A family is described in which 2 siblings born to healthy parents presented with abnormal facies, persistent diarrhoea, and early death. Exhaustive pathological and biochemical investigations failed to find a cause. The scalp hair of both babies had an abnormal amino-acid composition, and presented an appearance that was unique on scanning electron microscopical examination; this fact and the clinical picture probably represents a new syndrome.
This is a report on ten patients with follicular psoriasis. Two distinct clinical types could be distinguished. An adult form, seen especially in women, presented with widespread psoriasis in which follicular lesions occurred on both thighs as part of the efflorescence. Follicular lesions were aggregated to form isolated asymmetrical plaques on the trunks of children with inactive psoriasis. The histological findings in follicular psoriasis varied according to the age of the lesion. In the early lesion there was a marked dermal infiltrate in which the mast cells were prominent but the hair follicle appeared normal. Older lesions were found to have nucleated cells in the ostium of the follicle. These findings suggest that the hair follicle may be affected as part of psoriatic involvement of the integument.
Summary
Questions from patients suffering from psoriasis indicate that treatment is carried out with diligence, but embarrassment still inhibits daily activities and the choice of clothing. The establishment of Day Care Centres, discussion groups and The Psoriasis Association may help to overcome this embarrassment.
Investigations on thirteen consecutive adult patients with classical lichen planus revealed a significant lowering in the levels of circulating IgA and IgM. Patients with lichen planus may have an immunological defect which makes them susceptible to infection with an unknown virus.
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