Colin Hindson

A drug eruption due to acebutolol with combined lichenoid and lupus erythematosus features

Many drugs have been implicated in the genesis of eruptions resembling lichen planus (Gange & Wilson Jones, 1978; Almeyda & Baker, 1970) and lupus erythemarosus (Raferty & Denman, 1973; Tuffanelli, 1972).

Phenyl salicylate (Salol) in a lip salve.

with Naphtha soap, betamethasone and Neosporin ointment. Apart from this, she had had no dermatologic illness and had not received topical steroids on a regular or routine basis. After an initial reaction to injected Kenalog, she displayed positive patch tests to multiple steroid creams. Comparison of the ingredients of each of these medications revealed that a given filler or preservative is present in one or two of the creams, and not in all of them; the simplest explanation is that the patient is sensitive to the steroid component and not to multiple different ingredients, although this is possible. For example, the negative patch test to Hytone would seem to rule out the sensitivity to propylene glycol, glyceryl monostearate, the cholesterol esters, isopropyl myristate, poylsorbate 60, cetyl alcohol, sorbitan monostearate, polyoxyl 40 stearate, sorbic acid, at least in those concentrations. Although I was later able to obtain some of the constituent ingredients from the drug companies, the patient unfortunately refused further testing of each individual component. She remains, however, a striking example of contact sensitivity to multiple, often used, dermatologic preparations. The therapeutic solution to a dermatitis felt to be contact to one steroid cream is therefore not necessarily the substitution of another steroid cream.

PUVA therapy of chronic actinic dermatitis.

A modified PUVA regime was used to treat five men with long‐standing chronic actinic dermatitis. They are all now symptom free on monthly maintenance PUVA therapy and no longer react abnormally to ultra‐violet radiation, with consequent improvement of their quality of life.

Dithranol‐UV‐A phototherapy (DUVA) for psoriasis: a treatment without dressings

Dithranol in yellow soft paraffin with 2% salicylic acid was applied daily (increasing concentrations from 0 2% to 5%) for i hour to twenty consecutive patients with diffuse psoriasis. The ointment was then washed off and patients were irradiated with 10 J cm‐2 of UV‐A radiation since the absorption spectrum of dithranol is maximum in the UV‐A waveband. The median clearance time was 14 days (range 7–39 days). No dressings were required. The patients were allowed to apply an emollient if the skin became dry.