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One hundred and sixty-three community volunteers were interviewed and examined. After a decade, the 69 survivors were again interviewed and examined. The incidences of their skin changes and lesions were recorded and interrelationships sought relative to internal and external signs of aging. Asteatosis of moderate or severe degree, large numbers of scrotal angiomas in men, and retention of nevi appeared to be associated with a relatively shortened life expectancy and may be signs of decline and approaching death in older individuals.

Aseptic (avascular) necrosis of the femoral head associated with psoriasis is reported. The clinical histories of nine patients with avascular necrosis of the femoral head and one patient with bilateral humeral head osteonecrosis are summarized. Psoriasis was the only associated condition found in three of the patients. Only two patients had received systemic corticosteroids in significant amounts (greater than 1 gm of prednisone). Four patients had received methotrexate therapy for psoriasis. Other possible contributing factors including serum uric acid levels are discussed. Psoriasis should be added to the list of systemic diseases associated with aseptic (avascular) necrosis. Avascular necrosis of the femoral head should be considered in any patient with psoriasis and pain in the hip or thigh.

Chloracne, an acneform eruption resulting from poisoning by halogenated aromatic compounds, has been a considerable problem over the last 40 years. The condition is always a symptom of systemic poisoning and should be familiar to all practitioners, particularly dermatologists. It is difficult to treat and can last for long periods without known additional exposure to chloracnegens. Some chloracnegens are capable of causing a variety of systemic signs and symptoms and may be oncogenic. Although there are probably fewer than 4,000 persons with chloracne worldwide, those found with the disorder should be evaluated medically on a regular basis and followed, if possible, throughout their lives.

The use of methotrexate in psoriasis has recently been questioned because of possible carcinogenic potential. Two hundred twenty-four patients began methotrexate therapy during 1960 to 1965 at the Cleveland Clinic and at Duke University Medical Center. The incidence of malignant neoplasms and mortality has been studied in 205 of these 224 patients. Mortality increased with hepatic disease. No increased incidence of total internal malignancy was found, nor did any one type of neoplasm appear predominant.