THE EFFECT OF SINGLE AND REPEATED APPLICATIONS OF HEXCHLOROPHANE ON THE BACTERIAL FLORA OF THE SKIN OF THE NEWBORN

SUMMARY. It has been shown previously that suppression of clinical pyogenic infection in infants as well as a reduction of the resident skin flora follows the application of hexachlorophane. In this study, the skin flora of 55 newborn babies was examined in 6 sites before and after washing the skin with soap and water and with single and repeated applications of hexachlorophane respectively. Marked suppression of the resident skin flora (diphtheroids and Staphylococcus albus ) and of Staph. aureus followed the use of both single and daily applications of hexachlorophane, the effect being more marked and prolonged with the repeated use of hexachlorophane. No significant effect on streptococci and E. col i was seen but an increase of proteus followed the use of hexachlorophane. No irritation of the skin or other side effects attributable to hexachlorophane were observed.     

THE MANAGEMENT OF VENOUS ULCERS OF THE LEGS

The first step in the management of venous leg ulcers is correct diagnosis of the ulcer as venous in type. Calf pump dysfunction and resultant increased venous pressure are significant factors in the pathogenesis of venous leg ulcers. Good management is aimed at correcting these. Exercise, elevation and compression are the most effective means of achieving this and form the mainstay of treatment. The use of topical preparations entails a high risk of sensitization and irritancy. If these develop, healing may be slowed by further damage to the ulcer tissue. Reducing the number of preparations used and avoiding the injudicious use of topical antibiotics minimises this risk. Frequent assessment of the ulcer is also essential. Once healed, prevention of recurrence is an integral part of correct management of venous leg ulcers.     

THE RELATIONSHIP OF THE STRUCTURE OF THE EPIDERMIS TO PERCUTANEOUS ABSORPTION

SUMMARY.— The epidermal barrier unit is composed of cells of the keratinocytic, transitional, and horny layers. The epidermis often contains other dendritic, leukocytic, and neural cells in the intercellular spaces. The epidermal intercellular canals and epidermal phagocytosis are 2 routes of transepidermal and transcorneal passage of materials. Individual, regional, age, and species differences in epidermis may account for variations in cutaneous permeability. Mitotic rate may be the most significant factor in barrier production.     

THE ROLE OF THE EPIDERMIS IN THE HISTOPATHOGENESIS OF LICHEN AMYLOIDOSUS

Summary.— Biopsies from 10 patients with lichen amyloidosus were investigated histochemically with special reference to the epidermal changes. The number of dopa-positive melanocytes was markedly decreased in the epidermis overlying the amyloid deposits, indicating that melanocytes are also involved and probably destroyed by the disease process. No increase in lysosomal enzyme activity could be detected in epidermal cells undergoing degeneration or in the epidermis immediately above the amyloid deposits. Respiratory enzyme activity was moderately reduced in the epidermis overlying the amyloid deposits. These histochcmical findings confirm that the epidermis is likely to be involved in the histopathogenesis of lichen amyloidosus. It is suggested that, prior to the deposition of amyloid, a specific cellular tolerance may develop to the presence of necrotic epidermal cells in the region of the dermo-epidermal junction.