The accidental intra‐arterial injection of the commonly used sclerosant sodium tetradecyl sulphate (S.T.D.) 3 per cent during the treatment of varicose veins can affect seriously the blood‐supply to the limb, and gangrene may follow. Intra‐arterial injection of S.T.D. into the limb arteries of dogs chemically disintegrates the blood in the slow‐moving stream of the capillaries and converts it into a thick sludge which obstructs the circulation locally, resulting in necrosis of the extremity.

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Pathologist, Our Lady's Hospital for Sick Children, CVumlin. Dublin, HEINZ body anaemia is a well recognized hazard in the treatment of dermatitis herpetiformis with dapsone (diamino-diphenyJ-sulphone) or sulpiia]>yridine. As effective therapy in this clironic and distressing skin disease is almost limited to this group of drugs, the occurrence of toxic side effects often makes the control of the skin condition difficult. The toxic effects include Heinz-body anaemia, leucopenia or agranulocytosis, drag rashes, liver damage and mental depression.Smith and Alexander {1959), reviewing the literature and adding four cases, stressed the usefulness of assessing the Heinz-body content of the blood as an index of haematological damage in dapsone anaemia. More recently Hutchison, Jackson and Cassidy reporting five more cases of daijsone and sulphapyridine anaemia, reiterated the advantage of the demonstration of Heinz bodies in detecting early damage. They also reported that the glucose-6-phosphatedehydrogenase activity of the patient's red cells was not deficient, clearly showing tiiat it is not necessaay to postulate an inborn defect of red cells to explain this form of dapsone Heinz-body anaemia.The purpose of the report is to add to the literature two further cases of Heinz-body anaemia with leucopenia induced by dapsone and to report the effectiveness of adreno-cortical steroid therapy in controlling the toxic side <'ffects of dapsone therapy. CASE REPORTS.The two children, aged 2 and 3 years respectively, were admitted to the skin department of this hospital with a diagnosis of juvenile dermatitis herpetiformis. The clinical diagnosis was supported by the finding of eoshiophiha, varying between 6 and H% in the first case and 12 to 32% in the second. Examination of blister fluids on hoth cases showed the presence of a high proportion of eosinophils and skin patch tests using 20% potassium iodide were positive in both, Sulphapyridine therapy was rapidly effective in controlling tho skin condition over a i)eriu(I of montlis but the drug was poorly tolerated, the two children being frequently unwell and out of sorts, vomiting after meals and suffering from anorexia.In June liiOl a course of dapsone 50 mg. daily, with prednisolone 10 mg. daily was prescribed for both cfiildren and the sulphaj>yridine discontinued. The combined therapy controlled the blister formation satisfactorily. In July the dapsone was VOL. 76,