Number 1

Abstract

For the past several years small blisters which were slow to heal appeared at the sites of trauma on the dorsum of his hands. The skin unprotected by clothing is getting darker. The patient has been a heavy drinker of whiskey. Examination of his urine in a Wood's light shows a pink rather than normal yellow fluorescence. As in some patients with porphyria cutanea tarda, his porphobilinogen is elevated. Avoidance of alcohol and barbiturates is the only important therapeutic advice known. These superficial vesicles which appeared suddenly are typical of chickenpox. The early crust in the center of the large vesicle is noteworthy. A simple method of confirming the diagnosis in the laboratory is the demonstration of multinucleate giant epithelial cells in Wright-stained smears of the cellular material from the base of the vesicle. Systemic steroids have caused fatal dissemination of the virus and are contraindicated. Marked