Foot pigmentation in Blacks

Pigmentation of the soles of the feet was studied during postmortem examination of 70 Black patients. Forty-eight (57%) showed some pigmentation (grade II) of the soles of the feet and 4 (6%) showed definite black spots, i.e. focal areas of dense black pigmentation (grade III). A distinction between clinical grade II or grade III lesions could not be made on the basis of microscopic appearance. No true naeyi were seen. Increases of melanin pigmentation and minor degrees of melanocytic proliferation were all that was apparent. Although the development of malignant melanoma may be related to the presence of black spots on the feet of darkly pigmented races, all such spots are certainly not naevi.

Maduromycosis (Madura foot) in Kentucky

The first case of proven maduromycosis originating in the state of Kentucky, and the 21st case reported in the United States, is described. The disease, which involved the foot, was caused by Monosporium apiospermum. The importance of suspecting and culturing for fungal organisms in cases of chronic or recurrent infections of the extremities is stressed. The method of treatment was experimental; whether true cure was accomplished may not be known for years. Although many fungi, including Monosporium apiospermum, are relatively resistant to all forms of chemotherapy, some types of fungi readily respond to easily administered antibiotics. Specific fungal identification by trained mycologists is important in all cases of mycetoma.

A new consideration in athletic injuries. The classical ballet dancer

The professional ballet dancer presents all of the problems of any vigorous athlete. The problems include osteochondral fractures, fatigue fractures, sprains, chronic ligamentous instability of the knee, meniscal tears, impingement syndrome, degenerative arthritis of multiple joints and low back pain. Attention to minor problems with sound conservative therapy can avoid many major developments and lost hours. Observations included the extraordinary external rotation of at the hip without demonstrable alteration in the hip version angle and hypertrophy of the femur, tibia and particularly the second metatarsal (in female dancers). Careful evaluation of the range of motion of the extremities, serial roentgenographic examination, and systematic review of previous injuries, training programs and rehearsal techniques have been evaluated in a series of cases to provide the basis for advice to directors and teachers of the ballet.

Malignant melanoma of the skin in Black Africans

Malignant melanoma of the skin in Blacks in formidable and sinister tumour. This study is concerned with the epidemiology of malignant melanoma, as seen in both urban and rural Black Africans. A smaller series in which follow-up on the patients was available is included. To our knowledge, this is the first study of its kind in which follow-up, and hence survival figures, can be quoted. Although the numbers are relatively small, they provide a valuable indication of the behaviour of melanomas in this group. The difficulties of follow-up cannot be overemphasised, and follow-up on 79 cases out of 100 could be obtained only by the employment of an able and enthusiastic Black social worker for 3 years. The first recorded survival figures in a Black population show a 3-year survival rate of only 28,4%. Prognosis is related to the size and extent of the tumour with larger and more widespread tumours faring worse than others. The incidence of malignant melanoma in Johannesburg Black was 1,2 per 100 000 and accounted for 2% of all cancers. The largest number of cases occurred in the 50- 70-year age group and there was a female preponderance. As in previous studies, the sites predominantly affected were the foot and the hand, mainly on the plantar and palmar surfaces.

Malignant melanoma in the Igbos of Nigeria

Twenty-one cases of malignant melanoma occurring in the Igbos of Nigeria have been analysed. The site of predilection is the sole of the foot. This result supports the conclusion that Negroes tend to have the disease in the non-pigmented parts. Since preventive surgery has been advocated in Caucasians in whom sole melanomas are not common, it merits consideration and, if possible, implementation in the African Negro. The challenge implicit in this form of preventive oncology should be accepted by plastic surgeons, including Africans who specialized in this field abroad.

Castration and other factors affecting the risk of equine laminitis

The characteristics of a series of equine laminitis cases were compared with that of other Equidae examined at the University of Missouri Veterinary Hospital and Clinic during May, 1965 through December, 1971. The model age for ponies with laminitis was 7-9 years and for all other cases the model age was 4-6 years. Also the predominant age for mares was 4-6 years and for males was 7-9 years. After controlling for age and breed differences, there were significantly fewer castrated males among the affected males than expected (P small than 0.02), indicating that hormonal factors may play a role in laminitis. Ponies had a significantly greater risk of laminitis (P smaller than 0.001) and their relative risk was 4.3 times greater than all other Equidae combined. There were more laminitis cases diagnosed during May than during other months.