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Tretinoin, or retinoic acid, is a compound related to vitamin A which has improved skin that has been aged by sun exposure. Of 30 patients who participated in a four-month study, 21 continued tretinoin treatment for 10 months, and 16 continued for 22 months. Patients who did not continue treatment cited inconvenience or objection to further biopsies, but not lack of effectiveness, as the reason. Evaluation of patients receiving the more prolonged treatment showed that improvement of skin appearance and structure continued in spite of reductions in the dosage or frequency of treatment. Most improvements occurred during the first 6 to 10 months of therapy. Besides continued improvement of skin wrinkling and texture, 71 percent of liver spots disappeared. Other notable changes associated with treatment were increased skin pinkness, which was not adverse, and skin dryness with a red, flaking dermatitis, which diminished with continued treatment. There was no difference in adverse effects at different doses of tretinoin. Anatomic changes and the persistence of improvement for two months after therapy was discontinued indicate that tretinoin alters basic skin structure rather than causing a transient, superficially beneficial, swelling of the skin. The study suggests that tretinoin is likely to benefit sun-aged skin. (Consumer Summary produced by Reliance Medical Information, Inc.)

• Daily application of 1% fluorouracil cream to normal white skin results in definite morphologic alterations of the epidermis. Although clinical changes were not present, electron microscopic examination of the tissue demonstrates changes especially pronounced in the epidermal keratinocytes. These changes consist of cytoplasmic vacuoles, alterations in the mitochondria, Golgi complex, and endoplasmic reticulum, as well as widened extracellular spaces.(Arch Dermatol 111:1301-1306, 1975)

• Epidermodysplasia verruciformis (EV) is a rare disease characterized by the early onset and unremitting progression of wart-like lesions and frequent association of cutaneous carcinomas. We report two siblings with EV. Immunologic study of both patients demonstrated normal immunoglobulin levels, normal numbers of T-lymphocytes and B-lymphocytes, but markedly depressed in vitro blastogenic reactivity to mitogens and antigens. Cutaneous anergy to a variety of common skin test antigens was noted. These observations may reflect an inherited abnormality in immune function, or the depressed immune function may result from the viral infection of EV.(Arch Dermatol 113:495-499, 1977)

• Biopsy specimens of normal skin and lentigines from an 82-year-old man with multiple lentigines syndrome were examined with light and electron microscopes. Giant melanosomes were found in dermal melanophages, melanocytes, and keratinocytes in all epidermal layers. Morphologic characteristics of these melanosomes are described, and other conditions in which they have been found are discussed.(Arch Dermatol 113:491-494, 1977)

• Localized brown to blue-black discoloration of the skin occurred in three patients receiving long-term minocycline hydrochloride therapy. Abundant perivascular pigmented material was present at all levels of the dermis below the upper papillary portion. Histochemical studies demonstrated reactivity with the Prussian blue stain and the Fontana-Masson silver technique. The granules were brightly refractile by dark-field illumination. Ultrastructurally, there were membranebound dense intracellular inclusions differing from melanin and iron but identical to those known to occur in the thyroid glands of minocycline-primed laboratory animals. The abnormal pigment most likely represents a metabolic derivative of minocycline.(Arch Dermatol 116:1262-1265, 1980)