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Biomedical subjects

R F Wagner

Publications and source records attributed to R F Wagner.

At least 91 records · Page 5Linked to original sources
PubMed1992

Mohs micrographic surgery for thin stage I malignant melanoma: rationale for a modern management strategy.

Mohs micrographic surgery is presented as a rational surgical management approach for thin malignant melanoma. Advantages of the Mohs micrographic surgery fresh-tissue technique include tissue conservation, low local recurrence rates, and outpatient reconstruction. It is likely that in the future many physicians and patients will choose Mohs micrographic surgery for the surgical treatment of thin malignant melanoma.

Humans↗
PubMed1992

Risk classification of life and health insurance applicants with atypical melanocytic hyperplasia or malignant melanoma in situ.

Physicians may attempt to disguise malignant melanoma in situ from insurance companies by diagnosing atypical melanocytic hyperplasia instead. This study indicates that the insurance industry is not misled by atypical melanocytic hyperplasia and treats it equivalently to malignant melanoma in situ. In addition, physicians' failure to diagnose malignant melanoma in situ may result in underestimation of the incidence of malignant melanoma and may cause inadequate initial treatment and patient follow-up.

Humans↗
PubMed1992

Photography for the early diagnosis of malignant melanoma in patients with atypical moles.

Several articles have been published that carefully describe techniques for obtaining reliable photographic series of patients with the atypical mole syndrome. Four common methods of total body photography are described. Follow-up studies of the effectiveness of photodocumentation for patients with the atypical mole syndrome are reviewed.

Dysplastic Nevus Syndrome↗
PubMed1992

Prevention of primary cutaneous malignant melanoma: increasing cure rate in the 1990's.

This review focuses on the epidemiology, risk factors, early detection, and metastatic risk of thin primary cutaneous malignant melanoma. Primary prevention strategies and the results of screening programs and public education campaigns are discussed. Recent advances in the development of noninvasive diagnostic devices for primary cutaneous malignant melanoma are summarized.

Female↗
PubMed1992

Possible role of adjuvant therapy for thin malignant melanoma.

Patients with thin (less than 0.75 mm) malignant melanoma generally have an excellent prognosis following adequate surgical resection. However, some patients will experience recurrent disease. Once features for a high risk of recurrence in patients with malignant melanoma can be reliably identified, adjuvant intervention will be offered. Two formidable challenges remain before this strategy is adopted: we cannot yet accurately predict the subgroup of patients with thin malignant melanoma who will experience disease progression and an effective, nontoxic adjuvant regimen for this subgroup is not currently available. Future prospects for the adjuvant management of thin malignant melanoma are reviewed.

Chemotherapy, Adjuvant↗
PubMed1992

Childhood malignant melanoma in a patient with dysplastic nevi.

A 14-year-old boy with sporadic dysplastic nevus syndrome and an in situ malignant melanoma is described. Patients with the dysplastic nevus syndrome should be routinely evaluated for signs of malignant melanoma. When malignant melanoma is diagnosed early, chances for cure are great. However, when the diagnosis of malignant melanoma is delayed, chances for survival decrease.

Adolescent↗
PubMed1992

Parents' use of sunscreen on beach-going children. The burnt child dreads the fire.

BACKGROUND: Little is known about why some parents elect to use sunscreen on their children while others do not. A survey was distributed to beach-going childrens' parents who used (n = 42) or did not use (n = 40) sunscreen on their children to determine differences between these two groups. RESULTS: Parents who applied sunscreen to their children had children who previously had experienced significantly more painful sunburns (chi 2 = 6.40; df = 1; P less than .05). CONCLUSIONS: Sunscreen use by beach-going children is motivated by parental attempts to prevent acute painful sunburn. Parental attitudes and behaviors about their childrens' sun exposure need modification if sun protection strategies are to reduce the future epidemic of skin cancer successfully. Sun protection education during well-child visits by pediatricians and family physicians is recommended.

Child↗
PubMed1991

Percutaneous injury during dermatologic surgery.

An anonymous survey was conducted among 100 randomly selected fellows of the American Society for Dermatologic Surgery. Forty-one respondents provided information about their experience with percutaneous injury. Causes of injury during 6278 invasive procedures performed during a 1-month period included suture needlesticks (two injuries), injection needlestick (one), needle recapping (one), scalpel blade (one), skin hook (one), and an injury during the transport of an instrument (one). Dermatologic surgeons were more likely to injure their dominant fingers. Attitudes of dermatologic surgeons were surveyed regarding operating on patients while the physician or assistant was actively infected with human immunodeficiency virus, hepatitis B virus, herpetic whitlow, or paronychia caused by Staphylococcus aureus. Dermatologic surgeons believed that they should be allowed to operate while infected with human immunodeficiency virus (41.5%), hepatitis B virus (40%), herpetic whitlow (25%), and paronychia caused by S. aureus (20%). Few dermatologic surgeons would disclose preoperatively to patients infections present in themselves or in operating team members that were due to human immunodeficiency virus (29.4%), hepatitis B virus (27.8%), herpetic whitlow (28.6%), or paronychia caused by S. aureus (33.3%).

Accidents, Occupational↗
PubMed1991

Prognosis and treatment of advanced squamous cell carcinoma secondary to epidermodysplasia verruciformis: a worldwide analysis of 11 patients.

Data were collected from three medical centers in the USA, Poland, and Japan regarding 11 patients with advanced squamous cell carcinoma (SCC) secondary to epidermodysplasia verruciformis (EV). Analysis was conducted regarding primary tumor location, age at onset of EV, age at diagnosis of SCC, treatment of SCC, history of local tumor recurrence, presence of metastases, and age at death. Three of 11 patients developed both lymph node and visceral metastases and the mean patient age at death was 44 years (N = 6) with no patient to date living past 54 years. Mean patient survival time following metastases was 1.7 years (N = 2). Human papilloma virus typing of nine patients was performed. Current controversies regarding the treatment of patients with advanced SCC in the setting of EV are reviewed.

Adolescent↗
PubMed1991

A new type of connective tissue nevus: isolated exophytic elastoma.

An unusual case of isolated exophytic elastic tissue nevi in the scrotal region of a 64-year-old man is described. The histological and ultrastructural findings were those of abundant abnormal elastic fibers and increased reticulin in the dermis. This hamartomatous lesion possesses clinical and histological features previously undescribed in connective tissue nevi.

Elastic Tissue↗
PubMed1991

Pseudohorn associated with basal cell carcinoma.

Cutaneous horns usually represent compacted keratin arising from an underlying pathologic process and are important to dermatologists because they may indicate an underlying malignancy. The differential diagnosis of cutaneous horns includes pseudohorns, which have the morphologic appearance of a cutaneous horn but consist entirely of benign or malignant tumor. We describe a second type of pseudohorn consisting of hair, dried serum, and inflammatory exudate that was associated with an underlying basal cell carcinoma.

Basal Cell Carcinoma↗
PubMed1991

Multidisciplinary treatment of facial skin cancer.

Skin cancer incidence is increasing rapidly. We outline the indications for and advantages of diagnostic techniques and treatments, including curettage and electrodesiccation, surgical excision, Mohs' micrographic surgery, cryosurgery, radiation therapy, interferon injection, and photodynamic therapy. We describe our interdisciplinary treatment protocol for skin cancer treatment and emphasize avoidance of the sun and early treatment of photodamaged skin. This treatment includes oral retinoids, topical tretinoin (Retin-A), 5 fluorouracil, and chemical peels performed with trichloroacetic acid or phenol.

Adolescent↗