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SUMMARYWe describe a case of a young woman who developed myelopathy and peripheral neuropathy following 1 year of recreational nitrous oxide (N 2 O) use. She presented with uncomfortable tingling sensation in her feet and poor balance. Physical examination revealed mild weakness and hyper-reflexia in the lower limbs. Proprioception and vibration were absent in the lower limbs. Pinprick and light touch sensations were reduced below the sixth thoracic dermatome. A broad-based gait and a positive Romberg sign were noted. The level of vitamin B 12 was low (76 pmol/l). T2-weighted MRI scans showed hyperintensity changes at the posterior column from the second to the fifth cervical vertebrae. She made a full recovery following injections of vitamin B 12 and physiotherapy. This case discusses subacute combined degeneration of the spinal cord on a background of N 2 O abuse. BACKGROUND

Ashy dermatosis and lichen planus pigmentosus, as defined in this study, appear to be two separate clinical entities with distinguishable clinical features and natural histories.

SUMMARYThe authors describe the case of a 38-year-old man with a history of schizoaffective disorder, who attempted suicide following the recent starting of a neuroleptic agent that resulted in the development of intolerable akathisia. He survived the attempt, and following changes in his medications the akathisia resolved with no further suicidal ideation. BACKGROUND

Assessing the skin of asylum seekers, immigrants, migrant workers, tourists or even locals who return from abroad, can be a confronting task due to the possibility of such people having non-autochthonous diseases. Primary-care physicians and dermatologists need to have a systematic approach in the assessment of such dermatoses. This article describes an interesting case of possible kerosene-induced and diesel-induced skin injury in an asylum seeker arriving on a boat. Dermatological conditions in asylum seekers and a suggested template for skin assessment are discussed.