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The presentation of a scaly papule or plaque on the glans penis should suggest more wide-spread papulosquamous disease. Careful examination of the remaining body surface, including the oral mucosa and nails, in almost all cases will yield clues to the correct diagnosis. Papulosquamous disease which may present as a penile lesion include psoriasis, Reiter syndrome, lichen planus, lichen nitidus, seborrheic dermatitis, secondary syphilis, fixed drug eruption, erythroplasia of Queyrat, plasma cell balanitis of Zoon, bowenoid papulosis, and discoid and lichenoid chronic dermatosis of Sulzberger and Garbe.

Patients with chronic snuff-induced keratosis associated with mucosal ulcerations were treated with topically applied vitamin A acid. In each case, after a marked, local inflammatory response initially, topical vitamin A acid showed a definite beneficial effect in promoting healing and involution of the precancerous snuff-induced leukoplakic keratosis. In one patient there was distinct involution of the oral lesions with complete healing and restoration of a normal-appearing mucosa within five weeks after beginning of treatment. In four patients there was healing of superficial ulcerations and regression in the size of the luekoplakic lesions.

As an investigative procedure, a hydrophilic ointment containing 20% 5-fluorouracil (5-FU) was applied to the skin of patients with extensive actinic keratoses of the face and neck, for a period of four weeks. This resulted in a selective inflammation, erosion, and disappearance of the keratoses without significant alteration of the normal skin. Transitory adverse reactions included corneal and conjunctival irritations, phototoxic reactions, and erosion of the lower lip border. No evidence of systemic absorption was detected. Only preliminary follow-up observations are available, and no conclusion can be drawn as to the long-term results.

We all would like to reduce the pain of injecting a local anesthetic, to simplify the treatment of xanthelasma palpebrarum and chondrodermatitis nodularis; and to improve methods of shave excision of nevi and cosmetic extirpation of large seborrheic keratoses. Here are some tips that might help.

Sweat glands from the palm of a patient with hyperhidrosis were examined by light and electron microscopy before and after treatment with tap water iontophoresis. No changes in structure were noted after treatment, disclaiming the currently accepted theory that mechanical ductal obstruction is the mechanism of action of this method. Furthermore, we believe the safety and effectiveness of this treatment are supported by our experience.

Selected benign dermatoses, recalcitrant to most other forms of therapy, respond to grenz-ray therapy. When appropriately administered, this is a safe treatment for such conditions. This paper delineates the practical application of grenz-ray therapy at the present time.

A practical treatment for superficial telangiectasias of the lower extremities of described that is a modification of sclerotherapy commonly used for the treatment of varicose veins. The key to our technique lies in the use of 32-gauge needles and precise injection of small amounts of sodium tetradecyl sulfate as sclerosant. The cosmetic results of our method are good and our patients are appreciative.

An evaluation of fluocinolone acetonide applied topically in the treatment of discoid lupus erythematosus is presented. Bilateral comparison of 0.025% fluocinolone acetonide cream to the cream base alone demonstrated the effectiveness of this program. In 59 patients an attempt was made to control this disease with topical fluocinolone acetonide as their only treatment. Forty three patients could be controlled in this fashion. Eleven patients responded partially, but for optimal response required a systemic supplement. Five patients did not show any improvement following topical fluocinolone acetonide applications. Noteworthy, is a group of 37 patients followed through two summer seasons. Twenty-four of these patients could be controlled with topical applications but reapplication the following summer was required. Three patients in this group cleared and remained clear. Six patients followed through two summers required a systemic supplement, while four in this group did not respond to therapy.