Topical antibiotics and minor skin trauma.

Recent double-blind controlled studies show that the application of a neomycin-bacitracin-polymyxin preparation reduces the incidence of staphylococcal and streptococcal infection of minor skin trauma. Allergic sensitization to neomycin is rare. Systemic side effects occur only with improper massive exposure. Resistant strains have appeared only in "closed populations." It is concluded that topical antibiotic combinations are safe and effective.

Epilogue as prologue. The skin: continual source of biologic problems and discoveries.

In much the same way as the survival of many species depends upon their abundant production of such genetic materials as pollens and spermatozoa, so does scientific progress depend upon a continual, lavish production of basic scientific works. In stimulating assembling, and disseminating various scientific studies related to the skin, the Montagna Symposia on the Biology of Skin have ensured progress not only in the understanding and management of skin was, is, and probably will always will be one of the richest sources of basic biologic information. No scientific discovery is wasted, no accurate clinical observation useless. No one can foresee when or how some seemingly irrelevant discovery in pure science or some seemingly insignificant clinical observation will yield fruits of incalculable practicable value. We cite here a few examples of some of the best results from apparently unrelated research and isolated clinical findings. In dermatologic research, the circular rhythm from patient with cutaneous disease to laboratory and from laboratory back to patient creates a centrifugal force that often spins off valuable discoveries.

Acne enigmas and some pure hypotheses about them.

The enigmas of why acne usually starts and stops at certain ages, why and how it so often cures itself, are recalled and some explanatory hypotheses are mentioned. Certain other enigmas are mentioned including why some patients have much oil and little acne, and some vice versa; why some blackheads and whiteheads initiate inflammation and suppuration and others not; why cysts and why scars form in some patients and not in others. Enigmas such as these show that acne is not only a common disease that supplies the practitioner's bread and butter, but one offering almost unequaled opportunities for research.

The patch test--who should and should not use it and why.

Since its introduction into medicine by Joseph Jadassohn in 1895, the patch test has proven its supreme value in tens of thousands of cases and in research. But emphasis must be placed on the grave errors which can occur when the test is used improperly. Errors are common in the direction of both false positives and false negatives. Common causes of errors are described in detail. The conclusion is drawn that this valuable test had best be used only by those who have been adequately trained and who can apply it regularly on a sufficiently large number of selected patients.