Batch variations.

One of the basic principles in the investigation of suspected contact dermatitis is always to test with the patient's "own" product or chemical, the one to which he or she was actually exposed. An equally basic second principle is not to rely solely on a positive test reaction. The author discusses a case of contact dermatitis involving only certain batches of a particular branded product.

Contact and photocontact allergy to musk ambrette.

Musk ambrette, a contact and photocontact allergen, is a synthetic fragrance present in aftershave lotions and many toiletries. Thirty-four patients with contact and photocontact allergy to musk ambrette were studied. All had a facial eczema. Four distinctive clinical pictures were seen. These were plaques of eczema, jawline (mandibular) dermatitis, acute contact dermatitis and chronic actinic dermatitis. Twenty-six patients were light sensitive by history and 10 were diagnosed by clinical criteria as having chronic actinic dermatitis. Patch and photopatch testing to musk ambrette showed that seven patients had pure photocontact dermatitis to musk ambrette. Eight patients had contact dermatitis to musk ambrette but this was exacerbated by irradiation. Cross reaction with moskene occurred. Scrupulous avoidance of musk ambrette has resulted in clinical resolution in most patients.

Lichen aureus: a localized persistent form of pigmented purpuric dermatitis.

Localized persistent pigmented macules and plaques due to a chronic form of pigmented purpuric dermatitis are described in forty-two patients. The designation 'lichen aureus' for this eruption can be justified because of the striking yellowish or bronze-like colour assumed by many of the lesions. The lower legs were the commonest sites but other body regions can be affected also. Histologically lichen aureus differs from other pigmented purpuric dermatoses in the density of the lichenoid tissue reaction and the marked accumulation of pigment-containing macrophages. Recently developed endothelial cell markers have been studied in selected cases.

Thalidomide in actinic prurigo.

Fourteen patients suffering from actinic prurigo were treated with thalidomide. Eleven patients showed lasting improvement on the drug and three of these remained symptom-free after discontinuing therapy. No major side-effects were observed. Thalidomide is an effective drug in the treatment of actinic prurigo but it must be used with adequate contraception in women of child-bearing age.

Allergy to phenyl salicylate.

Six cases of contact dermatitis from a lip salve are described. Five were allergic to phenyl salicylate and one to geraniol in the fragrance. The dermatitis spread in a ring around the mouth. Phenyl salicylate has been removed from the formulation.