SHORT COMMUNICATIONS

Case Report A 35-year-old man had had psoriasis from age 7 years. He had used various topical corticosteroids and, more recently, topical calcipotriol, with little benefit. He then tried a proprietary non-prescription cream called PsorigonA. His psoriasis improved during the 1st month of treatment, but thereafter, the cream appeared to worsen his psoriasis and cause pruritus. After 5 weeks of treatment, he stopped using PsorigonA. On examination, he had widespread psoriasis with superimposed eczema. A potent topical corticosteroid was prescribed and he was patch tested to the European standard series, a corticosteroid series and PsorigonA cream as is. On D4, he showed a ππ reaction to PsorigonA, all other allergens being negative. Subsequently, he was patch tested to serial dilutions of PsorigonA (as is, 50%, 25% and 12.5%) and also to a new formulation of PsorigonA (PS-98A). Positive patch test results were obtained with both formulations at all dilutions. 12 volunteer controls demonstrated negative patch tests to PsorigonA. He was then further patch tested against the ingredients of this formulation. Samples of the herbal ingredients (Cistus labdaniferus, Salmo, Melia azadirachta, Oenothera biennis (evening primrose), Quercus robur (oak) and Cereus (syn. Cactus) grandiflorus) were obtained from the manufacturer. Dilutions of 1%, 2%, 5%, and