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Background Vulval carcinoma is a relatively rare disorder that may have various aetiologies. Objectives To document the features and outcome in a series of patients with this disorder. Methods Retrospective analysis of patients presenting to a vulval clinic over a 5-year period. Results Twenty-one women presented with a squamous cell carcinoma (SCC) and two with a verrucous carcinoma (VC). The age range was 43–83 years. Twenty-one had well-established (1–30 years) vulval symptoms prior to developing their tumour. Specific tumour-related symptoms ranged from 3 weeks to 11 months. Eight had had a prior diagnosis of lichen sclerosus (LS) or lichen planus (LP), only two of whom were on regular treatment and follow-up. At presentation, 12 patients had clinical signs of LS, three of LP, and five had some changes of both LS and LP. Two patients had multifocal vulval intraepithelial neoplasia (VIN3). Only one had no evidence of any background vulval skin disease. The commonest histological changes noted in the epithelium either adjacent to or distant from the SCC were those of atrophic LS (n = 8), LS with squamous cell hyperplasia (n = 3), LS with hyperplastic foci and lichenoid infiltrate (n = 4), and LS with differentiated VIN3 (n = 1). Four cases demonstrated the changes of LP, and three showed VIN3. All patients were treated surgically and, in those who had lymphadenectomy, four had positive nodes. There have been two deaths due to metastatic disease, and one further patient has developed a second primary SCC at a different site. Conclusions An underlying skin disorder prior to the development of their carcinoma was found in 22 of 23 patients with vulval SCC and is therefore an important risk factor. [ABSTRACT FROM AUTHOR]

In 1969 an apparently unique patient with myasthenia gravis alopecia and an associated wide-spread hair follicle hamartoma was reported by Brown, Crounse & Winkelmann (1969). We describe here a case which shows striking clinical and pathological similarities to that original patient. [ABSTRACT FROM AUTHOR]

Two dark-skinned patients presented with well-defined hypopigmented macules, a biopsy of which showed the characteristic features of mycosis fungoides. Immunohistochemical studies with UCHI1 antiserum (a pan T cell marker) confirmed the almost complete T lymphocyte nature of the infiltrate. UCHT4 antiserum (a suppressor/cytotoxic marker) showed that the epidermal infiltrate consisted predominantly of T suppressor/cytotoxic cells and Leu3a antiserum (a T helper cell marker) showed that the dermal infiltrate was composed of helper and suppressor/cytotoxic cells in approximately equal proportions. Ultrastructural studies identified normal melanocytes in the basal layer of the epidermis from both patients but mitochondrial vacuolation was seen occasionally in Case 2. We believe that this is the first report which documents T cell subsets in skin biopsies from patients with hypopigmented mycosis fungoides. Infiltrate of these two patients contrasts with the usual predominance of T helper lymphocytes in the more common forms of mycosis fungoides. [ABSTRACT FROM AUTHOR]

The clinical features and response to therapy of histologically confirmed lichen sclerosus et atrophicus affecting 25 males arc reported. The disease affected the penis alone in 22 patients and the trunk alone in the remaining 3 patients. Of those with penile lesions, the majority had involvement of both the glans penis and the prepuce. Circumcision proved to be an effective therapy in 8 out of the 11 patients in whom it was performed. [ABSTRACT FROM AUTHOR]

A case of Stevens-Johnson syndrome precipitated by the sulphonamide-containing anti-malarial drug, Fansidar, is described. [ABSTRACT FROM PUBLISHER]

Presents a letter to the editor about Depo-Provera injections.

Presents a letter to the editor about systemic carcinoma.