Wide variety of dermatology in urban Aboriginal Health Service
Eczema and benign, pre-malignant or malignant neoplasms are the most common dermatologic presentations for urban Aboriginal and Torres Strait Islander patients.
The study comprised 255 episodes of care at the dermatology clinic at the Victorian Aboriginal Health Services (VAHS). Almost two thirds of patients were women and the mean age was 41 years.
The study said the rate of malignant skin neoplasms including melanoma highlighted the skin phenotype variability within urban Indigenous populations.
Conditions in which serious sequelae were diagnosed and referred onwards for prompt care include a diagnosis of juvenile dermatomyositis and one of psoriatic arthritis mutilans.
“These time-critical cases demonstrate the importance of access to specialist dermatology services optimising outcomes for these patients.”
Predictable sun damage patterns in Qld adults
Moderate to severe photodamage across much of the body is common in Queensland adults.
A study using three-dimensional total body photography rated the severity of photodamage on each of 10 body sites in 190 men and women.
Overall, 90% of participants had moderate or severe photodamage on their head and neck, 80% on their lower arms, 81% on their front upper torso and 77% on their upper back.
Gender differences were apparent with women having more severe photodamage on their upper arms than men, while men were more likely to have moderate to severe photodamage on their lower backs than women.
“The importance of these findings is the known association of photodamage with the development of skin cancer and specifically with UV-induced mutations in the skin,” the study said.
Melanoma presents late in young people
A national case series of all paediatric and adolescent malignant melanoma presenting to ANZCHOG Childhood Cancer Centers in Australia and New Zealand has demonstrated the lethality of the disease in under 18 year olds.
In the series of 37 cases seen between 1994 and 2014, staging at diagnosis were 21.6% stage I, 24.3% stage II, 10.8% stage III and 29.7% stage IV.
The median age at diagnosis was 10 years. Where descriptions of the lesions at presentation were available, most lesions were pigmented (55%).
“Breslow thickness was reported in 25 cases and nearly 30% (11 cases) had thick lesions with a measurement greater than 4mm at presentation.”
Of the 11 patients who relapsed, 90% of patients died of the disease.
“Our findings strongly suggest that patients are usually referred to tertiary oncology centers only when harboring advanced stages of the disease, which likely also explain the relatively high death rate of 27% that was observed.”