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An in vitro technique was used to measure the monochromatic protection factors of all emollients available on prescription. The action spectra for ultraviolet erythema and erythema in psoralen-sensitized skin were used to calculate, for each emollient, erythema protection factors relevant to UVB phototherapy and psoralen photochemotherapy, respectively. Of the 40 products tested, 22 (55%) had a UVB erythema protection factor > 1.2 at an application density of 2 microliters/cm2, and 31 (78%) at an application density of 4 microliters/cm2. Fewer products, 25% at 2 microliters/cm2 and 50% at 4 microliters/cm2, had a psoralen erythema protection factor > 1.2. A protection factor of 1.2 is equivalent to a reduction in ultraviolet dose of 17%, and is thus likely to be of clinical importance. These results allow a choice of emollient products which may improve response by increasing transmission of radiation through psoriasis scale without a concomitant decrease in transmission due to a sunscreening action.

Patients frequently request removal of benign papular naevi for cosmetic or functional reasons. Shave excision plus electrocautery is probably the most widely used method of removal, but this method is said to result in retained hair or pigment if deeply pigmented or hairy naevi are treated. In a prospective study, 82 benign papular naevi of all types were treated by shave excision using hot-wire electrocautery for haemostasis. Details of the naevi were accurately recorded before treatment and reassessment of shave sites carried out at 6-8 months. At review, a scar was visible at only 63% (52/82) of shave sites and all of these were cosmetically acceptable. Only 27% (15/55) of the initially pigmented naevi retained pigment and only 24% (5/21) of the initially hairy naevi regrew hair. Shave excision and electrocautery of benign naevi, including hairy and deeply pigmented ones, produce excellent cosmetic results. The patient must be warned that there is a potential risk of a scar or pigment remaining after shave excision of any naevus and for hair regrowth after shave excision of hairy naevi.

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