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We have examined the clearance of UVB‐induced erythema in 10 non‐melanoma skin cancer (NMSC) patients, comparing their responses to a control group. All participants were followed to resolution of erythema, as measured by a chromameter. The resultant response pattern was modelled in three phases, with comparison of the rates of decay in erythema carried out. Analysis of the rapid decay phase demonstrated a significantly slower rate of resolution of erythema in the NMSC group, compared with the controls. Further elucidation of the molecular and genetic mechanisms controlling this response may improve our understanding of UV‐induced carcinogenesis.

In view of the concern over the rising incidence of malignant melanoma in many parts of the world, and the suggestion that emigrants of Scottish and Irish descent have a higher incidence of melanoma in North America and Australia, a Scottish Melanoma Group has been formed to study epidemiological, pathological and therapeutic aspects of the tumour. In 1979, 260 histologically proven primary cutaneous malignant melanomas of the skin presented. This represents an incidence of 5.1/10(5) for Scotland as a whole. Studies over the next 5 years will determine whether the incidence of melanoma is rising in Scotland as rapidly as in other parts of the world.

A case-control study of occupational and recreational sun exposure, Mediterranean and other sun-exposed holidays, tanning history and history of isolated episodes of severe sunburn has been carried out on 113 patients with cutaneous malignant melanoma and 113 age- and sex-matched controls. Social class and skin type were also considered in the analysis of the data which involved the use of conditional multiple logistic regression. A highly significant increase in the history of severe sunburn was recorded in melanoma patients of both sexes in the 5-year period preceding presentation with their tumour. Higher social class and negative history of recreational sun exposure were also significantly increased in patients by comparison with controls. In the male group severe sunburn, lack of occupational sun exposure and higher social class were significant factors while in the female group only severe sunburn was significantly increased in the melanoma patients. This study thus provides evidence to suggest that short intense episodes of UV exposure resulting in burning may be one of the aetiological factors involved in subsequent development of melanoma.

Subungual melanoma is rare and experience in treating this condition with isolated limb perfusion is limited. Between 1985 and 1990, 24 patients were treated by digital amputation and isolated limb perfusion with melphalan and mild hyperthermia. The disease was staged according to the M.D. Anderson classification: stage I (17 patients), stage IIIA(one), stage IIIB(two) and stage IIIAB(four). Thirteen lesions were on the foot and 11 on the hand. Seven patients have developed locoregional recurrence. The estimated overall 2- and 5-year probabilities of survival were 77 and 46 per cent respectively, while for disease-free survival the rates were 58 and 51 per cent. When these results were compared retrospectively with those in 111 patients treated by amputation alone, no significant difference in survival was demonstrated. This experience suggests that isolated limb perfusion with melphalan and mild hyperthermia confers no additional survival benefit over appropriate surgery.

The incidence of cutaneous malignant melanoma continues to rise. Strategies to reduce mortality in this situation include improving therapy, encouraging earlier diagnosis, and promoting prevention. New developments such as epiluminescence, sentinel node biopsy, arterial limb perfusion and the use of vaccines are discussed in this context.