Correspondence

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The actions of this drug in psoriasis are not yet fully understood, and certainly the drug appears to have other actions than blocking DNA synthesis. PETER GOODWIN SUSAN HAMILTON LIONEL FRY

St Mary's Hospital, London W.2

REFERENCES GOODWIN, P., HAMILTON, S. & FRY, L . (1974) The cell cycle in psoriasis. British Journal of Dermatology, 90, 517. GROVE, G.L., ANDERTON, R . , SMITH, J . G . & GELFANT, S. (1974) Cytophotometric studies of the cell cycle in

psoriasis. J'oMrna/ of Investigative Dermatology, 62, 538. IvERSEN, O.H. & EvENSEN, A. (1962) Experimental skin carcinogenesis in mice. Acta pathologica et microbiologica Scandinavica. (Suppl.), 156, 97. QuASTLER, H. & SHERMAN, F . G . (1959) Cell population kinetics in the intestinal epithelium of the mouse. Experimental Cell Research, 17, 420. WEINSTEIN, G . (1971) Biochemical and pathophysiological rationale for methotrexate in psoriasis. Annals of New York Academy of Sciences, 186, 452. WEINSTEIN, G . & FROST, P. (1968) Abnormal cell proliferation in psoriasis. Journal of Investigative Dermatology, 50, 254. WEINSTEIN, G. & HOUSMAN, R. (1972) Interrelationship of epidermal proliferative and differentiated cell kinetics. Journal of Investigative Dermatology, 58, 265.

MYCETOMA AND TRICHOPHYTON RUBRUM SIR, I recently read the publication, 'Mycetoma formation in Trichophyton rubrum infection', by Burgoon et al. (1974). The case presented by these authors closely resembles a patient described by us (Thome & FusarOj 1971). Our patient also developed small lumps on the lower extremities that slowly enlarged and discharged pus. Of note, our patient was also taking prednisone, 30 mg a day, at the time of the onset of her Trichophyton rubrum abscesses. We were fortunate in our case to be able to demonstrate the organism by culttire and by direct microscopy. I believe these two cases support the concept that an innocuous organism, such as Trichophyton rubrum, can cause a spectrum of diseases all the way from a chronic scaling dermatosis of the foot to subcutaneous abscess and even mycetoma abscesses. When patients taking steroids, even in low doses, develop abscesses, we should always look for an organism like T. rubrum which may respond to griseofulvin. GEORGE THORNE

Veterans Administration Hospital, Denver, Colorado 80220, U.S.A. REFERENCES BURGOON, C.F., BLANK, F., JOHNSON, W.C.

&

GRAPPEL, S.F.

(1974) Mycetoma formation in Trichophyton rubrum

infection. British Journal of Dermatology, 90, 155. THORNE, E. & FUSARO, R. (1971) Subcutaneous Trichophyton rubrum Abscesses. Dermatologica, 142, 167.

Letter: Mycetoma and Trichophyton rubrum.

Correspondence 2fl The actions of this drug in psoriasis are not yet fully understood, and certainly the drug appears to have other actions than blo...
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