Forty-eight patients (23 male, 25 female) with severe alopecia areata were sensitized and treated with topical diphencyprone. Thirty-eight per cent of the subjects had good regrowth of hair at a mean follow-up period of 30.8 months. The presence of nail changes, a personal history of atopy and a long duration of alopecia had an adverse prognostic effect.

We recently made a double-blind safety-in-use comparison of four different brands of baby wipes using a panel of 302 infants over a period of 10 weeks. For the first two weeks, only soap and water was used to clean the babies' skin after each diaper change, and then for the eight-week test phase each baby was allocated one or other of the products for normal home use. The wipes differed in cleansing lotion formulation (emollients, preservative, pH) and fibrous composition. There were no clinically detectable differences in the effects of the wipes in terms of erythema, frequency of rashes, edema, and desquamation, but we recorded significant changes in the pH of pubic and buttock skin inside the diaper area. In particular, the brand of wipes with the lowest pH (2.8) in the lotion reduced the mean skin pH from 5.6 to 5.0 (p < 0.01), and those with a pH of 5.5 had no significant effect. Wipes of intermediate pH (3.7) gave a final skin pH of 5.4-but the downward trend was not statistically significant. These data indicate that skin pH can be depressed by such topical application, although the trial lasted only a fraction of the total time wipes might be used on each infant. Further research is necessary to evaluate the implications of these findings.

No abstract

Mitomycin C is an alkylating agent, used by intravesical instillation to treat carcinoma of the bladder. Repeated instillations can induce cystitis and an eczematous eruption affecting the palms, soles and face. If these effects are due to delayed hypersensitivity with sensitization to mitomycin C occurring in the bladder wall, it should be possible to demonstrate antigen-presenting cells in the bladder wall and positive patch tests to the drug. Using an immuno-alkaline phosphatase method we have identified CDI+ cells in bladder epithelium and submucosa and have demonstrated Birbeck granules in a few cells. In further support of our hypothesis it was also possible to demonstrate delayed type hypersensitivity in 13 out of 26 patients who had received mitomycin instillations by applying the allergen as a patch test. These results indicate that the eczematous eruption in this group of patients is most likely a hypersensitivity reaction and that it may be mediated transvesically.