Treatment of seborrhoeic dermatitis with ketoconazole: I. Response of seborrhoeic dermatitis of the scalp to topical ketoconazole.

A randomized, double-blind, placebo-controlled cross-over study was made of ketoconazole shampoo in the treatment of 20 subjects with seborrhoeic dermatitis of the scalp. Responses were measured by clinicians using clinical gradings, and by the patients using a linear analogue scale. Scaling and itching of the scalp improved significantly with ketoconazole and no response was seen with placebo. Topical ketoconazole appears to be an effective therapy for seborrhoeic dermatitis of the scalp, and more suitable for long-term treatment than the oral preparation.

Fibrosis as in indication of time in infiltrating breast cancer and its importance in prognosis.

The histological grading of tumours according to their intrinsic malignancy is very important in the prognosis of breast cancer but within each grade the ultimate prognosis depends mainly on the age of the tumours.We have shown that tumour fibrosis is an indication of this time factor, increasing with the age of the tumour. Within each grade the metastatic ratio is higher and the 5 year and 10 year survival less with the scirrhous than with the non-scirrhous tumours. The establishment of axillary metastases is closely connected with both the degree of malignancy and the time available, the unfavourable effect upon survival being greater in the scirrhous than in the non-scirrhous tumours.Another consequence of the passage of time, as indicated by fibrosis, is the gradual diminution of lymphoid infiltration (LI) which is mostly present in young tumours, especially those of high grades. The favourable effect of LI upon survival is demonstrated in the non-scirrhous tumours of grade III, possibly because of its great intensity, but this influence upon survival is lost as fibrosis increases and the intensity of the reaction diminishes.