Systemic treatment modalities for eradication of multiple therapy resistant genital warts are so far not available. In this study laser treated patients with multiple genital warts received postoperatively either interferon alpha-2b subcutaneously (s.c.) 5 x 10' IU or matching placebo three times weekly for four weeks. At the conclusion of the study, 6-8 weeks after discontinuation of therapy, a significantly higher cure rate was found in the group of interferon-treated patients (14 of 27 (52%) patients cured) than among placebo treated patients (5 of 22 (23%) patients cured) (p < 0-05). The side effects of fever, chills, myalgia, headache and leukopenia occurred more commonly in the interferon treated group than in the placebo group. However, only three of 32 patients discontinued interferon therapy because of side effects. We conclude that the addition of s.c. administered interferon alpha-2b to laser treated patients with chronic therapy resistant genital warts is fairly well tolerated and that it significantly enhances the chance ofeliminating the disease. IntroductionThe optimal treatment modality has not been established in patients with recalcitrant multiple genital warts. A variety of ablative treatments for podophyllin resistant genital warts are available, including cryosurgery, electrocautery and laser therapy.

Fundus affliction with generalized scleroderma was studied in 21 patients by ophthalmoscopy, fundus ocular photography and fluorescein angiography. Slitlamp examination of the anterior chamber, the iris and the lens revealed no evident affections. Neither did ophthalmoscopy reveal obvious abnormalities related to scleroderma. Abnormalities of pigmentation were not noted. Visual acuity was normal in 20 patients, and 1 patient had reduced visual acuity due to macular degeneration. Fundus fluorescein angiography was within normal physiological variation in 14, and definitely abnormal in 7 patients as assessed independently by 2 ophthalmologists. Angiographic abnormalities consisted of variable hyperfluorescence of the pigment epithelium layer, and, additionally, in 2 cases minute hyperfluorescence of the retinal layer. These angiographic abnormalities indicated affection of the retinal pigment epithelium probably caused by a vascular lesion of the choroidal layer. Retinal vessels were in general not affected. In conclusion, the choroidal vasculature appears affected in 1/3 of patients with generalized scleroderma as assessed by fundus fluorescein angiography.

A case of reactive perforating collagenosis in an adult male patient with chronic renal failure. Pruritic, umbilicate papules, showing extrusion of collagen fibers through the epidermis were detected histopathologically. Electron microscopy showed absence of basal membrane beneath the perforation and collagen fibers with preserved periodicity passing through widened intercellular spaces with islands of cytoplasmic material.

Central cornea thickness (CCT) was measured in 32 patients with systemic sclerosis by the Haag-Streit pachymeter with improved centrality. Results were compared with measurements in 29 healthy adults matched with respect to sex and age. CCT was increased (P less than 0.001) in patients with systemic sclerosis (mean 0.56 mm, average SD right and left side 0.0297 mm) as compared to the controls (mean 0.51 mm, SD 0.0109 mm). CCT of right and left eye was increased in 69% and 72% of patients with systemic sclerosis as compared to controls (mean 0.51 mm +/- 2 SD). CCT increased during the first 8 years of the disease (correlation coefficient 0.593) reaching a plateau after 8 years (correlation coefficient 0.005). CCT did not increase during medical treatment with collagen inhibitors. Measurement of CCT may be useful as a supplement to other quantitative methods for diagnosis and control of systemic sclerosis.