How much disability is caused by acne?

One-hundred patients completed a questionnaire designed to assess the disability resulting from acne; patient acne severity was also graded clinically. Ten questions which correlated strongly with clinical acne severity were used to form an Acne Disability Index (ADI). This ADI correlated with the severity of facial acne (r = 0.

Assessment of disease progress in psoriasis.

Effective methods of recording and measuring progress of the signs of psoriasis are essential and central to the accurate assessment of therapy. Currently there is wide variation in assessment methods used, and even well-designed clinical assessment techniques have a wide observer error: objective assessment methods may have advantages. The clinical assessment techniques used in 30 clinical trials of treatment in chronic plaque psoriasis in 1985 and 1986 were reviewed and a detailed analysis is presented.

Integrated in-patient and out-patient dermatology management.

The physical integration of out-patient clinics, out-patient treatment and in-patient management areas allows full cohesion and continuity of medical and nursing care of dermatology patients. The conversion of a dermatology ward to an out-patient treatment centre has resulted in major benefits in the daily management of dermatology patients, allowing increased flexibility of care despite a reduction in bed numbers and financial savings. Broad changes in concepts of dermatology management are described and arguments given which may be used in the negotiation for improved facilities.

Lymphomatoid granulomatosis presenting with polyarthritis.

Polyarthritis in lymphomatoid granulomatosis is rare. In the present report we describe a patient with lymphomatoid granulomatosis who presented with an acute inflammatory polyarthritis three years before the typical skin and pulmonary manifestations of the disease became evident.

The lateral spread of clobetasol 17-propionate in the stratum corneum in vivo.

Radiolabelled clobetasol 17-propionate in two different bases, propylene glycol (PG) and di-n-butyl adipate (BA), was applied to the backs of 10 normal male volunteers, and the application sites protected. After 8 h samples of stratum corneum (SC) were taken from the application site and an adjacent site, and the level of steroid measured. At the application site there were higher concentrations of the PG formulation at the deeper levels of the SC.

The effect of the vehicle formulation on the stratum corneum penetration characteristics of clobetasol 17-propionate in vivo.

The multiple skin surface biopsy technique to measure stratum corneum (SC) penetration characteristics in vivo has been more accurately quantified and used to provide information on the kinetics of transfer of a topical steroid through the SC. Radiolabelled clobetasol 17-propionate formulated in two different vehicles, consisting primarily of dibutyl adipate or of propylene glycol, was applied and the penetration characteristics compared. Using exponential expressions for radioactivity in skin surface biopsies as a function of SC depth, and total SC radioactivity as a function of time, a mathematical model was developed to calculate the rate of loss of steroid through superficial shedding and the rate of transfer of steroid from the SC into the epidermis.

Ultrasound transmission time: an in vivo guide to nail thickness.

Human fingernail thickness was measured distally in 39 subjects using an adapted electronic micrometer and ultrasound transmission time was measured both distally and proximally. Distal ultrasound nail transmission time correlated well with micrometer measurements. There was a clear rank order of distal and proximal nail transmission times: thumb greater than index greater than middle greater than ring greater than little fingers.

Expert systems in dermatology: the computer potential. The example of facial tumour diagnosis.

The expert system approach to computer diagnosis uses a non-algorithmic method to represent and manipulate an expert's knowledge and reasoning. This information, which may be provided by a dermatologist, is represented by rules in a logic-based computer language in order to provide interactive and explanatory features. The major advantages of using expert system techniques for computer-aided diagnosis in dermatology are that knowledge is made explicit, the heuristic nature of an expert's knowledge can be more easily captured and the more easily readable programs make modification easier.

Atypical lichen planus associated with ulcerative colitis.

A case is reported of a patient known to have ulcerative colitis who developed atypical lichen planus. This did not resolve when the patient discontinued sulphasalazine treatment but became more extensive within 48 h of an exacerbation of colitis. This case supports the view that there may be an association between ulcerative colitis and lichen planus.

Crossed-leg callosities.

We report five patients in whom localised callosities were found on the dorsum of the feet. This was bilateral in four cases and was due to repetitive minor trauma associated with the sitting posture adopted by the patients. Three of the patients also had psoriasis vulgaris which was clinically dissimilar to the lesions we describe.

Chronic granulomatous disease carrier geno-dermatosis (CGDCGD).

A persistent eruption in light-exposed areas in two related carriers of X-linked chronic granulomatous disease is described. This eruption appears to be a separate entity, rather than a variant of cutaneous lupus erythematosus or Jessner's disease. Recognition may enable detection of carrier females prior to the birth of an affected son, so that genetic counselling and antenatal diagnosis can be instituted.