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By Bethel Solomons (Auth.)

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M A L I G N A N C Y . — H o d g k i n ' s d i s e a s e , t u m o u r s of t h y r o i d . D i a g n o s i s . — B y t e n d e n c y t o bilateral s y m m e t r y , t h e r e d colour, p r e d i l e c t i o n for b a c k of h a n d s a n d feet, r i n g e d l e s i o n s , a n d a b s e n c e of i t c h i n g . F r o m : (1) U r t i c a r i a ; s m a l l , i t c h y w h e a l s , r a r e l y s y m m e t r i c a l . (2) D r u g e r u p t i o n s ; b y c a r e f u l h i s t o r y t a k i n g . (3) O t h e r s y m p t o m a t i c c a u s e s : see above.

A G E . — M a y a p p e a r a t a b o u t 2 y e a r s of a g e , o r l a t e r , u p t o a d u l t life. I N H E R I T A N C E . — D i s e a s e m a y a r i s e de novo b y m u t a t i o n o r a s simple d o m i n a n t . S E X . — M a l e s c o m m o n l y affected. S E A S O N . — W o r s e in s u m m e r . M E T A B O L I S M . , f a i l u r e of cells t o u t i l i z e t h e v i t a m i n p r o p e r l y . P a t h o l o g y . — H y p e r k e r a t o s i s , e s p e c i a l l y of follicles, a n d a c a n t h o s i s a r e p r e s e n t .

T r a n s m i t t e d as a regular dominant. P a t h o l o g y . — K e r a t o t i c edge shows hyperkeratosis with a groove containing a h o r n y plug, t h e cornoid lamella, whose centre consists of p a r a k e r a t o t i c cells. A c a n t h o s i s m a y a l s o b e p r e s e n t . The a t r o p h i c c e n t r e s h o w s a t r o p h y of t h e prickle-cell l a y e r a n d fibrosis of t h e u p p e r d e r m i s . C l i n i c a l F e a t u r e s . — O n s e t g r a d u a l . E a r l y lesion is t i n y , firm, d r y , h o r n y p r o j e c t i o n ; a r o u n d it, flat-topped h o r n y lesions d e v e l o p , a n d projection slowly subsides.

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