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Chloracne was found in 52% of 226 workers in a 1979 cross-sectional survey at a plant where 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) had been manufactured from 1948 to 1969. Mean duration of residual chloracne was 26 years, and in 29 subjects, it had been present for 30 years. A significant increased prevalence of abnormal gamma-glutamyl transpeptidase (GGT) and higher mean GGT were found in those with chloracne, compared to those without. Although mean triglyceride values were higher in those with chloracne, the difference was not statistically significant. Neurological examination showed a statistically significant higher prevalence of abnormal sensory findings in those with chloracne. Increased prevalence of angina and reported myocardial infarction in those with chloracne was not significant when age-adjusted. Increased prevalence of reported sexual dysfunction and decreased libido in those with chloracne compared to those without was statistically significant after age adjustment. No differences were found between those with and without chloracne in serum cholesterol, total urinary porphyrins, or in reproductive outcome.

Two outbreaks of hand dermatitis in light engineering works are reported. In both cases a number of workers shown to be allergic to soluble coolant oils were found to be allergic to ethylenediamine, which had either been incorporated into the oil or had been added to it later.

After a brief review of the subject of chloracnegenic toxicity, this paper examines two proposals. Firstly that the acnegenic potential of all chloroacnegens correlates perfectly with their systemic toxicity and, secondly, that with almost no exceptions chloracne still appears to be the most sensitive marker of poisoning by chloracnegens in the human subject. It is as such a marker that it is of great importance. Various alternative markers are examined and rejected in favor of chloracne. It is, of course, emphasized that the failure of chloracne to appear after apparent poisoning rules out short and medium term effects but cannot entirely preclude the potential existence of long term low dose effects, although none have so far been proven statistically to exist in over 30 years of follow-up.

SUMMARY.— Economic pressures have brought about a change in the conductors of electrical power cables; aluminium is now widely used in place of copper. The development of a jointing flux containing aminoethylethanolamine made this possible, and this has been very extensively used by the Electricity Supply Industry in this country. This amine has given rise to a high incidence of dermatitis amongst cable jointers, and is here shown to be a powerful sensitizer. Surveys have shown an incidence of dermatitis of 10% to more than 30%, in all grades of severity. A satisfactory alternative flux has been developed and is now in field use. This investigation underlines many principles of economic as well as medical importance.

SUMMARY.— A review was undertaken of 22 patients originally sensitized by tetrachlorosalicyianilide (T4CS) in 1960–61 to determine the pattern of cross-reactions to tribromosalicylanilide, bithionol and hexachlorophane. Two sets of patch tests were applied, one covered for 48 hr. with black paper, the other irradiated after 24 hr. by a source of “black light”. Readings were taken at 48 and 96 hr. Thirteen of 15 patients re-tested have remained sensitive to T4CS. Fifteen of 22 patients tested gave positive photopatch tests to an “impure” form of T3BS, 11 to a laboratory purified form. Half the patients showed positive 48 hr. conventional tests. These were thought likely to be “masked” photo-reactions. There were 9 positive photo-reactions to bithionol, but only 1 “conventional” positive reaction. Hexachlorophane only gave 2 positive photo-reactions. This low incidence is in line with the findings of other investigations. A group of 6 control patients without photodermatitis gave negative reactions to all agents used for testing. “Black light” provides a useful addition to methods of testing for contact photo-sensitizers.

Sixty-five patients with axillary hyperhidrosis took part in a trial of treatment with a solution of 20% aluminium chloride hexahydrate in absolute alcohol, applied topically each night for a week and then whenever the patient thought it necessary. Excellent control of sweating was achieved in 64 patients, and occlusion of the area was found to be unnecessary. No troublesome side effects were reported. The results of this study indicate that 20% aluminium chloride hexahydrate in absolute alcohol is the treatment of first choice for patients with axillary hyperhidrosis.