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Tear gas dermatitis

treat mycosis fungoides. In the case presented there were significant advantages to the use of topical PDT in view of the location and size of the lesion. PDT is a safe, relatively selective, noninvasive procedure, which is administered as an out-patient and associated with excellent healing and minimal or no scarring. This patient was treated on three occasions (following gentle surface preparation using a disposable curette, without local anaesthetic) with topical 5-aminolaevulinic acid (ALA) PDT at 3-monthly intervals using 20% ALA in unguentum merck (Crawford Pharmaceuticals, UK) applied under occlusion. Six hours later, excess ALA was removed and strong disease-localized fluorescence of protoporphyrin IX (PpIX) was seen under Wood’s light examination (Fig. 2). Subsequent irradiation was performed using a halogen lamp (570–680 nm, irradiance 98–130 mW ⁄ cm, 125 J ⁄ cm, Curelight, Photocure , Norway). Treatment was well tolerated by the patient with the application of tetracaine gel (Ametop ) under occlusion for 1 h preirradiation and the use of a fan during treatment. Clinical clearance of disease was achieved after one treatment, but reports in the literature suggest that multiple treatments are required for histological clearance of mycosis fungoides. We therefore performed a further two PDT treatments which resulted in both clinical and histological clearance of disease. Clinical clearance has been maintained 1 year after the third and final PDT treatment (Fig. 1c). Histological confirmation was obtained 2 months after the last treatment (Fig. 1d). This is the first reported case of successful clinical and histological clearance of localized pagetoid reticulosis (Woringer–Kolopp disease) by topical PDT.