We report six patients with a previously undescribed but characteristic pustular dermatosis confined to the scalp. All the patients were elderly women who developed chronic, extensive, pustular, crusted and occasionally eroded lesions of the scalp which produced scarring alopecia. Investigations were essentially negative and skin biopsies showed only non-specific changes of atrophy and chronic inflammation, sometimes with increased plasma cells in the infiltrate. The condition did not respond to antibiotics, but was suppressed by potent topical steroids.

SUMMARY.— We examined 1555 school children aged 8 to 18 and graded them according to the presence and severity of acne lesions on the face and neck. Comedones were present in a large proportion of even the youngest children and were virtually universal by the mid‐teens. Clinical acne appeared 2 years earlier in girls than boys and the maximum prevalence was reached at age 14 in girls and 16 in boys. Thereafter the prevalence of the more severe grades of acne continued to increase steadily in boys, but declined in girls. The age of the menarche in girls did not affect the severity of acne which ultimately developed. More girls than boys sought medical advice despite the generally milder form of the disease in girls.

We have measured all the essential fatty acids (EFA) in plasma phospholipids in forty-one adults with atopic eczema and fifty normal controls. The major dietary n-6 EFA, linoleic acid, was significantly elevated, but all its metabolites, 18:3n-6, 20:3n-6, 20:4n-6, 22:4n-6, and 22:5n-6 were significantly reduced. The major dietary n-3 EFA, alpha-linolenic acid, was also elevated, though not significantly, while all its metabolites were also significantly reduced. These observations suggest that atopic eczema is associated not with any defect of EFA intake, but with abnormal metabolism, possibly involving the enzyme delta-6-desaturase. Treatment with oral evening primrose oil produced partial correction of the n-6 EFA abnormality, but had no effect on the n-3 EFAs.

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