[Public education in recognizing melanoma]. / Offentliche Erziehung zur Melanomerkennung.

We report on the first German "melanoma screening week" (Offenbach Melanoma Week). According to the model of the Melanoma/Skin Cancer Detection Week in Dayton/Ohio, the population of Offenbach (100.000 inhabitants) were informed about cutaneous malignant melanoma and its early recognition by means of public media, in particular the local press; the people were asked to participate in a voluntary screening including examination of the entire skin. These examinations were offered in 5 local dermatological practices on 5 working days during the European Week Against Cancer in May, 1988, under the auspices of the Hessian Cancer Society. With 2 to 4 dermatologists daily volunteering, a total of 697 persons were screened. Their average age was 48 years. An illustrated brochure ("Red Light for Black Cancer") with instructions for self-examination of the skin served as a consultation basis and memory aid. The screening week was concluded by a 3-hour's question time ("The citizen asks - the expert answers"). The most surprising result of this campaign was the fact that - contrary to earlier experience - 76% of the persons seeking advice were well aware of "black" cancer. The sole new melanoma detected was an extended lentigo maligna melanoma on the right cheek, which had not been noted during a prophylactic medical examination (!) 2 weeks before. The high public awareness of melanoma and the extremely low percentage of undetected melanomas in Hesse are most probably the result of the 8-year's educational campaign against "black" cancer.

Diagnostic excision of the Rosenmüller's node. Screening for occult metastases before elective regional lymph node dissection in patients with lower limb melanoma?

Elective radical groin dissection was performed on 297 consecutive patients with high-risk melanoma of the leg, Anderson Stages I, IIA, IIIA. By separate histologic examination of the so-called "Rosenmüller's node," the other inguinal, and the external iliac lymph nodes, the diagnostic excision of the Rosenmüller's node was tested as a suitable mode of screening for metastases before a planned elective regional lymph node dissection. Eighty patients (27%) presented with what was histologically determined to be occult groin metastases. Rosenmüller's node was involved in 30 of these cases; in the remaining 50, however, it was not affected; that is, 63% of the cases were false-negative. Thus, the involvement of Rosenmüller's node is not representative of metastases in the other ilioinguinal lymph nodes, but is rather a matter of chance. In women with superficial spreading melanoma the rate of occult lymph node metastases was significantly lower than that in men with melanomas of the other type. Iliac lymph node involvement was observed in 18 patients (22%) depending on clinical stage and depth of invasion of the primary tumor.