Supernumerary Mammary Gland in the Vulva

increase. The patients who proved refractory to this form of treatment had received recent systemic therapy with triamcinolone. Chronic Eczema and Pompholyx of Hands.-It was found that cases falling into this category required fullstrength fluocinolone or triamcinolone ointments or cream applied generously under polythene gloves made airtight at the wrist to achieve a good result. The onetenth strength fluocinolone cream, which works well with thin plaques of psoriasis, produced no benefit or made the patient worse. Six of the cases which did well and remained in a comfortable state were using the gloves and cream once or twice weekly. The cases that showed the best response were those with a fissured eczema of the palms and fingers. Only one case of true pompholyx with frank vesicles on the hands and fingers was benefited. Four other cases of pompholyx worsened; two of these had discontinued systemic steroid therapy within a month of starting the new treatment and it was to be expected, on this account, that they might prove refractory to local treatment. Atopic Dermatitis.-Three adults and four children were treated and within three days lichenified patches affecting the antecubital and popliteal fossae, and lichenified patches on the wrists, showed a striking response with cessation of itching. The one case where treatment was stopped was due to the development of boils under the dressings, though here there was initial improvement so far as the disappearance of his lichen ified and eczematous patches were concerned. The most gratifying case was that of a West Indian negro child with exudative patches on his face. One week of in-patient treatment with four-hourly inunction of triamcinolone cream produced little improvement. A dramatic response was noted within 24 hours of applying the same cream under a polythene mask which covered the cheeks only. He relapsed on return home, as his mother had neither the time nor the patience to continue with the treatment. Lichen S.mplex Chronicus.-There was good response in all cases, with uniform flattening of the lesions. The results achieved were better than those that might have been expected from intralesional injection with triamcinolone. Pustular Bacterid of Soles of Feet.-Small polythene bags were used, made airtight around the ankles with scotch tape. All cases had been under treatment for over a year; some had received local triamcinolone by injection and x-ray therapy. All the cases, save one, showed a 70-90% resolution of their lesions within a week. The vesico-pustules desiccated and the surrounding eczematized skin became pink and glazed. One woman doctor patient said that it was the only treatment which had helped her in ten years. Miscellaneous Group.-This group comprised three cases of chronic discoid eczema, two cases of lichen planus hypertrophicus, two cases of keratosis pilaris, and one case of ichthyosis simplex. Their response to the polythene technique was in contrast to their relative lack of response to the same local preparation applied without the polythene covering.