Malignant melanoma of the lip spreading in a pagetoid manner into the minor salivary glands.

We describe a malignant melanoma of the lower lip that upon recurrence extended in a pagetoid manner into the ducts of the oral minor salivary glands. Immunohistochemistry with antibodies to MART-1 and HMB-45 confirmed that the atypical cells in the ducts of the salivary glands were indeed melanoma cells. Pathologists involved in staging of oral melanoma are urged to look out for this previously unreported mode of spread of labial malignant melanoma.

Frequency and etiology of hand and forearm dermatoses among veterinarians.

BACKGROUND: Veterinarians are exposed to a range of skin irritants and allergens, yet few studies have addressed the occurrence of dermatoses among veterinarians. OBJECTIVES: The goals of this study were to determine the frequency of noninfectious hand and forearm dermatoses among Kansas veterinarians, to estimate the role of occupational exposures in the aggravation of such dermatoses, to determine the frequency and nature of infectious dermatoses among veterinarians, and to investigate patterns of glove use. The secondary goals of this study were to collect information about the impact of skin disease on the lives and careers of veterinarians and to provide physicians with a practical approach to the treatment of veterinarians with dermatoses. METHODS: A questionnaire was mailed to all members of the Kansas Veterinary Medical Association. RESULTS: The response rate was 60%. Twenty-four of respondents reported noninfectious, recurrent/persistent hand or forearm dermatoses; 66% were work related. Large animal veterinarians (P =.026) and atopics (P =.009) were more likely than their counterparts to attribute their dermatoses to work-related factors. Thirty-eight percent of respondents had contracted at least one infectious skin disease from an animal. Veterinarians who never or rarely use gloves during obstetric procedures were more likely to report work-related dermatoses (odds ratio, 4.25; 1.78 < OR < 10.07; P <.001) than those who use gloves. CONCLUSION: Veterinarians are affected frequently by infectious and noninfectious dermatoses. Improvement of barrier protection habits during obstetric procedures would likely reduce the frequency of occupational dermatoses among veterinarians.

Psoriasis and pregnancy.

BACKGROUND: Women comprise half of all psoriasis patients and because the majority of psoriasis cases present before age 40 the disease affects women who may become pregnant. Information regarding the heritability of psoriasis can be used in counseling patients who inquire about the potential risk to their children. Patients with psoriasis who become pregnant will likely notice an associated improvement of their symptoms if any change is noted at all. OBJECTIVE: Because of potential fetal effects, the treatment of chronic psoriasis in pregnancy involves prudent consideration of whether the severity of the disease warrants treatment and selection of the safest treatments available. CONCLUSION: Topical corticosteroids and topical calcipotriene as well as topical anthralin and topical tacrolimus appear to be safe choices for control of localized psoriasis in pregnancy. UVB is the safest treatment for extensive psoriasis during pregnancy, particularly when topical application of other agents is not practical. Short-term use of cyclosporine during pregnancy is probably the safest option for management of severe psoriasis that has not responded to topical or UVB treatment.