVA exclusively and the other three used oral methoxsalen. Information on their PUVA-treated patients was collected and linked with information from the Swedish Cancer Registry to identify individuals with squamous cell carcinoma of the skin. RESULTS: A total of 18 squamous cell carcinomas of the skin were reported in 2975 PUVA-treated patients until 1987. The expected number was 3.1. The center using bath PUVA only had no increased risk of squamous cell carcinoma of the skin in contrast to the three centers using oral methoxsalen-PUVA. The increased risk for male subjects from those centers varied from six to 13 times that in the general population, but for female subjects a significant increased relative risk was found only at one center. CONCLUSION: In this preliminary report, PUVA treatment with trioxsalen bath seems to be less carcinogenic than the oral dosage. However, differences in the patient populations might also have affected the outcome of the study. More information on this field is needed.

Administration, Oral↗
PubMed1992

Seborrheic keratoses and cancer.

BACKGROUND: The eruptive appearance of numerous seborrheic keratoses, the sign of Leser-Trélat, has been regarded as a reliable cutaneous marker of internal malignancy. OBJECTIVE: We have evaluated the possible association of malignant disease and the sign in 1752 consecutive cases of seborrheic keratoses. METHODS: First, the Swedish Cancer Registry was searched for records of malignancies in the study population (1958 to 1984), and the expected number of malignancies was calculated. Second, records of persons with malignancy within 1 year before or after the diagnosis of seborrheic keratosis were checked for the sign of Leser-Trélat. Third, a case control study was performed to evaluate the possibility of eruptive seborrheic keratoses among the noncancer patients in the study population. RESULTS: The results showed a slight increased risk of cancer in the study population (relative risk = 1.2; 95% confidence interval = 1.0 to 1.3), mainly because of an increased risk of cutaneous squamous cell carcinoma. In 62 patients with seborrheic keratoses, a malignancy (excluding skin) was diagnosed within 1 year before or after the diagnosis of seborrheic keratosis. Of these 62 patients, 6 were regarded as possibly having presented with the sign of Leser-Trélat. For every one of the 62 cases with seborrheic keratosis and malignancy within one year, an age- and sex-matched control patient without cancer was selected from the study population and the records were checked for sudden and eruptive seborrheic keratoses. Among the control patients, five were regarded as possibly having presented with the sign of Leser-Trélat. CONCLUSION: This study gives no evidence to support the opinion that eruptive seborrheic keratoses are related to internal cancer risk.

Adolescent↗
PubMed1991

Condylomata acuminata and risk of cancer: an epidemiological study.

OBJECTIVE: To determine whether patients with condylomata acuminata have an increased risk of developing cancer. DESIGN: Prospective cohort study on patients diagnosed as having condylomata acuminata. The number of malignant tumours in the cohort was compared with national incidences obtained from the Swedish Cancer Registry. SETTING: Dermatology department of the Karolinska Hospital, Stockholm, Sweden. SUBJECTS: 3260 patients (2549 males and 711 females, median (range) age 23 (1-80) years) seen during 1969-84, with a mean follow up of 7.8 years. MAIN OUTCOME MEASURES: Number of malignant tumours observed in the cohort during the study period and expected number from national incidence. RESULTS: There were 27 malignancies in the study group. There was no significant increase genital cancer in females compared with the national incidence. Only one patient had invasive cervical cancer (relative risk = 1.8; 95% confidence interval 0 to 10.1). Seventeen women had cervical carcinoma in situ (1.5; 0.9 to 2.5) compared with an expected number of 11.5; this increase was not significant. For males 22 cancers were observed at all sites (1.6; 1.0 to 2.5). The number of genitourinary cancers observed in males was almost three times higher than expected (2.6; 1.2 to 5.0). CONCLUSION: The results indicate that the risk of developing cervical carcinoma in situ or invasive cervical cancer after a genital human papillomavirus infection is less than previously thought. The implications of increase in the genitourinary malignancies in males are uncertain.

Adult↗
PubMed1991

PUVA and cancer: a large-scale epidemiological study.

There is concern about the long-term carcinogenic effects of psoralen and ultraviolet A radiation (PUVA) therapy for treatment of skin disorders. A study of 4799 Swedish patients (2343 males, 2056 females; mean age at first treatment 45.3 years, range 6-93; mean follow-up 6.9 years males, 7.2 years females) who received PUVA between 1974 and 1985 showed a dose-dependent increase in the risk of squamous cell cancer of the skin. Male patients who had received more than 200 treatments had over 30 times the incidence of squamous cell cancer found in the general population. Significant increases (p less than 0.05) were also found in the incidences of respiratory cancer in males and females, pancreatic cancer in males, and kidney and colonic cancer in females. This study confirms previous reports of a dose-dependent increase in the incidence of squamous cell cancer in patients treated with PUVA.

Adolescent↗
PubMed1991

Lichen planus and malignancy. An epidemiologic study of 2071 patients and a review of the literature.

The literature contains 36 reports of squamous cell cancer associated with lichen planus, and several reports on increased frequency of oral cancer in patients with oral lichen planus. To examine the risk of malignant transformation, 2071 patients with lichen planus were followed up for an average of 9.9 years. Only eight squamous cell carcinomas were observed in this population after the first visit for lichen planus, producing a morbidity ratio of 1.0 (95% confidence interval, 0.9 to 1.2). Significant increase for oral cancer was observed in male subjects, with a morbidity ratio of 5.9 (95% confidence interval, 2.5 to 11.4). This study indicates that patients with cutaneous lichen planus do not carry an increased risk of malignant transformation of the skin lesions or internally; however, there is increased risk of oral cancer.

Adolescent↗
PubMed1991

Occurrence of other malignancies in 1973 patients with basal cell carcinoma.

To evaluate the possible association of other malignancies with basal cell carcinoma, we reviewed 1973 consecutive patients with basal cell carcinoma. We searched the Swedish Cancer Registry for records reporting malignancies in the study population (1958-1984) and the expected number of malignancies was calculated on the basis of age- and sex-standardized incidence data. In 452 patients with basal cell carcinoma another malignancy was diagnosed. The expected number was 323 (relative risk = 1.4; 95% confidence interval = 1.3 to 1.5). A significant association with basal cell carcinoma was found in four cancer types for men and in three for women. For skin malignancies other than malignant melanoma there was more than a sixfold increased risk for men (relative risk = 6.8; 95% confidence interval = 4.8 to 9.4) and more than a threefold increased risk for women (relative risk = 3.1; 95% confidence interval = 1.4 to 5.9) during the period after the diagnosis of basal cell carcinoma. During the period before the diagnosis of basal cell carcinoma, there were also increased risks (men: relative risk = 5.0; 95% confidence interval = 3.1 to 7.5; women: relative risk = 4.0; 95% confidence interval = 1.9 to 7.4). This was in contrast to the risks of malignant melanoma. Before the diagnosis of basal cell carcinoma there was no significant increased risk of malignant melanoma but after the diagnosis there was more than a sixfold increased risk for men (relative risk = 6.8; 95% confidence interval = 4.8 to 9.4) and more than a fourfold increased risk for women (relative risk = 4.2; 95% confidence interval = 1.5 to 9.2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Langerhans' cell histiocytosis in an adult.

A woman with typical skin lesions of histiocytosis X is reported. Electron microscopic and immunohistochemical investigations revealed a large number of markedly long Birbeck Langerhans' cell granulae. During treatment with Interferon alpha -2b, the patient developed infarctus cerebri and died.

Adult↗
PubMed1991

PUVA treatment in Sweden.

To investigate the pattern of PUVA treatment in Sweden, eleven centers supplied protocols of 4945 PUVA-treated patients between 1974 and 1985. The information collected was evaluated by computer. The most common indications for PUVA treatment were: Psoriasis; 64%, Pustulosis Palmo Plantaris; 10.5%, and Eczema; 9.4%. Fifty-five different diagnoses were reported. The treated area was mainly the whole body; 70.6%. The type of psoralen regimen varied between different centers, but oral 8-MOP was the dominating psoralen; 77.1%. Forty-five patients had received more than 400 treatments, the highest number being 758, and 537 patients had received more than a total dose of 1000 J/cm2, the highest being 6476 J/cm2. The average PUVA dose per treatment was highest for Vitiligo patients but Alopecia Areata and Pustulosis Palmo Plantaris also received high doses per treatment. One hundred and thirty-eight patients were treated for Mycosis Fungoides and 11 for Sézary's Syndrome.

Adolescent↗