Notes: In order to assess the impact of eczema on the lives of affected individuals a postal questionnaire was sent to all members of the National Eczema Society (NES). The survey also sought to ascertain their expectations of their initial consultation with general practitioners and hospital doctors; to assess their satisfaction with these consultations; to obtain their views on the treatment prescribed, and their reasons for joining the NES.Information on 1972 adults (614 male, 1358 female) and from 1944 parents of affected children was received, representing an overall response rate of 29%. The work of 1061 (54%) adults, and the choice of career of 391 (20%) had been affected. Eczema affected the ability to perform domestic duties in 1128 (83%) women compared with 439 (71%) men. Social and leisure activities were affected in 1269 (64%) of adults. The development of personal relationships had been impaired in 273 (14%), and the sex lives of 373 (19%) had been affected. In children sleep (60%) was the most commonly affected activity.The expectations of the initial consultation with their general practitioner of 659 (17%) had not at all been met, of 2528 (65%) partly met, and of only 483 (12%) completely met; 2638 patients had seen a hospital specialist. The expectations of 478 (18%) had not at all been met, of 1164 (62%) partly met, and of only 512 (19%) completely met. Forty-lour per cent (1713) were either‘extremely satisfied’or 'satisfied’with the treatments they had been given, 1529 (40%) were‘neutral', 480 (12%) were dissatisfied, and 103 (2·6%) were extremely dissatisfied. Seventy-two per cent of the respondents stated their main reason for joining the NES was to obtain further information about eczema and its treatment. Only 10% wished to be put in touch with other sufferers.Members of patient support groups arc likely to be highly motivated. This may be due to increased severity of disease, increased anxiety or increased dissatisfaction with treatment. Thus it may be difficult to generalize from the results of this survey, particularly as the response rate was 29%. However, the results do reveal the considerable effect of eczema upon the lives of affected individuals. It also revealed much dissatisfaction with patients’initial consultations with both general practitioners and hospital doctors. Patients require from doctors not only treatment and diagnosis, but also an explanation as to the nature of eczema and advice on how to use the treatments prescribed. These requirements are reflected in their reasons for joining the NES.

Notes: Summary The lines of Blaschko describe a distribution pattern which may represent embryologlcal development pathways. The distribution may occasionally be followed by some skin disorders. We report a patient who had multiple lesions of linear lichen planus which followed Blaschko's lines. There were multiple streaks affecting several different areas of the body.

Notes: Summary A 78-year-old man with a long-standing left-sided hemiplegia presented with bullous pemphigoid which affected his paralysed side only. Although the rash was unilateral, direct immunofluorescence demonstrated IgG antibody at the dermo-epidermal junction on both sides of the body. Indirect immunofluorescence was also positive. A suction-blister test showed increased skin fragility on the affected side.

Notes: Summary The plasma of patients with overt variegate porphyria contains porphyrin with a fluorescence emission maximum at about 626 nm, which is diagnostic for the condition. We have evaluated qualitative fluorescence emission scanning of saline-diluted plasma as a method for the identification of asymptomatic carriers of the gene for variegate porphyria. Plasma from 36 unrelated patients with variegate porphyria. 136 of their asymptomatic first- and second-degree relatives aged 15 years or over, and 322 normal subjects was scanned. An emission maximum between 621 and 627 nm was observed in the 36 patients with variegate porphyria and 54 of their relatives, but not in any normal subject, nor in 56 patients with other types of porphyria. For the detection of asymptomatic adult carriers of the gene for variegate porphyria. fluorescence emission scanning of plasma appears to be 100% specific, with a sensitivity of 86% (95% confidence interval 71–98%). In contrast, the sensitivity of faecal porphyrin analysis as a test for adult gene carriers was 36%. These results suggest that fluorescence emission scanning of plasma should replace faecal porphyrin analysis as the test of first choice for this purpose.