A cream containing 10% glycolic acid and 2% hydroquinone (Neostrata AHA Age Spot and Skin Lightening Gel) improved melasma and fine facial wrinkling in Asian women. In combination with glycolic acid peels at 3-week intervals the lightening of melasma is subjectively much better. This improvement does not reach statistical significance and the sample size is small (n = 10).

The pattern of pustular psoriasis seen in Singapore is similar to that reported in the Western literature. Using these categories we can provide guidelines for treatment and prognosis.

The inducing or exacerbating effect of sunlight on skin diseases is often not appreciated in tropical countries, perhaps because of the perennial presence of sunlight, and a retrospective review of photodermatoses seen in a referral skin clinic was therefore carried out. The photodermatoses seen were secondary photoaggravation of primary skin diseases (32.2%), systemic drug photosensitivity (11.3%), polymorphic light eruption (13%), chronic actinic dermatitis (5.3%), solar urticaria (5.3%), actinic prurigo (4%), photoallergic contact dermatitis (2.6%), porphyria (1.3%) and xeroderma pigmentosum (1.3%). Compared with the results of Western studies, there were more photoaggravated underlying skin diseases and systemic drug photosensitivity, and fewer idiopathic photodermatoses and photoallergic contact dermatitis; the common photoallergens were chlorpromazine, promethazine and musk ambrette, very similar to those seen in the West.

The antipsoriatic efficacy, tolerability and safety of calcipotriol ointment was compared with tar in a prospective, right/left randomized, investigator-blinded controlled study. Calcipotriol ointment 50 micrograms/g twice daily was applied to one-half of the body. On the opposite side, white soft paraffin was applied in the morning, and coal tar solution BP 15% v/w in aqueous cream in the evening. Thirty patients with stable chronic plaque-type psoriasis were recruited. Assessments were made at 2, 4 and 6 weeks. Three patients were withdrawn from the study. A decrease in PASI score was seen on both sides at 2, 4 and 6 weeks. The differences from baseline between the two treatments were statistically significant in favour of calcipotriol. Improvement with calcipotriol was rapid in the first 2 weeks of treatment. With tar, significant improvement occurred only after 4 weeks of treatment. The differences in the scores for erythema, induration and desquamation from baseline between the two treatments were also statistically significantly in favour of calcipotriol at all evaluation points. Seven patients developed irritation on the calcipotriol-treated side, but there were no adverse effects on the tar-treated side. In two patients, itching associated with psoriasis was reduced by the calcipotriol. Although the mean serum calcium and phosphate levels remained within the normal ranges after 6 weeks' treatment, there were significant changes in their values compared with baseline.

Genital syringomas are rare and usually asymptomatic. We report 2 young women who presented with pruritus vulvae. Examination revealed multiple bilateral skin-coloured papules over the labia majora. Histology showed syringoma. Syringomas should be considered in the differential diagnosis of pruritic papular lesions of the vulva.