Atrophie blanche. Report of two patients treated with aspirin and dipyridamole.

Atrophie blanche was originally attributed to syphilis or tuberculosis, but recent investigators have generally implicated a localized cutaneous vasculitis. In an attempt to inhibit the occlusive vascular changes believed responsible for the cutaneous lesions, drugs such as phenformin and ethylestrenol, which increased the blood fibrinolytic activity, were used with favorable results. When phenformin was taken off the market, the use of drugs that act by preventing platelet aggregation was suggested by encouraging results in the management of other occlusive vascular disorders such as coronary artery disease and stroke. Excellent results are reported in two cases of atrophie blanche treated with two anti-platelet-aggregating medications, aspirin and dipyridamole (Persantine). It is imperative that low doses of aspirin be used, since high doses have the effect of increasing the thrombotic tendency by preventing prostacyclin formation.

Elephantiasis nostras.

Elephantiasis nostras is one of the most striking yet, at the same time, one of the most poorly understood dermatologic entities. We present a report on two patients with this disorder, each of whom had a marked enlargement of a lower extremity following recurrent attacks of infection and/or ulceration. In one case obesity and chronic cardiac disease may have been aggravating factors. In the second, the enlargement and deformity was severe enough to require amputation of the foot and lower leg. Study of these and other cases may lead to further insight into the pathogenesis of elephantiasis nostras.

Bowen's Disease of the Finger.

Four cases of Bowen's disease of the finger have been treated, three during the past two years. This form of carcinoma-in-situ should be considered in the differential diagnosis of any persistent scaly and/or crusted lesion of the finger. Bowen's disease in this particular site may be more common than the literature suggests.