Methotrexate maintenance following Ingram therapy in 'difficult' psoriasis.

A retrospective analysis is presented summarizing 9 years' experience using a combined regime of Ingram therapy followed by methotrexate maintenance in the management of especially difficult psoriatic patients. The lesion-free period was extended from about 1 month (controls) to 1 year, and the period before re-admission was extended from 5 months to more than 3 years.

Low-dose PUVA maintenance in psoriasis following Ingram therapy.

Following the initial treatment of severe psoriasis with conventional Ingram therapy, it is shown that PUVA maintenance at a mean dose-rate of 28.6 J/cm2/month increases the average period of remission from 7 weeks to more than a year. Surprisingly, the patients who withdrew from maintenance therapy whilst still in remission have so far continued (10 months) to show an extremely low relapse rate.

Deafness, ichthyosiform erythroderma, corneal involvement, photophobia and dental dysplasia.

Early childhood deafness, congenital non-bullous ichthyosiform erythroderma, corneal involvement, photophobia, chronic blepharoconjunctivitis, hypotrichosis, anhidrosis, hyperkeratosis of the nails and dental dysplasia were the symptoms observed in the 19-year-old girl described in this paper. The literature comprises reports on 8 patients with this syndrome, which McKusick (1975) listed as no. 24215.

A lysosomal storage disorder of the epidermis characterized by a deficiency of alpha-mannosidase and an accumulation of mannose-rich materials.

Laboratory investigation of a patient diagnosed as ichthyosiform erythroderma bullosa revealed the following abnormalities: (1) alpha- and beta-galactosidases were elevated in the lesion. (2) alpha-mannosidase activity was extremely low both in the lesion and in relatively normal epidermis. (3) The mannose:glucose ratio of water-soluble hexose-containing material in the scales was very high. (4) Membrane-limited vacuoles, apparently enlarged secondary lysosomes, were observed. We conclude that this patients is the first documented example of a lysosomal storage disease in which overt clinical lesions are confined to the epidermis.

An evaluation of betamethasone dipropionate (Diprosone) versus Locacorten 0.02% cream.

A double-blind randomized evaluation of betamethasone dipropionate cream (Diprosone) compared with Locacorten 0.02% cream flumethason privalate in 60 patients over 3 consecutive weeks showed the betamethasone dipropionate cream to be significantly more effective in the treatment of psoriasis and other steroid-responsive dermatoses.