\Ielbo'/ini,e Forty eases of " prurigo of pregnancy " }iavc been diagnosed during a three year period, and it is possible to divide these elinieally into early and late tyjjes. The prognosis in each type is good, and as response to simple measures is adequate, steroid medication is rarely requireeL Hejiatic dysfunction-in prefiiiaiicy may produce irritation, but on a basis of morphology of the eruption, time of onset in pregnancy, and loio rate of recurreriee in successive pref/naneies, it ts considered that hcjiatic di/sf unction is not Ihe cause of prurigo of pref/}iancy.Dermatological conditions in prc^giiaiicy are on tlu* borderline of tA\'o A\'idely separated speeialties in medicine, and no thorough x'l'osxiectiA'e study has ever b(HMi mad(^. It lias been found that a non-bullous itchy papular prnrigo is not nncommon, and 40 cases Avere diagnosed during the three year period 1664-1960. Under this heading tAyo A'ariants Avill be described-Avith intermediate tyjies and certain overlapping features. The first occurs in the middle trimester of pregnancy and is a tyincal prurigo, Avliile the second occurs at or near term, and lias features of (a-ytliema multiforme as Ayell as of prui'igo. The clinically distinct bullous eruptions including herpes gestationis, Avill not be discnssed, (^xce])t Avhere direct comparison is important.PllYSlCAlj BACICGKOXJKD
Summary and conclusions A pilot screening programme for congenital hypothyroidism covering most of North London, Essex, Bedfordshire, and Hertfordshire entailed carrying out an assay of thyroid-stimulating hormone on single Guthrie dried blood spots. During one year 87 444 babies were screened and 26 cases of primary congenital hypothyroidism detected, giving an incidence of 1:3363.
The history is presented of a patient who developed an acral keratotic rash diagnosed as paraneoplastic acrokeratosis, associated with cervical metastases from a carcinoma of the tongue. The skin changes settled with surgical removal of the tumour and metastases. During treatment localized bullous pemphigoid also developed.The relationship of these problems is discussed.
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