melphalan and Skin-Ulcer

Cisplatin and L-PAM are DNA-crosslinking anticancer agents which have not been systematically studied for vesicant potential. Mitoxantrone is a new active anthracene-based, DNA intercalator which is undergoing widespread clinical testing for antitumor efficacy in man. These three agents were tested for vesicant activity in dehaired BALB/c mice given ID injections equivalent to human clinical doses. Neither cisplatin (up to 150 mg/m2) nor L-PAM (up to 71 mg/m2) produced any skin necrosis in the mice. The L-PAM solvent (acid/alcohol in propylene glycol) was ulcerogenic if injected undiluted. Mitoxantrone (up to 14 mg/m2) was not ulcerogenic in the mice, although the skin site retained a blue drug discoloration for several weeks. It is concluded that in clinically relevant doses, cisplatin, L-PAM, and mitoxantrone are not vesicants.

Topics: Animals; Anthraquinones; Cisplatin; Drug Evaluation, Preclinical; Female; Injections, Intradermal; Irritants; Melphalan; Mice; Mice, Inbred BALB C; Mitoxantrone; Skin Ulcer

Since 1968 we have been treating a patient, who has had a combination of pyoderma gangraenosum (dermatitis ulcerosa) and signs that may indicate early multiple myeloma. She also had carcinoma of the colon, which was successfully operated. The pyoderma healed later after intensive and successful cytostatic treatment of the "myeloma". The ulcers remain practically healed and the protein pattern is normal in May 1977. Such cases are rare and a search in the literature has not been very rewarding. In our own series of more than 200 cases with myeloma this combination is unique. The lieterature is discussed in detail with data on the follow-up on some of the patients.

Topics: Aged; Bone Neoplasms; Drug Evaluation; Female; Follow-Up Studies; Humans; Immunoglobulin A; Male; Melphalan; Middle Aged; Multiple Myeloma; Pyoderma; Skin Ulcer

This paper reviews the changing concepts in the treatment of patients with malignant melanoma localized on the arm or leg. In addition to conventional surgical treatment, isolated regional perfusion of the extremities is discussed. An evaluation is presented of clinical and histological criteria applied to determine indications for conventional surgical treatment and for perfusion. It is maintained that isolated regional perfusion of arm or leg should be performed when the primary tumor meets one of the following criteria: (1) depth of tumor invasion beyond the papillary layer (Clark levels III, IV and V); (2) vascular invasion; (3) tumor diameter exceeding 1 cm; (4) ulceration. If none of these four criteria applies, conventional surgical treatment alone has proved to give very good results.

Topics: Adult; Aged; Chemotherapy, Cancer, Regional Perfusion; Evaluation Studies as Topic; Extremities; Female; Humans; Lymphatic Metastasis; Male; Melanoma; Melphalan; Middle Aged; Neoplasm Invasiveness; Recurrence; Skin Neoplasms; Skin Ulcer

Topics: Cryoglobulins; Crystallization; Diagnosis, Differential; Female; Humans; Immunoglobulin G; Leukocyte Count; Leukocytosis; Melphalan; Middle Aged; Purpura; Skin Ulcer; Temperature

Topics: Adrenal Cortex Hormones; Adult; Amyloidosis; Autoimmune Diseases; Bence Jones Protein; Cold Temperature; Cryoglobulins; Humans; Hyperlipidemias; Immunoglobulin M; Male; Melphalan; Mucous Membrane; Multiple Myeloma; Mycosis Fungoides; Osteoporosis; Plasma Cells; Plasmacytoma; Purpura, Hyperglobulinemic; Pyoderma; Skin Manifestations; Skin Ulcer; Tongue; Xanthomatosis