1. Gupta AK, Matteson EL, Ellis CN, et al. Cyclosporine in the treatment of psoriatic arthritis. Arch Dermatol. 1989;125:507-510. 2. Ellis CN, Gorsulowsky DC, Hamilton TA, et al. Cyclosporine improves psoriasis in a double-blind study. JAMA. 1986;256:3110-3116. 3. Stern RS. Risk assessment of PUVA and cyclosporine. Arch Dermatol. 1989;125:545-547. Alternatives to PhotographyTo the Editor.\p=m-\The recent spate of articles on photography of dysplastic nevi certainly creates medicolegal problems. The standard of care must vary with the availability of elaborate equipment, facilities, and the cost. Although some patients have numerous suspicious lesions, most do not. It is about this latter group that I write. The Polaroid camera shots provide an accurate, immediate photograph of a suspicious lesion at a cost of about $2 (1989). Even such shots of ten lesions at $20 is far below the cost of $100 mentioned by Slue and Knopf1,2 (now $125). Also, consider that follow\x=req-\ up may be needed at 6to 12-month periods. I am further intrigued by identification of the location of the photographic lesion. There are alternative ways to do this without photography! A recent article mentioned the use of tattooing to permanently mark the location of an important lesion, especially those needing surgical attention, which has to be postponed for a variety of reasons, such as travel, intervening ill¬ nesses, finances, or search for a special or different physi¬ cian. I have found this type of tattooing to be very useful for many years. I have used india ink, although other markers can be considered, such as silver nitrate, graphite (lead pencil), or ferric chloride. A hypodermic needle, hammered flat, will pick up an adequate amount of india ink to make a permanent tiny mark. This flattened needle avoids exces¬ sive capillary filling. This mark is readily identified when looked for, yet is almost invisible to the casual eye. The tat¬ toos of black-skinned patients may be best done with silver nitrate solution.I learned my tattooing technique from Charlie Wagner and Harry the Horse-famous New York Bowery tattoo artists. Charlie told me he inserts his needle at an angle in order to "shovel" the material more effectively into the skin.My tutelage came about when it was popular to tattoo cinnabar (red) pigment into pruritic areas, especially for pruritis ani! My purpose in describing the use of tattoos in the care of dysplastic nevi is threefold, and will hopefully appeal as an easy, accurate, and low-cost method. I have long identified my patients' lesions by mentioning the area, such as malar, temple, right or left cheek, or ala nasi, followed by the measured (in centimeters) distance from two or even three prominent markers, such as the tragus, the inner canthus of the eye, or the cubital fossa.This localization is not only easy, but can be further helped by a tattooed number, if the lesion warrants. This number can be accurately accomplished by the use of the braille capital lettering system, such as we see in elevators. ...