What is Acral lentiginous melanoma

Acral lentiginous melanoma

Prevalence: accounts for 7% of all melanomas.

Anatomic sites: occurs primarily on the hands and feet, including about the nails, also occur on the modified skin around the mouth, anus and genitalia.

Course: develops and evolves over years.

Gender: more common in males than females.

Age incidence: usually in older people.

Ethnic groups: the most common form of melanoma in the skin of Asian and Black people, accounting for more than half of melanomas in these groups. It is the least common form of melanoma in Caucasian people.

Appearance: flat slowly expanding pigmented macule with a fairly uniform, mottled color.

What is Hutchinson's sign? sudden appearance of a pigmented band originating at the proximal nail fold or pigmentation in the proximal or distal nail fold.

Significance of Hutchinson's sign: suggestive of acral-lentiginous melanoma.

Kaloula Kokacii

Many of us probably have not heard of this species called Kaloula Kokacci or Catanduanes Narrow-Mouthed Frog. This can only be found on our island and some parts of bicol.

"This species is found on Catanduanes Island and on several mountains of the Bicol Peninsula, in the Philippines, from 200-300m asl.
It inhabits lower altitude mountain and lowland forests, where it is found in forest, along forest edges, and in secondary growth vegetation. This is a highly adaptable species that also occurs in modified habitats beside these forests. It lives and presumably breeds in water-filled tree-holes and hollows".

The main threat to this species is continued destruction of lowland rainforest for agricultural development and human settlements. However, this species is adaptable and is probably not significantly threatened.

It was classified by International Union for Conservation of Nature (IUCN) Red List of Threatened Species as Near Threatened in 2007.

Skin moles

Skin moles appear during the first few years of life. Most people have 20-30; some have many more. The common skin mole should be uniformly pigmented, with a regular margin. A halo of pale skin around a skin mole may be seen in adolescence. Occasionally congenital skin moles are large (greater than 1 cm), multiple or confluent (bathing trunk pattern). These lesions carry a risk of malignant transformation. Skin Moles deeper in the dermis appear blue in color. Skin Moles tend to regress in old age. If skin moles change in size, become irregular in shape or pigmentation, itch or bleed they should be regarded as unstable and potentially malignant. Sunburn can irritate and activate skin moles. During pregnancy, skin moles tend to increase in size and darken. Malignant melanomas can arise de novo or from pre-existing skin moles. The incidence of this malignant tumor is increasing, especially in fair-skinned people with high sun-exposure.

Atypical Skin Moles Features

Atypical Skin Moles do not follow an evolutionary pattern of either persistence with stability or differentiation in the direction of ultimate regression, as seen in Common Acquired Melanocytic Skin Moles. Rather, Atypical Skin Moles demonstrate a persistent and disordered growth, evident both clinically and microscopically. The clinical recognition of Atypical Skin Moles focuses on several characteristics that help distinguish them from Common Acquired Melanocytic Skin Moles: shape, border, color, diameter, and surface features. Many of these features may also be seen in melanoma, although often to a greater degree.
1 Shape: The shape may be round or oval, like the common acquired Skin Mole, although asymmetric notching and/or outgrowth of pseudopodia are usually observed in lesions over 3 to 4 mm in diameter.
2 Border: The boundary may be irregular with slightly indiscrete to frankly hazy or fuzzy areas, with traces of pink or brownish pigment spilling into surrounding normal skin.
3 Color: The coloration of Atypical Skin Moles is often variegated, with irregular speckling with tan/brown colors and sometimes including foci of tan/brown/dark brown hues or black pigment. redness may be seen as a component of Atypical Skin Moles but is not normally seen in Common Acquired Melanocytic Skin Moles. This is manifest as a pink background color, the intensity of which may vary from trace to slight to moderate. Sometimes only a focal area of pink or a subtle pink hue at the periphery may be seen. The redness does not blanch readily; the degree of redness varies considerably from lesion to lesion and from patient to patient.
4 Diameter: Atypical Skin Moles are most easily recognized when larger than 5mmin diameter. The Clark group’s initial description of Atypical Skin Moles in BK mole syndrome patients had emphasized that they were frequently 5 to 10 mm or larger, and that size was an important clue in identifying Atypical Skin Moles. Large size, however, is not a prerequisite for the diagnosis of Atypical Skin Moles.
5 Surface features: The surface features within any given Atypical Skin Mole may include macular and papular components. A minimal elevation to tangential lighting is noted in most of them. The skin surface markings may be suggestive of early lichen simplex chronicus, showing subtle elevation and coarsening. Scale is only infrequently noted. Erosion is not seen in the non traumatized Atypical Skin Mole.
The clinical presentation of patients with Atypical Skin Moles seems as varied as the morphology of individual Atypical Skin Moles. The classical type D2 phenotype may be first evident with numerous distinctly large, irregular, variegate Skin Moles, mostly concentrated on the trunk and less numerous on the head, neck, and lower extremities. More commonly, however, Atypical Skin Moles are not strikingly large. Fromseveral to a dozen Atypical Skin Molesmay bemixed among several to several dozen Common Acquired Melanocytic Skin Moles. In patients with a solitary Atypical Skin Mole, it may be located anywhere.

Economics of Mine Development Somewhat Risky

There has been efforts to exploit our coal deposits in view of the constantly increasing price of oil in the world market. And our coal deposit was identified by DOE and was contracted to a private investor. Perhaps we should take a second look at the conclusion of this 1980 World Bank study:... Read more