Summary Treatment of the pregnant woman with melanoma is contentious. With the aid of a computerized melanoma register, in which pregnancy data can be recorded, 290 women with melanoma were reviewed (249 alive and 41 dead). Overall, 23 patients were pregnant at ithe time of diagnosis of melanoma, and another 23 became pregnant at some time after primary treatment of a melanoma. Pregnancy appears to have no significant influence on the survival of patients with melanoma J but it is recommended that pregnancy should be avoided for the first three years following excision of a melanoma.

Treatment of the pregnant woman with melanoma is contentious. With the aid of a computerized melanoma register, in which pregnancy data can be recorded, 290 women with melanoma were reviewed (249 alive and 41 dead). Overall, 23 patients were pregnant at the time of diagnosis of melanoma, and another 23 became pregnant at some time after primary treatment of a melanoma. Pregnancy appears to have no significant influence on the survival of patients with melanoma;! but it is recommended that pregnancy should be avoided for the first three years following excision of a melanoma.The management of pregnant women with a melanoma can be difficult. The literature is confusing, and reports on the behaviour of melanoma in pregnancy are often contradictory. A study of a melanoma register was therefore undertaken to try to clarify this situation by asking three questions: (1) Is there a difference between pregnant and non-pregnant women in the occurrence of melanoma at various sites? (2) Do women who develop melanoma while pregnant have a worse prognosis than non-pregnant women? (3) Does a subsequent pregnancy have any effect on the prognosis of melanoma? Patients and methodsA melanoma register has been in use at Frenchay Hospital since the early 1950s. This was originally maintained as a card index but, in 1980, the records from 1967 onwards were transferred to a computer (Briggs et al. 1984) with an Frenchay Hospital, Bristol BS16 1LE Department of Reconstructive Surgery D. S. McMANAMNY Registrar in Plastic Surgery

We report the successful use of tissue expansion in the lower limbs of five children and one young adult. It was possible to replace dense adherent skin grafts by expanded skin and subcutaneous tissue. Such expansion needs to be undertaken slowly, but expanded tissue matches the normal local tissue and has normal sensation. These qualities were particularly important in three amputations which were revised.

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