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General description Chemical peeling is a procedure frequently used to treat unaesthetic cutaneous alterations such as photoageing, actinic keratosis. chloasma, senile lentigo, and post-acneic scars as well those of a non-strictly aesthetic nature such as seborrhoeic keratosis and flat warts. Several chemical agents are used depending on the depth of peeling to be obtained. The most commonly used agents are: alpha hydroxy-acids, resorcinol, Jessner's solution, and trichloroacetic acid. In the present study the characteristics of the individual substances, technical procedure, and applications are taken into consideration. Finally, the main risks and side-effects, depending on the depth of peeling, are considered.Learning objective The reader will have learned what a chemical peeling is, what chemical agents are available, and how to perform chemical peeling in the office. The mechanism of action of different chemical agents, expectations from this procedure, potential risks and complications are also reviewed with insight into criteria for selecting patients.

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Disabling pansclerotic morphea of childhood (DPMC) is an aggressive form of cutaneous scleroderma that involves all layers of the skin, extending through the dermis and subcutaneous tissues to involve muscle, tendon, and even bone. As DPMC is extremely rare, its association with skin squamous cell carcinoma (SCC) is rarer still. To our knowledge there are only two cases of SCC in patients with DPMC that developed within areas of chronic skin ulceration. We report the first case of lower lip squamous cell carcinoma arising in a young woman with DPMC and discuss the carcinogenic pathway that may have led to its occurrence.

Objectives To investigate clinical, serologic. histopathologic and immunopathologic markers of PURPLE (painful purpuric tilccrs wit[i reticular pattern of lower extremities) or atrophie blanche.Design Twelve consecutive patients affected with idiopathic PURPLE were studied in ihc period 1992-1996. Patients with systemic diseases correlated to PURPLE were excluded from the study.Subjects All iwelve patients were hospitalized at (he Istituto Dcrmopatico Immacolata in Rome.Results Various and dishomogeneous immunt)logieal alterations were delected. Circulating immune complexes, increased serum levels of anticardiolipin and antinuclcar antibodies, reduced serum complement levels, and deposition of immunorcactants in dermal vessels, were found in a limited number of patients. The results were not statistically significant. All the patients showed very similar histopathological aspects, characterized by microvascular thromboses, endothelial swelling and scgmentai hyalinizalion of small dermal vessels.Conclusion PURPLH is a thrombogenic vaseulopathy in whieh unspeeitied immunological and laboratory changes are present. The recently suggested pathogenetic role of anticardiolipin and protein C deficiency in the disorder is not contirnied by this study. © 1997 Eisevier Science B.V.Kewiords: PURPLE; Atrophie blanche; Thrombogenic vaseulopathy 0926-9959/97/$17-()0 © 1997 Eisevier Science B.V. All rijihts reserved P/l S()926-9959(97)OOO92-5