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To the Editor:
In the Archives of Dermatology for March, 1933 (page 373), there is an article by Dr. J. A. Elliott entitled "Treatment of Epithelioma of the Lip by the Dermatologist." To deal first with the etiology of cancer of the lip as discussed by Dr. Elliott, I wish to point out that a most important factor in the production of cancer of the lip seems to have escaped attention.Perhaps I had better explain that cancer of the skin and cancer of the lip are much more common in Australia than in England. The number of cases that I see both in public hospitals and in private practice vastly outnumber those seen by such men as Whitfield and Adamson in London. I have discussed the subject with an old teacher of mine, Professor Jadassohn, on many occasions. It is true that men in Australia smoke a great deal and smoke pipes more frequently than is the case in England. But a hot-stemmed pipe such as the old clay pipe is absolutely unknown in this country. All pipes used here have vulcanite stems and cannot by any stretch of the imagination be described as hot.Moreover, in this country epithelioma of the lip begins almost invariably on the exposed portion of the mucous membrane of the lip and is almost as often preceded by keratosis. Quite an appreciable proportion of the sufferers are nonsmokers. If the tobacco distillates had a carcinogenic influence in the production of these tumors of the lip, the inner surface on which the distillates must be deposited would be the starting point of a large proportion of these cases.
Molesworth EH. CANCER OF THE LIP. Arch Derm Syphilol. 1933;28(2):228–229. doi:10.1001/archderm.1933.01460020082015
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