hereditary. Psoriasis is found in two thirds of all adult white males but is rarely found in blacks. SYMPTOMS—It   is   clearly   defined   erythe- matous papules covered with shiny or opalescent scales. The patient may complain of itching. The lesions are usually self-healing and heal without scarring. The  scalp,  extensor  surface  of extremities, back and buttocks, and the nails are the most common sites. A secondary bacterial in- fection  may  occur. TREATMENT—There  is  no  known  cure  for psoriasis.  The  existing  treatments  may  produce temporary  relief.  Corticosteroid  cream  is  the  most widely  acclaimed  of  the  various  treatments  and should  be  applied  at  bedtime.  Cover  the  lesions with polyethylene strips during the night. In the morning scrub the lesions thoroughly with a soft brush to remove scales. Repeat the treatment until the sysmptoms are relieved. Refer the patient to a dermatologist for routine evaluation. There are other  treatments t  resting  psoriasis. a  dermatologist. Acne that  may  prove  effective  in Request  advice  on  them  from Acne   is   probably   the   most   commonly encountered  dermatitis.  It  is  an  inflammatory disease  occurring  in  areas  where  sebaceous  glands are the largest, most numerous, and most active. Human sebum is a tissue irritant. Overfilling of the sebaceous glands or squeezing by the patient causes  this  irritant  to  escape  into  the  surrounding tissue  and  develop  a  papule.  A  secondary bacterial  infection  occurs,  leading  to  pustule  or cyst  formation.  These  formations  may  lead  to pitting  and  scarring. TREATMENT—The initial treatment of acne should  include  advice  to  the  patient  to  avoid contributing  foods,  such  as  chocolate,  nuts,  and colas. Vitamin A supplements are sometimes given for 3-month periods, with a l-month interruption to avoid hypervitaminosis. Intruct the patient to thorougly wash twice daily with an antibacterial, abrasive  soap.  A  drying  lotion  may  be  used.  A broad-spectrum antibiotic administered systemi- cally  may  be  given  during  episodes  of  severe  acne. Tetracycline  is  the  most  widely  used  of  these drugs.  Use  of  this  regimen  should  be  restricted to  only  the  most  severe  cases  due  to  the  side effects of tetracycline or other antibiotics of this type. Seborrheic  Dermatitis This  is  an  acute  or  chronic  scaly  inflamma- tion of the skin that usually affects the scalp, face, presternal   and   interscapular   areas,   and   body folds.  It  occurs  in  persons  with  oily  skin.  Also, hereditary  factors  appear  to  play  a  part  in  this condition. SYMPTOMS—These include scaling that may be  greasy  or  dry  and  sometimes  pruritic.  Redness, fissuring,  and  infection  may  be  secondary. TREATMENT—A  well-balanced  diet  with the   reduction   of   sweets   is   indicated.   Steroid creams  and  lotions  are  often  beneficial,  and  the patient  should  be  advised  to  wash  with  an antiseborrheic  cleanser,  such  as  Fostex^®. Urticaria (Hives) This is an acute or chronic allergic inflamma- tory  skin  reaction.  It  is  normally  the  result  of ingesting   certain   foods   or   drugs   (commonly shellfish,  eggs,  milk,  and  penicillin). SYMPTOMS—Raised wheals may occur over any  or  all  of  the  body  and  itch  intolerably.  The patient  may  run  a  mild  fever  and  experience general  malaise.  Swelling  may  cause  laryngeal obstruction. TREATMENT—Antihistamines are indicated for itching. Urticaria is usually self-limiting, but may last for years. Caution the patient to avoid reexposure   to   sensitizing   foods   or   drugs. Epinephrine   1:1000   may   be   administered   for laryngeal  obstruction. Calluses and Corns These are callous skin lesions that normally occur on the feet or toes. Faulty fitting shoes are the  common  cause. SYMPTOMS—There is usually tenderness or sensitivity  to  pressure.  These  lesions  may  be differentiated  from  plantar  warts  by  their glassy  cores. TREATMENT—Soak  the  affected  area  in warm   water   and   carefully   pare   the   callus. Correct any orthopedic abnormalities, and make sure  the  patient’s  shoes  fit  correctly. 2-24