Blood glucose concentrations in a woman with severe retinopathy, nephropathy, and neuropathy were found to be within the normal range. A high random blood glucose concentration was recorded only once, six months before her initial presentation. At necropsy the anterior lobe of the pituitary gland showed old, extensive infarction.Occult pituitary hypofunction may explain severe diabetic microangiopathy in patients with normal glucose tolerance.

The possible clinical value of fine needle aspiration cytology (FNAC) has been assessed prospectively in 60 patients presenting with cutaneous lesions. The cytological diagnosis in each case has been compared with the clinical diagnosis and biopsy result. The principal potential use appears to be the rapid confirmation of the clinical diagnosis of basal cell carcinoma to allow immediate referral for radiotherapy or plastic surgery. FNAC could also prove useful when the clinical diagnosis of malignant melanoma is in doubt and primary diagnostic excision is difficult or disfiguring. Accurate distinction could usually be made between benign and malignant lymphoproliferative conditions, but further classification was difficult. Metastatic malignancy could be diagnosed with ease and other characteristic cytological appearances were seen with naevocellular naevi, pyogenic granuloma and pilar cysts. However, there were limitations in achieving an accurate diagnosis in approximately half the cases, and consequently, FNAC cannot be regarded in general as a substitute for histological diagnosis.

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Summary Two patients with dermatomyositis presented with violaceous lichenoid eruptions on the light exposed areas. Histology and direct immunofluorescence showed the typical features of lichen planus. The rash in dermatomyositis usually consists of a purplish‐red heliotrope erythema on the face, erythematous changes on the hands and backs of the fingers with diffuse redness and shining of the nail folds (Rowell, 1979). A pathognomonic sign in dermatomyositis is the Gottron papule, a violaceous flat‐topped lesion over the dorsal interphalangeal joints and occasionally a diffuse lichenoid eruption occurs which may be mistaken for lichen planus (Braverman, 1983). However, there have been no previous reports of the histology and immunofluorescence findings in these patients. Two cases are reported showing clinically a violaceous lichenoid eruption on the dorsal aspect of both hands with the histology and direct immunofluorescence typical of lichen planus. The association of lichen planus and dermatomyositis is discussed.

A preliminary trial is reported studying the effectiveness of pseudomonic acid in primary superficial skin infections in 20 patients. Staphylococcus aureus was isolated in 18 patients and beta-haemolytic streptococci group A in two. Only on one occasion was a pathogenic organism, Staph. aureus, isolated post-treatment and clinical cure or improvement was achieved in 19/20 (95%) of patients. All isolates were found to have pseudomonic acid MICs of between 0.06 and 0.25 mg/l.