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Iridoscopy was carried out in 40 patients with rosacea and seborrheic dermatitis in order to detect visceral abnormalities. Various gastrointestinal diseases were revealed in 32, vascular and neuropsychic disorders in 16, and renal or pancreatic shifts in 5 patients.

The authors review the data on the incidence and type of fungal involvement of the face in T. rubrum-induced trichophytosis in the USSR and other countries of the world. Exquisite localizations are cited, i.e. involvement of the lacrimal nasal channel, external acoustic meatus, eyelids and eyelashes. Extraordinary variants of trichophytosis of the face are described: tumor-like, wart-like, infiltrative suppurative, seborrheal, as well as the forms simulating photodermatoses, perioral dermatitis, etc. 35 case histories of patients suffering from this condition, observed by the authors over 21 years, are cited, and photographs are presented of 8 of them with the most incident trichophytosis variants, i.e. seborrheal, infiltrative suppurative, and those simulating discoid lupus erythematosus and perioral dermatitis. The authors emphasize that fungal nature should be excluded in cases with uncommon course of this or that dermatosis.

Essentials of the author's own way of therapeutical proceeding are: in cases of low inflammatory seborrheic dermatitis, ointments containing salicylic acid and sulfur; in children, zinc oil and zinc paste with bismuth; in cases of acute seborrheic dermatitis, ointments with glucocorticoids; in seborrheic erythroderma, systemic glucocorticoids.

The papulosquamous diseases have certain common morphologic appearances which may at times lead to confusion in diagnosis. They do not have any common etiologic factor. The most common diseases in this category are psoriasis, seborrheic dermatitis, lichen planus, pityriasis rosea, and secondary syphilis. Exfoliative erythroderma is included here since it rarely may be a complication of a pre-existing papulosquamous disease such as psoriasis, seborrheic dermatitis, and lichen planus.

The intensity and duration of the clinical symptoms and signs determine the type and spectrum of the necessary and essential diagnostic measures in women with signs of hirsutism. Women with specific disease entities and women who desire pregnancy are in a different category. When severe signs of adrogenization (virilism) and obvious progression are noted the hormones testosterone and dehydroepiandrosterone (T and DS) must be determined in the peripheral blood. When the peripheral testosterone value exceeds 1.5 ng/ml and when the peripheraldihydroepiandrosterone value exceeds 7000 ng/ml the existence of a virilizing tumour must be excluded as soon as possible. The exclusion or localization of a small androgen producing tumour can be achieved with the greatest certainty with selective catherization. In patients with mild androgenization a specific diagnostic work-up is not necessary.

Dandruff is a sign of low specificity but high sensitivity for atopic constitution. Of 32 (40%) patients consulting the clinic for other reasons than dandruff, atopic dermatitis, or seborrheic dermatitis, 13 had raised IgE PRIST values of greater than 120 IU/ml. In only 6 (19%) of these patients was screening for atopy completely negative (family and personal history, total and specific IgG, prick test).

Total and antigen-specific IgE levels using the radioallergosorbent test (RAST) were measured in a prospective study of thirty-seven infants with dermatitis of early infancy, with the aim of distinguishing between atopic and infantile seborrhoeic dermatitis at an earlier age than is usually possible on clinical grounds. The results were correlated with the clinical diagnoses made after 1-2 years close follow-up. They showed that a RAST screen to egg white and to milk antibodies, and to a lesser extent total IgE levels, are of value in diagnosing atopic dermatitis at an early age and distinguishing this from infantile seborrhoeic dermatitis.

Observations surrounding the clinical manifestations and pathological studies of a neonate who died at 9 weeks of age, indicate that distinctive cutaneous, histopathologic, and ultrastructural findings occur when graft-vs-host reaction (GVHR) complicates combined immune deficiency syndrome (CIDS). The prominence and specificity of the epidermal lesions, particularly a necrotic cell that occurs in association with satellite lymphocytes ("satellite cell necrosis" (SCN)), lead us to recommend that a cutaneous biopsy be performed to facilitate an early definitive diagnosis. Dermatologists can recognize GVHR at the bedside and establish the diagnosis with the pathological findings obtained from the skin biopsy.

Five cases of verrucous malignant melanoma--a rare variant of melanoma that was described in 1967, but is rarely mentioned today--are presented and the clinical and histopathologic criteria defining this variant are discussed. The importance of this rare entity in the differential diagnosis of verrucous pigmented skin lesions is emphasized.

Eczematids are itching dermatoses showing indistinct redness, pityriasiform scales, and superficial fissures of the horny layer. The seborrheic and sebostatic variants differ with regard to localization of the dermatosis and condition of the skin surface. Their relationship to the imbalance of production and consumption of skin surface lipids is discussed.

Diaper dermatitis is a term used to encompass a wide range of inflammatory processes that occur in the area covered by the diaper. The term "diaper dermatitis" is thus simply a description of the location of a rash. Numerous factors can be involved in the pathogenesis of dermatitis in the diaper area. These factors, including the role of the diaper, of friction and contact irritation, of urine and ammonia, of feces, of infection, and of underlying dermatologic conditions, are discussed with an emphasis on management of the rash.

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.

Two Tanner stage IV adolescent females with secretion of material from the areolar glands of the breast are described. This report, as well as previous case reports, indicates that the condition is benign in the presence of an otherwise unremarkable physical examination. In contrast to galactorrhea, which must be evaluated completely, areolar gland discharge appears to be a curiosity that may be as rare as the number of case reports would suggest. It appears to warrant nothing more than careful observation.

A 46 year old woman had suffered from Erythema anulare centrifugum Darier (EAC) since 20 years. During a rush of the erythema numerous seborrhoic keratoses appeared (Leser-Trélat sign/LTS). Clinical examination revealed a ductular carcinoma of the breast. During the last two years, both types of lesions increased although the tumor had been treated. In addition, the patient developed several basal cell epitheliomas at forehead and chest.

Intensive investigations between 1969-1974 on 245 patients with perioral dermatitis are reported. Results are discussed with special regard to clinical behaviour, histology, differential diagnosis and etiology of the disease. Eczematous sources, bacterial and mycotic infections can be ruled out as etiological factors. Therapeutical considerations are discussed.

This article gives a brief synopsis of the most common dermatologic disorders likely to be encountered by a plastic surgeon. Clinical features and aids to diagnosis are emphasized, along with treatment suggestions and characteristic photographs.

The clinical differential diagnosis between seborrheic dermatitis and psoriasis vulgaris of the scalp can be difficult. We, therefore, tried to elaborate histopathological criteria for a differentiation of the two dermatoses. Forty excisional biopsies were analysed without knowing the clinical diagnosis. The histopathological substrate within the epidermis is characterized in psoriasis by dermatitis-like and in seborrheic dermatitis by psoriasis-like alterations. Therefore, in some cases a definite histopathological diagnosis could not be made. Strong criteria favouring psoriasis are: moderate condensed hyperkeratosis with alternating parakeratosis, PAS-reactive serum inclusions and Munro abscesses within the horny layer, spongiform pustles and neutrophilic leukocytes within the epidermis. Strong criteria for seborrheic dermatitis are: irregular acanthosis with relatively thin condensed orthoor parakeratotic horny layer, spongiosis and spongiotic vesicles, exocytosis of lymphocytes and the lack of any hard criterias for psoriasis. The results may suggest that seborrheic dermatitis of the scalp may transform into psoriasis in patients with a genetical disposition ("psoriatic diathesis", "latent psoriasis") via a Köbner reaction. The existence of the seborrheic dermatitis (Morbus Unna) is not doubted by these investigations.

By judicious consideration of the clinical appearance, by direct examination with magnification, and by culture results, skin biopsy, and other laboratory results, the clinician is able to diagnose most pathological conditions of the scalp. The scalp participates in many systemic disorders and frequently is the chief site of involvement. Similarly, many generalized disorders limited to the skin exhibit their most typical manifestations in the scalp. Whenever a diagnosis eludes the investigator, more than likely he or she has not considered all of the etiological possibilities or has not pursued an adequate laboratory investigation. A few scalp diseases initially present nonspecific clinical pictures. By utilizing follow-up examinations at appropriate intervals, the diagnosis can eventually be made. Once a diagnosis is made, appropriate treatment will generally produce satisfactory improvement or cure. Nevertheless, a few generally rare conditions will defy the physician's most enlightened and aggressive therapy.

To date the most reliable procedure for the diagnosis of milk hypersensitivity is a properly conducted elimination-challenge test. Several in vitro tests have been developed but because of the diverse underlying mechanisms of hypersensitivity reactions to milk developing a single laboratory test that can be universally positive in every patient would be rather difficult. However, with a better categorization of milk-sensitive patients, together with the development of relevant, standardized and practical tests, the laboratory diagnosis of milk allergy should become more reliable. Milk hypersensitivity can be effectively treated and is largely preventable. Avoidance is the most effective mode of treatment and results in a good prognosis. In instances where the desired degree of avoidance cannot be attained pharmacologic agents may be of help. The need still exists for developing an effective procedure of hyposensitization. For prevention, prolonged breast feeding should be recommended, especially in infants of atopic families.

Of 7887 patients with eczema seen in a private dermatological practice over a period of 2 years and 4 months, a specific final diagnosis was found in 5376 (68%), while a final diagnosis of non-specific eczema was made in 2511 cases (32%). The most common final diagnoses were seborrhoeic dermatitis (1351), contact dermatitis (1317), atopic dermatitis (1009) and nummular eczema (822). Battery patch testing was the initial diagnostic procedure performed, and 897 of the 3164 patients who were patch tested had one or more positive patch tests. In 545 cases, the reactions were considered of relevance to the current dermatitis. Tests for immediate-type allergy were carried out in 618 patients, and 284 of these had one or more positive tests. In 86 patients, these test results were of diagnostic significance. 257 patients with positive patch tests were challenged orally with the relevant substance, and 53 of 156 reacted to metal salts, most commonly nickel, while 25 of 101 reacted to orally ingested balsam of Peru. Among patch-test-negative patients, 66 of 408 had positive reactions to one or more metal salts; 41 of 180 reacted to balsam of Peru, while 15 of 41 reacted to various food additives.

The authors describe a case of pathomimesis with simulation of seborrheal pemphigus, when the patient was referred to Group II invalidity.

Annular facial dermatoses in blacks are common. Although the diagnosis of these dermatoses is usually made without difficulty, occasionally problems are encountered. A patient with annular seborrheic dermatitis that closely resembled the annular lesions of secondary syphilis is presented. The differential diagnosis of annular facial lesions in the black patient is then briefly reviewed.

Most common groin lesions are caused by fungi, bacteria, psychogenic factors, viruses, parasites, or tumors. The workup of all patients with an inguinal skin disorder should include a history, physical examination, microscopic examination and culture of scrapings from the eruption, and examination of the eruption by Wood's light. Agents useful in treating groin lesions include topical and systemic corticosteroids and antibiotics, antipruritic agents, Burow's solution, and lindane. Prolonged use of high-potency topical corticosteroids can be deleterious.

Papulosquamous diseases are a heterogeneous group of disorders whose etiology primarily is unknown. The nosology of these disorders is based on a descriptive morphology of clinical lesions characterized by scaly papules and plaques. The major entities in this group include psoriasis, parapsoriasis (including pityriasis lichenoides et varioliformis acuta), lichen planus, lichen nitidus, lichen striatus, pityriasis rosea, pityriasis rubra pilaris, seborrheic dermatitis, and the Gianotti-Crosti syndrome. Many other conditions may become papulosquamous and should be considered in the differential diagnosis.

In a prospective study of thirty-seven infants presenting with dermatitis in infancy it was found that pruritus, a positive family history of atopy, and the age of onset of skin lesions were of little value in distinguishing atopic dermatitis from infantile seborrhoeic dermatitis. The most useful distinguishing features were the increased incidence of lesions on the forearms and shins in atopic dermatitis, and in the axillae in infantile seborrhoeic dermatitis. The onset of skin lesions solely in the napkin area favoured a diagnosis of infantile seborrhoeic dermatitis, but when more than one site was involved the distinction was less clear. Infantile seborrhoeic dermatitis carried a much better prognosis than atopic dermatitis. In thirty-six out of thirty-seven infants the definitive diagnosis could be made with confidence on clinical grounds by the age of I year, but was often difficult at first presentation in early infancy.

In the outpatient clinic of the Institute of Venereology clinical examinations were carried out in 37 patients with HIV infection, who were in a good general condition. In 28 patients peripheral lymphadenopathy was present, with involvement of the lymph nodes in at least two areas besides groins in 15 cases (40.5%). In 11 cases oral candidiasis was present, in one out of 6 females vaginal candidiasis was found. Seven patients (19%) had moderately intense seborrhoea, one (3%) had seborrhoeic dermatitis. Paradontosis was found in 4 patients (11%), 5% had follicular keratinization and 5% had recurrent pharyngitis and high fever. In some cases short-lasting maculoerythematous rash developed on the chest and face or chest and on the legs, recurrent herpes, paraparesis, and a history of short-lasting convulsions developing 6-10 days after alleged infection. In some patients 2 or 3 above mentioned symptoms occurred at the same time.