Richard R. Marples

Staphylococcus aureus in the lesions of atopic dermatitis

Quantitative aerobic cultures were obtained from fifty patients with chronic plaques, and from twenty with exudative lesions of atopic dermatitis. In the former, Staphylococcus aureus was isolated from 90% and the density exceeded 1 × 106/cm2 in 45% of the samples. In the exudative form, Staph. aureus was recovered in every case with a mean density of 14 × 106 organisms per cm2. Staph. aureus was the dominant organism not only in the lesions but in nearby clinically normal skin. Despite these high numbers, clinical signs of infection were lacking. Systemic and topical antibiotic therapy pro‐duced a profound decrease in Staph. aureus density.

Gram-negative folliculitis–a complication of antibiotic therapy in acne vulgaris

Fifty cases of Gram‐negative folliculitis have been identified amongst 1200 new cases of acne vulgaris in a period of 4 years. Two clinical varieties are recognized. Type I, the more common, presents as superficial pustules, usually grouped around the nose and is associated with a lactose fermenting Gram‐negative rod. Type II lesions are characterized by deep nodular and cystic lesions; Proteus appears to be the causative agent. The treatment of this condition is discussed.

Limitations of paired comparisons of topical drugs

The spread of a drug from the site of application to other areas of skin may give rise to false interpretations in paired comparison tests of efficacy. In infected dermatoses treated with topical neomycin the placebo treated site improved clinically and there was almost as great a reduction in the Staphylococcus aureus population. Applied to one axilla, topical penicillin engendered resistance among cocci in both axillae. Similarly, washing one axilla with a bacteriostatic soap greatly reduced the microflora in the opposite axilla. When potent antibacterial agents such as chloramphenicol or sodium pyridinethione were applied to a small area of forearm skin, there was sufficient translocation to the opposite side to prevent the great increase in the resident organisms which normally follows wrapping with impermeable plastic film.