Faculty Bibliography

A case of adenocarcinoma of the gallbladder associated with acanthosis nigricans and the sign of Leser-Trelat is presented. The significant underrepresentation of adenocarcinoma of the gallbladder in association with malignant acanthosis nigricans is noted. If malignant acanthosis nigricans is caused by an ectopic peptide, a relative lack of production of the postulated substance by gallbladder adenocarcinoma cells could account for this finding

In a prospective study of 455 consecutive patients with superficial spreading malignant melanomas entered into the data base of the Melanoma Cooperative Group of New York University Medical Center, it was found by linear-regression analysis that there is a statistically significant (p = 0.005) positive correlation between the ages of the patients and the thickness of their lesions. Although the reasons for the correlation between ages and thicknesses ae not certain, several possible explanations were considered, namely: (1) the greater prevalence of superficial spreading malignant melanomas in the aged on the lower limbs where thicker lesions were present in our patients, (2) the altered skin of the elderly, which may favor deeper penetration by these neoplasms, (3) impaired immunologic responses in the aged, (4) the delay in diagnosis of malignant melanomas in the elderly because of obsuration of them by numerous benign pigmented lesions that frequently develop with aging, and (5) lesser concern of the elderly with their physical appearances in particular and medical problems in general

Malignant acanthosis nigricans is a dermatosis that appears grossly as a hyperpigmented, velvety, or verrucous hyperplasia of the epidermis, most marked in flexural areas. It is always associated with a malignancy. In 277 cases reviewed, the condition was associated with gastric carcinomas in 55.5%, with other intra-abdominal carcinomas in 17.7%, and with malignancies in other sites in 26.8%. Current theories for the association and pathogenesis of the cutaneous process are discussed