Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2014-09-15, 12:31:02 | version 1.32.01
4. Naafs B. Bangkok Workshop on Leprosy Research. Treatment of reactions and nerve damage. Int J Lepr 1996; 64: S21-8. 5. Hees C van, Naafs B. Common Skin Diseases in Africa. An illustrated guide 1st, 2nd, 3rd edition. Stichting Troderma, Voorburg, the Netherlands, 2001, 2009, 2014 Cutaneous melanoma: risk factors, screening activities Frans H.J. Rampen During his academic career (1980-87) Frans Rampen (1945) wrote many publications on naevi and melanoma. Melanoma was also the subject of his PhD thesis of 1982: “Malignant melanoma, prognostic factors”. From 1987 until 2009 he practised as a dermatologist in the general hospital Sint Anna/Bernhoven in Oss. During this period he continued his research on melanoma. Special subjects he addressed were swimming as a risk factor, and screening programmes. In the nineties, more than forty case-control studies on melanoma aetiology had been published. Sunlight was believed to be the main culprit, albeit with relative risks of only 1.5-2.0. These weak risk factors could easily be ascribed to information bias. Rampen’s crusade against the sunlight hypothesis resulted in a study on water pollution and swimming behaviour as risk indicators, with sunlight exposure merely being a confounding factor.[1,2] With regard to a) regular swimming, b) the age at which swimming was learned, and c) the number of swimming certificates held, it was concluded that swimming increased the risk of melanoma. For certain subgroups risk ratios of up to 3.0 were observed. Rampen supervised Patty Nelemans’ 1993 PhD thesis on this subject.[3] Rampen also organised three melanoma screening campaigns in the Netherlands. One of these formed the basis of a PhD thesis written by Michette de Rooij in 1997, studying the fundamentals, methods, advantages, and limits of secondary prevention campaigns for melanoma.[4] It was clear that melanoma screening did not fulfil all the principles of screening for disease that were generally accepted by epidemiologists, research groups and government authorities. Moreover, no definitive conclusions could be drawn as to the feasibility and the cost-effectiveness of the screenings. Therefore, according to Rampen, melanoma screening based on self-assessment of volunteers was not suitable as a national strategy. This recommendation was subsequently adopted by the Dutch Dermatology Society. 164 Superficial spreading melanoma. BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:41 Pagina 164