'Fiddler's neck' is a condition affecting violin and viola players. Although well known to musicians it is not well recognized by dermatologists. Clinically the lesions usually consist of a localized area of lichenification of the left side of the neck--just below the angle of the jaw. Pigmentation, erythema and inflammatory papules or pustules are frequently present, while severe inflammatory induration, cyst formation and scarring occur in more severely affected subjects. The aetiology of the skin changes is probably due to a combination of factors; friction giving rise to lichenification, while local pressure, shearing stress and occlusion may play a part in producing the acne-like changes and cyst formation. In addition, poor hygiene may predispose to local sepsis.

Summary.— Using an instrument designed to exert known pressures on the skin, an incidence survey of factitious wealing in the general population has been carried out; 2813 subjects have been tested with a pressure of 4900 g/cm2, and the overall incidence was 4·24% (females, 5·2%; males, 4·34%). The incidence did not vary significantly in the different age groups. A series of patients with symptomatic dermographism has been followed up in the outpatient Department and serial measurements of the weal size have been made. In 20 of these comparable measurements are available over prolonged periods. The total number of patients showing at least 50% reduction in weal size was: at 2 months, 1; at 4–6 months, 7; at 6–9 months, 10; at 9–12 months, 12. The incidence of factitious wealing in various patterns of urticaria is mentioned and the results of the incidence survey are discussed in relation to patients presenting with symptomatic dermographism.

A family with X-linked cytochrome-negative chronic granulomatous disease (CGD) involving three generations is reported. The diagnosis of CGD in both the latest male patient and the index male was confirmed by marked impairment in polymorphonuclear leucocyte oxidative burst activity in association with absence of both subunits of cytochrome b. The two female carriers have suffered from chronic inflammatory skin disorders characterized by slowly fluctuating erythematous plaques. The reported cases are discussed in the context of a literature review of the dermatosis of CGD.

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In ten patients suffering from symptomatic dermographism the combined administration of chlorpheniramine + cimetidine produced a greater reduction in the weal and flare response provoked by a standardized scratch than the administration of chlorpheniramine alone. There was a statistically significant improvement in the overall assessment of the patient's skin condition with the combined administration of chlorpheniramine + cimetidine. Chlorpheniramine given alone produced no significant benefit whilst cimetidine alone produced a marked exacerbation in itching in nearly half the patients who initially entered the study and was sufficient to require withdrawal.