D. Harris

Comparative effects of calcipotriol (MC903) solution and placebo (vehicle of MC903) in the treatment of psoriasis of the scalp

The efficacy and safety of calcipotriol solution in the treatment of scalp psoriasis was compared with placebo (vehicle solution), in a multicentre double‐blind, randomized, parallel‐group study of 49 adult patients. Calcipotriol solution (50 μg/ml), or placebo, was applied twice daily over a 4‐week period. At the end of the study period 60% of patients on calcipotriol showed clearance or marked improvement of their psoriasis compared with 17% on placebo. Overall assessment of treatment response showed that calcipotriol was superior to placebo in both investigator (P<0.001;95% confidence interval for difference 19.0–67.6) and patient (P<0.001; 95% confidence interval for difference 18.3–68.0) assessments. Total sign score for psoriasis (i.e. the sum of the scores for redness, thickness and scaliness) decreased by 48.9% in the calcipotriol group, and by 18.6% in the placebo group (P =0.005). Calcipotriol was significantly superior to placebo in reducing redness, thickness, scaliness and extent of psoriasis, and in the patients’assessment in reducing scalp flaking and itching.

Phenytoin-induced pseudolymphoma. A report of a case and review of the literature.

Summary We report a patient with phenytoin‐induced pseudolymphoma mimicking cutaneous T‐cell lymphoma (CTCL). Despite withdrawal of phenytoin, there was persistence of the cutaneous eruption and lymphadenopathy. Southern blot analysis of immunoglobulin and T‐cell receptor genes was therefore used to assess whether there was a clonal lymphoid expansion. However, no rearrangement of the beta T‐cell receptor gene or immunoglobulin heavy‐chain gene was detected in tissue DNA from skin and lymph nodes. One year later the patient became asymptomatic, although he is still at risk of developing a true malignant lymphoma in the future, a condition known as pseudo‐pseudolymphoma. It is suggested that genotypic studies may help in the initial diagnosis and the subsequent management of such patients.

Eosinophilic pustular folliculitis in an HIV-positive man: response to cetirizine

Eosinophilic pustular folliculitis is a rare condition which is being increasingly reported in HIV‐positive patients. Many therapies have been used to treat this condition. We report the first successful use of the H1 antihistamine cetirizine to treat the condition and postulate that the specific antieosinophilic action of this drug may explain the beneficial clinical effect seen in our patient.

Cutaneous granulocytic sarcoma (chloroma) presenting as the first sign of relapse following autologous bone marrow transplantation for acute myeloid leukaemia

Summary A 25‐year‐old man suffering form acute myeloid leukaemia developed a solitary lesion on the upper abdominal wall 6 months after receiving an autologous bone marrow transplant. These lesion was a chloroma and proved to be the only evidence of clinical relapse. This is the first reported case of this rare condition occurring following bone marrow transplantation.

Scabies associated with a bullous pemphigoid‐like eruption

We report a patient who developed a bullous‐pemphigoid‐like eruption associated with scabies. A subsequent recrudescence of the scabies was associated with recurrence of the bullous eruption.

Atypical systemic sclerosis following exposure to vinyl chloride monomer. A case report and review of the cutaneous aspects of vinyl chloride disease

An unusual case of systemic sclerosis occurring in a patient exposed to the vinyl chloride monomer (VCM) is presented. The dermatological aspects of vinyl chloride disease (VCD) are outlined and the mechanisms of pathogenesis discussed.

Stelazine‐induced pigmentation

A case of a West Indian patient is reported who developed abnormal blue‐grey pigmentation on exposed areas of skin following treatment with low dose stelazine.

Acute infectious erythemas in children

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3) Gastrointestinal and cutaneous vasculitis associated with a gonococcal infection

for filarial parasites were negative, he had a very strongly positive ELISA test. Repeated blood tests showed filaria typical of Mansonella perstans. He was treated with albendazole 200 mg b.i.d. for 2 weeks. Her husband, a missionary who was apparently in good health, also had an eosinophilia. His urine and faeces showed the presence of the ova of Schistosoma mansoni. He was treated with praziquantel with good effect. The family have returned to Senegal but have been advised as to how to avoid any future infestation and on their return to the U.K. will be investigated at the Hospital for Tropical Diseases to make sure of no recurrence.

Briquet's Syndrome – an Unusual Case of Urticaria

Briquets syndrome is a psychiatric disorder with similarities to the chronic factitious disorders which include Munchausen syndrome and dermatitis artefacta. Unlike Munchausen syndrome the underlying personality is not antisocial or psychopathic but hysterical. A patient is described who presented with a common dermatological complaint and whose past medical and social history typify the condition as well as highlighting the monotonous regularity with which these patients submit themselves to unnecessary investigations and operations.