G.B. Colver

Tattoo removal using infra-red coagulation

Using a radiation source from which the output is maximal in the near infra‐red range, we have successfully treated thirty‐six tattoos in twenty‐one patients. This technique is described and its place in practice is discussed.

Is childhood idiopathic atrophy of the nails due to lichen planus

Four children with symptomtess or ‘idiopathic’ atrophy of the nails were studied. There were no other cutaneous signs. A longitudinal nail biopsy was performed on each patient and demonstrated active lichen planus in three cases and changes consistent with scarring lichen planus in the fourth.

Cyproterone acetate and two doses of oestrogen in female acne; a double-blind comparison

Cyproterone acetate was used in combination with either 35 or 50 μg ethinyl oestradiol in a double‐blind comparison of their effects on acne in females. There were no significant differences between the two groups in the degree of improvement in acne as assessed objectively by the investigators, or subjectively by the patients using a visual analogue scale. Oestrogen related side‐effects were significantly lower in the 35 μg group during the course of the 9‐month stud.

Multiple Beau's lines due to dysmenorrhoea?

Four young women who complained of nail ridging, were found to have several evenly spaced Beaus lines. The lines appear to be related to their menstrual cycles and each one had severe dysmenorrhoea. Linear nail growth was not impaired.

Precise dermal damage with an infrared coagulator

Using an infrared coagulator, we have shown, in pigskin, a direct relationship between depth of injury and the duration of infra‐red pulses, which was highly reproducible at a particular site. This has been related to the clinical results achieved in one patient whose three tattoos were treated with different pulse times.

Dermatitis repens, Lapiere and generalized pustular psoriasis

The presence of subcorneal pustules in a solitary, indolent, crusted plaque, or in erythema annulare‐like lesions with a trailing scale, is evidence of atypical psoriasis. When these lesions appear late in life there is a significant risk of generalized pustular psoriasis with a poor prognosis. A case is presented in whom both of these atypical forms occurred and who developed severe generalized disease. Clinical and histological features are described.

Atypical malignant melanoma of the nail apparatus

Malignant melanoma of the nail is a serious disease with a five year survival rate of between 21% (Booher & Pack, 1957) and 50% (Graham, 1973). The diagnosis of atypical cases ultimately depends on interpreting histological material. We report here a case in which two initial biopsies of the affected nail failed to show malignant melanoma. The diagnosis was eventually made by formal longitudinal nail biopsy including matrix tissue proximal to the dystrophic area, and examination of sections cut at several levels.

(25) Port wine stain treated by infra‐red coagulation

intralesional steroid injections, did not alter either the symptoms from the lesions or their appearance. Liquid nitrogen cryotherapy, using two 20 s freezc-thaw cycles has considerably relieved the symptoms of discomfort in the areas treated and has similarly improved their appearance. Comment. Lichen sclerosus et atrophicus affecting the trunk is usually asymptomatic. The lesions in this patient were more hyperkeratotic than is usual and gave rise to considerable discomfort, especially where clothing rubbed. Cryosurgery has been reported to be of benefit in the therapy of lichen sclerosus et atrophicus affecting the vulva, resulting in both relief of the irritation and improvement of the lesions (August & Milward, 1980) and has similarly been of benefit in the treatment of this patients non-genital lesions.

Cutaneous vascular ectasia treated by non‐laser infra‐red

The use of lasers to treat abnormal vasculature of the skin is proliferating. However there is now considerable evidence that, despite its theoretical advantages, the argon laser causes a rather non‐specific thermal burn: the CO2 laser, which vaporizes tissue on contact, has produced satisfactory results in treating port wine stains. This casts doubt on whether laser radiation or specific wavelengths are essential for the results being obtained.