Background: The incidence of cutaneous malignant melanoma has been rising ste adily in Caucasian populations for several decades, with a doubling time of 10- 14 years. An increase in incidence of about 5% per year has...Background: The incidence of cutaneous malignant melanoma has been rising ste adily in Caucasian populations for several decades, with a doubling time of 10- 14 years. An increase in incidence of about 5% per year has been reported in most Caucasian populations since the early 1960s. Objectives: This study was des igned to determine the changing incidence of primary cutaneous malignant melanom a in Northern Ireland and to examine changes in survival rates from cutaneous ma lignant melanoma in two 5- year periods, 1984- 88 and 1994- 98. Methods: One thousand three hundred and twenty-six patients with invasive primary cutaneous melanoma were included in the study. Results: The age standardized rate of mela noma rose from 4- 3 per 100 000 population per year in men and 8.6 per 100 000 population per year in women to 7.7 and 11.8, respectively, p er 100 000 population per year in the 1994- 98 period. Overall, the absolute 5 - year survival for the 1984- 88 period was 71.0% (95% confidence interval (CI) 66.9- 75.1% ) and 77.4% (95% CI 73.4- 81.4% ) for the 1994- 98 pe riod. Women consistently showed better survival at all ages and within almost al l categories of thickness of primary tumour. Younger patients of both sexes show ed better survival rates. Conclusions: When survival rates between the 1984- 88 and 1994- 98 periods were compared using multivariate analysis, we found that patients diagnosed in the second period had a one-third lower risk of dying th an those in the earlier period. Much of this reduction was explained by changes in the number of melanomas of thin Breslow depth and ulcerated melanomas.展开更多
Background:Topical tacrolimus has been reported to be effective for the treatme nt of oral lichen planus. This article describes our experience with topical tac rolimus in patients treated for symptomatic oral lichen ...Background:Topical tacrolimus has been reported to be effective for the treatme nt of oral lichen planus. This article describes our experience with topical tac rolimus in patients treated for symptomatic oral lichen planus. Observations:A survey was mailed to 40 patients with symptomatic oral lichen planus treated wit h topical tacrolimus. Surveys were completed by 37 patients (93%) a mean of 1.3 years after initiation of treatment. Thirty-three (89%) of the 37 patients re ported symptomatic improvement, and 31 (84%) reported partial to complete lesio n clearance while using topical tacrolimus. On average, patients noted improveme nt in 1 month. Twelve patients(32%) reported adverse effects consistent with th ose reported previously (ie, burning, irritation, and tingling). Among the 28 pa tients still using the medication, 15 patients (54%) apply it at least once dai ly. Of the 9 patients who discontinued using the medication, 5 experienced recur rence. Conclusions:Topical tacrolimus is effective for the treatment of oral li chen planus. Most patients experienced symptomatic improvement in less than 1 mo nth. However, the effect is temporary; when topical tacrolimus is discontinued, oral lichen planus may flare again.展开更多
文摘Background: The incidence of cutaneous malignant melanoma has been rising ste adily in Caucasian populations for several decades, with a doubling time of 10- 14 years. An increase in incidence of about 5% per year has been reported in most Caucasian populations since the early 1960s. Objectives: This study was des igned to determine the changing incidence of primary cutaneous malignant melanom a in Northern Ireland and to examine changes in survival rates from cutaneous ma lignant melanoma in two 5- year periods, 1984- 88 and 1994- 98. Methods: One thousand three hundred and twenty-six patients with invasive primary cutaneous melanoma were included in the study. Results: The age standardized rate of mela noma rose from 4- 3 per 100 000 population per year in men and 8.6 per 100 000 population per year in women to 7.7 and 11.8, respectively, p er 100 000 population per year in the 1994- 98 period. Overall, the absolute 5 - year survival for the 1984- 88 period was 71.0% (95% confidence interval (CI) 66.9- 75.1% ) and 77.4% (95% CI 73.4- 81.4% ) for the 1994- 98 pe riod. Women consistently showed better survival at all ages and within almost al l categories of thickness of primary tumour. Younger patients of both sexes show ed better survival rates. Conclusions: When survival rates between the 1984- 88 and 1994- 98 periods were compared using multivariate analysis, we found that patients diagnosed in the second period had a one-third lower risk of dying th an those in the earlier period. Much of this reduction was explained by changes in the number of melanomas of thin Breslow depth and ulcerated melanomas.
文摘Background:Topical tacrolimus has been reported to be effective for the treatme nt of oral lichen planus. This article describes our experience with topical tac rolimus in patients treated for symptomatic oral lichen planus. Observations:A survey was mailed to 40 patients with symptomatic oral lichen planus treated wit h topical tacrolimus. Surveys were completed by 37 patients (93%) a mean of 1.3 years after initiation of treatment. Thirty-three (89%) of the 37 patients re ported symptomatic improvement, and 31 (84%) reported partial to complete lesio n clearance while using topical tacrolimus. On average, patients noted improveme nt in 1 month. Twelve patients(32%) reported adverse effects consistent with th ose reported previously (ie, burning, irritation, and tingling). Among the 28 pa tients still using the medication, 15 patients (54%) apply it at least once dai ly. Of the 9 patients who discontinued using the medication, 5 experienced recur rence. Conclusions:Topical tacrolimus is effective for the treatment of oral li chen planus. Most patients experienced symptomatic improvement in less than 1 mo nth. However, the effect is temporary; when topical tacrolimus is discontinued, oral lichen planus may flare again.
