Trigeminal trophic syndrome (TTS) is a rare cause of facial ulceration, which is believed to develop after insult to the trigeminal ganglia or other parts of the peripheral/central nervous system in the trigeminal pathway. The pathogenesis of TTS is poorly understood. Developing a better understanding of TTS will allow early recognition and improved treatment. Although the ulcers develop predominantly on the ala nasi, the literature on ulcer locations is limited. In this article, we review the epidemiologic aspects of TTS, expand on our knowledge of the anatomic location of the ulcers, and discuss current theories for its aetiology and briefly review the approaches to its management.

Excimer is a useful and effective treatment for psoriasis that may be used as a compliment to topical medications as well as NB-UVB. However, large randomized trials with long-term follow-up are needed to further support this.

EditorAlopecia often frustrates clinicians and patients because of the lack of clear aetiology and treatment options. Androgenic alopecia, in particular, is a challenge because of the perceived obvious diagnostic clinical presentation. This 'classic presentation' is exemplified by the frequency with which the diagnosis is often made using only the physical exam. In this report, we sought to determine how often the clinical diagnosis was supported by the histological diagnosis.A search was preformed on our dermatopathology database from 2007 to July of 2009. The search was preformed without identification of patient data except for any clinical history that was provided by the physician for pathologist use. Submitted tissue samples were limited to those from dermatologists trained by ACGME accredited dermatology residency programmes. Samples were collected based on two criteria with (i) those listing only non-scarring and non-inflammatory alopecias in the clinical impression and (ii) those listing non-scarring (a) (b) (c) (d) Figure 2 Clinical features: (a) webbed fingers, pseudosyndactyly and nail dystrophy; (b) poikiloderma on the neck; (c) whitish plaques on oral mucosa; (d) skin atrophy with 'cigarette-paper'-like wrinkling on the dorsa of the hands. LETTERS TO THE EDITOR 979 ª 2010 The Authors JEADV 2010, 24, 974-985 Journal compilation ª

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