Library

Notes: A series of eleven comparative wart treatment trials undertaken between 1969 and 1975 and involving 1802 patients is described. A method of coding provided groups of patients matched for age, type, number and duration of warts, within which treatments could be randomized. The variation in response to treatment was shown to be influenced significantly by these factors and the level of cure to depend on the proportions of the various response groups within the population under consideration. These proportions were found to vary geographically and at different periods. In all the trials the results were assessed at 12 weeks.In the treatment of hand warts, the percentage cure of patients treated with liquid nitrogen fell significantly from 75 to 40% when the interval between freezings was increased from 3 to 4 weeks. The average number of freezings required for a cure was 3 I amongst all patients cured by 6 or less freezings at intervals of 2 or 3 weeks.In a two–centre trial there was no significant difference between the percentage cure of patients with hand warts treated with liquid nitrogen (69%) and of those applying a paint containing salicylic and lactic acids (SAL) (67%). Patients receiving both treatments concurrently did better (78%) but the difference was not found to be statistically significant.In the treatment of simple plantar warts the percentage cure for the SAL paint (84%) was found to compare favourably with that for a podophyllin treatment (81%). Only one of the patients cured by the paint in that trial was found to have had a recurrence after 6 months. The paint was found to be satisfactory for use under general practice conditions. Additions to the formula did not alter its effectiveness.In the treatment of mosaic plantar warts the overall percentage cure for the SAL paint in a series of comparative trials (1969–75) was 45%. In these trials it was compared directly with one or more other preparations. No differences were found between its efficacy and that of 10% buffered gluteraldehyde (47%), 40% benzalkonium chloride dibromide (Callusolve 40) (30%) and 5% 5-fluorouracil in dimethyl sulphoxide (53%). Only 25% of thirty-six patients treated with 5% idoxuridine in dimethyl sulphoxide were cured.Throughout the trials approximately 30% of patients with hand warts, 2o% of those with simple plantar warts and 50% of those with mosaic plantar warts were found to be resistant to treatment.The adoption of treatment with SAL paint for hand warts and simple plantar warts by the general practitioners in the Edinburgh area has proved satisfactory. Only resistant cases are now referred to hospital and these can be treated within a few weeks instead of 4-5 months as was the case in 1969.

Notes: SUMMARY. The source, nature and properties of propolis (bee g̀lue) are described and the world literature on propolis dermatitis is reviewed. Propolis has been shown by a field survey to be a significant cause of occupational dermatitis in beekeepers in Britain, of which at least 0·05% are probably affected.Fourteen proven cases are recorded and 11 possible cases are mentioned.The clinical features are described and the possible effects of the volatile fraction of propolis are discussed. Prophylactic measures are suggested.Patch tests were carried out with propolis from different sources. Balsam of Peru, poplar and other tree resins, the volatile fraction of propolis and certain cinnamic derivatives.It is concluded that the allergens in propolis are derived mainly from poplar but also from other tree resins. None of the cinnamic derivatives so far tested appears to be the principal allergen involved.

Notes: SUMMARY.— A case is reported of molluscum contagiosum on the sole of the foot, which was diagnosed virologically. The difficulty of making the diagnosis on clinical grounds in this site is emphasized. The diagnosis may rather be missed than rare.

Notes: Fish handlers frequently suffer from hand warts. The clinical form and HPV type in these lesions were studied. Eleven individuals (10 fishmongers and one fisherman) with multiple hand warts were examined clinically and samples from their warts examined by Southern blot and reverse blot analysis. Clinically, with one exception, the warts were of the common type. HPV DNA was detected in all but one individual. HPV4 was found in one sample, HPV1 related virus in three, a virus hybridizing with both HPV27 and HPV2 in five (four individuals) and HPV7 in seven (six individuals). More than one type was detected in four individuals. HPV7 infection was related to the greater length of time spent in handling fish. These findings indicate that HPV7 is not, as was previously thought, found exclusively in those handling butcher meat and suggest that environmental conditions may be a factor in the clinical manifestation of HPV7 infection. The exact nature of a virus designated HPV2/27 and the significance of its presence in these fish handlers remains uncertain.