Primary idiopathic cutaneous amyloidosis: can coconut oil be a contributing factor? - abstract

Twenty patients who presented clinically with either macular or lichen amyloidosis at clinics at the Port of Spain General Hospital or the St. Joseph Health Centre had skin biopsies done. Two control groups of male and female patients were randomly selected. They presented with other unrelated skin conditions and either used coconut oil only occasionally or used other types of oil. Skin biopsies were stained with haematoxylin and eosin and congo red/methyl violet. The study group were all female Indo-Trinidadians who had daily applied coconut oil to the arms, legs and hair for an average period of 31 years (range 4 months - 40 years). In 15 patients, there was histological confirmation of amyloid. Seven patients had at least 1 family member with a similar skin condition. Papular and macular skin lesions were seen on the anterior aspect of the leg and the extensor aspect of the arm and scapular region. It is proposed that the common practice among female Indo-Trinidadians of daily application of coconut oil to arms, legs and hair is a risk factor in the development of primary cutaneous amyloidosis and that genetic and familial factors are also involved in this condition (AU)

Racial and other characteristics of human T cell leukemia/lymphome (HTLV-1) and AIDS (HTLV-111) in Trinidad

Adult T cell leukaemia/lymphoma was first recognised as a clinical entity in southwest Japan. Subsequently the Caribbean has been found to be another area where the disease is endemic, and sporadic cases have been identified in different parts of the world. The human T cell leukaemia/lymphoma virus (HTLV-1) is causally related to adult T cell leukaemia/lymphoma. A sub-group of HTLV, designated HTLV-111, has recently been isolated from many patients with the acquired immunodeficiency syndrome (AIDS) and preAIDS, and there is now evidence that this variant is the primary cause of AIDS. This is the first report from Trinidad to describe twelve cases of adult T cell leukaemia/lymphoma and 14 of AIDS. All were in patients of African descent. No cases were seen in subjects of East Indian descent, who, like those of African descent, comprise as much as 40 percent of the population

Histoplasmosis in the eastern Caribbean: a preliminary survey of the incidence of the infection

A preliminary survey of the incidence of histoplasmosis in the eastern Caribbean was carried out. The percentages of positive histoplasmin skin test reactors in the populations studied were as follows: Barbados (4 percent), Trinidad (42 percent) and Guyana (29 percent). In Trinidad 69 percent of individuals under 60 had positive tests. However a lower proportion (4 percent) had serological evidence of past infection with Histoplasma capsulatum. The organism was not isolated from the soil although it had been found previously in Trinidad. On this island five previously diagnosed cases of histoplasmosis were identified. The study confirmed the presence of the infection in the area and further investigations are suggested (AU)

A decade of malignant skin disorders in Trinidad and Tobago - abstract

This paper reviews the incidence over a 10-year period (1962-1971) of pre-malignant and malignant conditions of the skin, and skin conditions associated with malignancy in Trinidad and Tobago. All cases seen in hospital as well as in private practice were included in this review. One hundred and twenty-six cases of skin conditions associated with or related to malignancy have been diagnosed. Basal cell carcinomas were the commonest conditions (63 cases) followed by solar keratoses (33 cases), and these conditions occurred almost exclusively in European types with only two basal cell carcinomas in patients who were obviously Negro or East Indian. This is in accordance with accepted fact that "factors such as racial origin and climatic conditions are involved in the relative frequency of occurrence" of these conditions. However, ten malignant were diagnosed in Negroes or East Indians, and it was striking that none were seen in European types. Finally, the small number of uncommon lesions mentioned in this paper does not allow for any significant conclusions, except that these conditions do also occur in Trinidad and Tobago (AU)

Hansen's disease in a dermatological practice - abstract

The purpose of this study was primarily to ascertain the amount of new cases of Hansen's disease found in 1968 in skin clinics in Trinidad and Tobago and to indicate the present extent of the problem of Hansen's disease from the point of view of its incidence relative to other skin disorders. It was possible also to review the ages of the patients seen as an indication of the minimum latent period in these parts and to show the incidence of cases appearing without any known history of contacts. The histology is discussed with special reference to the very young cases. Cases reviewed so far indicate that the incidence is about 20 new cases per year and about half of these are old cases which have concealed the history of previous diagnosis. Fifty percent of the new cases are children and the youngest case so far seen is 3 years old. We conclude that there are still a significant number of undiagnosed cases in the community and that young children are as usual mostly at risk. We advise that Public Health measures should be stricter in finding contacts for inoculation and/or treatment, and that efforts should be made to interest our General Practitioners in early diagnosis of these cases, if the relative small but quite significant problems of Leprosy is to be contained and eventually eradicated (AU)

Skin cancer in Trinidad and Tobago

This paper reviews the various types of skin cancer diagnosed in a dermatological practice covering all of Trinidad and Tobago. Also included are precancerous skin conditions, dermatoses associated with malignancy, kerato acanthomas, as well as reticuloses involving the skin. The breakdown of these cases seen over the last five years (1962-1966) is presented: (a) malignant conditions: basal cell carcinoma - 21, squamous cell carcinoma - 2, basi-squamous carcinoma - 1, malignant melanoma - 4, Bowman's intra-epidermal cancer - 1 (b) precancerous skin conditions: solar keratosis - 8 (c) sermatomyositis complicating carcinoma of cervix - 2 (d) reticuloses: mycosis fungoides - 1, kaposi's sarcoma - 1 (e) kerato acanthomas - 3. In some measure, the type of cancer was determined by the degree of skin pigmentation. All four malignant melanomas were in Negroes or East Indians. This disagrees with the frequently quoted observation that malignant melanomas tend to occur in Caucasians rather than in pigmented races. All the melanomas occurred on the feet. Three were on the planter aspect, and on a pre-existing eczematous condition of the great toe. All patients except two with basal cell or basi-squamous carcinoma were of European ancestry. The two were of mixed race and fair complexion. This is to be expected since basal cell carcinoma is known to be a frequent complication of excessive exposure to sunlight in skin unprotected by melanin. The kerato acanthomas and the solar keratoses also fall into this category in my group, occurring only in European types. The small number of the other uncommon lesions seen does not allow for any valid conclusions (AU)