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Biomedical subjects

J K Rivers

Publications and source records attributed to J K Rivers.

At least 73 records · Page 4Linked to original sources
PubMed1988

Risk factors for the development of malignant melanoma--I: Review of case-control studies.

Data concerning risk factors for the development of cutaneous malignant melanoma (MM) were abstracted from published case-control studies. Relative risks (more appropriately "odds ratios") and 95% confidence intervals were quoted or calculated for each risk factor in each study. Those risk factors that were reported to be significant in over half of the studies include: phenotypic factors (blue eyes, blond or red hair, light complexion, freckles, sun sensitivity, and inability to tan); personal history of non-melanoma cutaneous cancer or precancer; higher socioeconomic status; increased numbers of nevocytic nevi; and bursts of sun exposure. Further study is needed on family history and personal history of MM; these were not found to be significant risk factors in over half the reviewed case-control studies. This review leaves out other undoubtedly important risk factors such as dysplastic nervus syndrome and race, which need investigation by the case-control method. Determination of risk factors allows the identification of that subset of the population most at risk for the development of MM. Given the continued increase in the incidence of MM, these data can help to focus preventive measures on the more susceptible subgroups of the population.

Humans↗
PubMed1988

Skin types in dysplastic nevus syndrome.

In order to determine if individuals with dysplastic nevi (DN) are relatively more sun-sensitive than controls who do not have DN, the sun-reactivity skin types (based on the Harvard classification) were determined in these two groups. Compared with controls, sun-sensitive types were significantly overrepresented in the DN group. This is consistent with the hypothesis that the fundamental defect in the dysplastic nevus syndrome is the genetically unstable melanocyte, which is susceptible to neoplastic transformation induced by sunlight.

Adult↗
PubMed1988

Melanomas arising in large congenital nevocytic nevi: a prospective study.

In 1979 a registry of large (20 cm or more in diameter) congenital nevocytic nevi was established at the NYU Medical Center. To date, 56 patients have been entered. Seven were lost to follow-up. An additional two patients had melanoma on entry into the study and were therefore excluded from the results of prospective following such patients for the development of melanoma. Thus, this report concerns 47 individuals who were followed prospectively for a mean of 53 months, only 1 of whom developed melanoma. This was a 2-month-old girl at entry into the study who subsequently developed Touraine's syndrome. She eventually developed a primary melanoma in the central nervous system and died of metastatic disease at the age of 21 months.

Adolescent↗
PubMed1988

Total-body photographs of dysplastic nevi.

A method of taking total-body photographs to document dysplastic nevi is described. A set of 24 views is taken. These 35-mm color slide transparencies are projected onto a rearview screen at the time of subsequent follow-up examinations. A comparison between the baseline photographs and the current clinical findings allows the physician to detect thin malignant melanomas in a curable stage.

Diagnosis, Differential↗
PubMed1987

Platelet hyperaggregability in a patient with Klinefelter's syndrome and leg ulcers.

We describe a patient with Klinefelter's syndrome complicated by recalcitrant leg ulcers, in whom marked platelet hyperaggregability was demonstrated and venous disease excluded. Androgen replacement therapy appeared to bring about healing of the patient's ulcers and was associated with reversal of the platelet abnormality. The possible role of androgen deficiency in the pathogenesis of leg ulceration is discussed.

Adult↗
PubMed1986

Walking dandruff and Cheyletiella dermatitis.

Two patients presented with pruritus and rash caused by Cheyletiella mites that lived on our patients' cats. Only with veterinary assistance was the correct diagnosis made and effective therapy instituted.

Adult↗
PubMed1985

Etretinate: management of keratoma hereditaria mutilans in four family members.

We are reporting four family members, spanning three generations, who were treated with etretinate for keratoma hereditaria mutilans. All four patients presented with mutilating keratoderma of the palms and soles, and all demonstrated remarkable benefit from the medication. In addition, in the most severely affected individual, several fingers had well-established pseudoainhums that resolved during therapy.

Adult↗
PubMedDate not supplied

The detection and management of dysplastic nevi and early melanoma.

Worldwide, the incidence and mortality rates for melanoma are increasing at an alarming rate. Recently, the recognition of dysplastic nevi as markers and potential precursors for melanoma has identified one group of individuals with an increased risk to develop this disease. Close surveillance of these individuals should improve the ability of clinicians to detect melanoma at an early stage when surgical excision of the primary tumor is curative in the majority of patients.

Diagnosis, Differential↗
PubMedDate not supplied

Cutaneous melanomas exhibiting unusual biologic behavior.

In rare instances, primary malignant melanoma thickness fails to predict the biologic course of the disease: lesions less than 0.8 mm thick may recur locally or metastasize, lesions greater than 5.5 mm thick may not prove to be fatal within the expected interval of time, and melanoma recurrences may develop greater than 10 years after first definitive melanoma treatment. The large Sydney Melanoma Unit data base of over 9,500 patients treated over a 41-year period provided a unique opportunity to study the characteristics and prognosis of these patients with unusual melanomas. In stage I patients with thin lesions, and no sign of disease elsewhere, presence of ulceration, high mitotic activity, and/or penetration into the reticular dermis predisposed these melanomas to recur and regression did not emerge as a risk factor for recurrence. This was in sharp contrast to the histology of the thin lesions in patients with concurrent regional lymph node metastases (stage II). Moderate to severe regression was present in all the latter lesions, ulceration and mitoses were absent, and none penetrated beyond the papillary dermis. No specific criteria were found that could identify those stage I or II patients with thick melanomas but at low risk for recurrence or those patients with localized disease (stage I) who required long-term follow-up beyond 10 years. These results indicate that guidelines for follow-up of melanoma patients after first definitive treatment may not be appropriate for a small proportion of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Dural melanoma associated with ocular melanosis and multiple blue nevi.

BACKGROUND: Primary meningeal melanomas of the central nervous system (CNS) are a rare malignant process with the majority originating from the leptomeninges. Primary dural melanomas have been reported to occur in isolation or in conjunction with Nevus of Ota. The association of primary dural melanoma with multiple cutaneous blue nevi has not been reported previously. OBJECTIVE: To describe a case of a 41-year-old Asian woman patient with a primary dural melanoma that arose in association with ocular melanosis and multiple cutaneous blue nevi. The patient is alive almost more than 8 years after subtotal and subsequent total resection of her primary tumor. Primary dural melanomas, Nevus of Ota, and blue nevi are discussed in relation to their coexistence and potential for intracranial melanoma. CONCLUSION: CNS melanoma is regarded as an extremely aggressive disease with poor prognosis. This case and previous reports of dural melanomas occurring in isolation or with Nevus of Ota have demonstrated relatively prolonged survival after surgical intervention. We conclude that dural melanomas are less aggressive tumors requiring surgical extirpation only.

Adult↗