Australasian Journal of Dermatology (2002) 43, 309–310
S IGN S, SYN DROM ES AND DIAGNOS ES
Isolated lichen planus of the lip
Roberto Cecchi and Andrea Giomi
Department of Dermatology, Spedali Riuniti, Pistoia, Italy
SUM MARY
Lichen planus (LP) is an inflammatory disease that
may involve multiple skin sites as well as mucous
membranes, hair follicles and nails. It rarely occurs on
the lips and usually then in association with oral
lesions. We report a 43-year-old man with a 7-month
history of inflammation and erosive lesions of the
lower lip. Histopathological and immunofluorescence
studies showed features of LP. Local treatment with
betamethasone dipropionate 0.5% ointment led to
complete resolution within 1 month. Four months
later, the patient developed typical cutaneous LP.
Isolated LP of the lip is unusual, although this con-
dition may be underestimated and therefore under-
reported in the literature.
Key words: erosive lesions, inflammatory disease,
lower lip.
CASE REPORT
A 43-year-old man presented with a 7-month history of
swelling and burning of his lower lip. Clinical examination
showed erythematous and whitish patches, reticular streaks
and ulcerated areas along the vermilion border of the lower
lip (Fig. 1). The upper lip and oral mucosa were normal. The
remainder of the skin, mucosal surfaces, hair and nails
showed no alterations. The patient was otherwise healthy
and had no previous history of any skin disorder or recent
drug intake. Laboratory investigations, including renal and
liver function, serology for hepatitis A, B and C, and anti-
nuclear antibodies were normal. Standard Italian patch
testing, as well as patch testing with mercury compounds,
were negative.
Histopathological examination of a biopsy specimen from
a non-ulcerated area of the lower lip disclosed orthokera-
tosis, hypergranulosis, irregular acanthosis, liquefaction
Correspondence: Dr Roberto Cecchi, UO Dermatologia, Ospedale
di Pistoia, Viale Matteotti 1, 51100 Pistoia, Italy.
Email: a.giomi@mail.pt.usl3.toscana.it
Roberto Cecchi, MD. Andrea Giomi, MD.
Manuscripts for this section should be submitted to Dr L Spelman.
Submitted 10 July 2000; accepted 6 December 2001.
degeneration of the basal cell layer and a dense band-like
lymphocytic infiltrate in the lamina propria, obscuring the
epithelial–connective tissue junction (Fig. 2). Direct
immunofluorescence of lesional mucosa revealed immuno-
globulin (Ig)M, C3 and fibrinogen deposits in fluorescent
bodies. These findings suggested lichen planus (LP). The
patient was treated with topical betamethasone dipropionate
0.5% ointment, twice a day, with complete resolution within
1 month. No local recurrence was observed. Four months
later, a typical lichenoid papular eruption occurred on the
limbs. Histopathology confirmed the diagnosis of LP.
DISCUSSION
The isolated occurrence of LP on the lip has been well
documented in only three recent reports. 1–3 In all cases there
was diffuse involvement of the lower lip along its entire
length. One patient presented with erosive lesions with
swelling and crusting, which resolved completely with oral
acitretin and prednisone.1 Another case showed irregular
white streaks in a reticular pattern, which healed with
betamethasone valerate 0.1% cream.2 A third patient with
long-standing LP of the vermilion border and skin of the
lower lip was successfully treated with chloroquine phos-
phate.3 However, in these reports there was no mention of
subsequent manifestation of LP elsewhere. Another case of
isolated LP on the lip had been previously mentioned,4 but
no detailed report had been provided.
Lichen planus rarely occurs on the lips and usually then
in association with characteristic intraoral lesions. 5
However, in a recent series of patients with oral LP, no case
of lip involvement in association with cutaneous LP has been
reported.6
To our knowledge, no case of isolated LP of the lip followed
by cutaneous LP has been up to now described in the
literature based on searching the Medline database.
Lichenoid eruptions with oral involvement may also occur
as adverse drug reactions7 and oral lichenoid reactions to
amalgam restorations have been described in patients with
mercury sensitivity.8 Our patient denied any drug intake in
the weeks preceding the onset of his disorder and there were
no dental restorations in his anterior teeth.
On the lips, the differentiation of LP from lupus erythema-
tosus, actinic cheilitis and early carcinoma in situ may be
quite difficult, both clinically and histologically.9 In our
patient, histopathology was consistent with LP, with no
atypical keratinocytes in the epidermis and no solar elastosis
310 R Cecchi and A Giomi
Figure 1 Whitish patches and erosive lesions on the lower lip.
in the dermis. Direct immunofluorescence was also
suggestive of LP.
The development of carcinoma on the lips, as well as in the
oral cavity, is a rare but potential danger in patients with LP,
mainly with ulcerated lesions. 10 This complication should be
ruled out by biopsy.
We believe that our case is noteworthy for its peculiar
clinical presentation. Isolated LP of the lips is an unusual
event, although it has been suggested that the condition may
be underestimated and therefore under-reported in the
literature.2
REFERENCES
1. Itin PH, Schiller P, Gilli L, Buechner SA. Isolated lichen planus
of the lip. Br. J. Dermatol. 1995; 132: 1000–2.
2. Allan SJR, Buxton PK. Isolated lichen planus of the lip. Br. J.
Dermatol. 1996; 135: 145–6.
Figure 2 Histological features of lichen planus (H&E). Biopsy of
non-ulcerated inflamed lower lip.
3. De Argila D, Gonzalo A, Pimentel J, Rovira I. Isolated lichen
planus of the lip successfully treated with chloroquine
phosphate. Dermatology 1997; 195: 284–5.
4. Altman J, Perry HO. The variations and course of lichen planus.
Arch. Dermatol. 1961; 84: 179–91.
5. Silverman SJ, Gorsky M, Lozada-Nur F, Giannotti K. A pros-
pective study of findings and management in 214 patients with
oral lichen planus. Oral Surg. Oral Med. Oral Pathol. 1991; 72:
665–70.
6. Eisen D. The evaluation of cutaneous, genital, scalp, nail,
esophageal, and ocular involvement in patients with oral lichen
planus. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod.
1999; 88: 431–6.
7. Jainkittivong A, Langlais RP. Allergic stomatitis. Semin.
Dermatol. 1994; 13: 91–101.
8. Laine J, Kalimo K, Forssell H, Happonen R. Resolution of oral
lichenoid lesions after replacement of amalgam restorations in
patients allergic to mercury compounds. Br. J. Dermatol. 1992;
126: 10–15.
9. Toussaint S, Kamino H. Lichen planus. In: Elder D, Elenitsas R,
Jaworsky C, Johnson B Jr (eds). Lever’s Histopathology of the
Skin, 8th edn. Philadelphia: Lippincott-Raven, 1997; 151–84.
10. Marder MZ, Deesen KC. Transformation of oral lichen planus to
squamous cell carcinoma: A literature review and report of
case. J. Am. Dent. Assoc. 1982; 105: 55–60.
Australasian Journal of Dermatology (2002) 43, 311–312
VIGN ETTE I N CONTACT DERMATOLOGY
Sensitization to saw palmetto and minoxidil in
separate topical extemporaneous treatments for
androgenetic alopecia
Rodney D Sinclair, Rica S Mallari and Bruce Tate
Skin and Cancer Foundation, Melbourne, Victoria, Australia
SUM MARY
We report a 24-year-old woman with androgenetic
alopecia who became sensitized to topical minoxidil
following use of an extemporaneous preparation of
minoxidil 4% with retinoic acid in a propylene glycol
base. She subsequently also became sensitized to saw
palmetto (Serenoa repens), a topical herbal extract
commonly promoted for the treatment of hair loss.
Key words: contact allergic dermatitis, retinoic acid,
Serenoa repens, tretinoin.
CASE REPORT
A 24-year-old woman had been diagnosed clinically with
androgenetic alopecia and treated with a combination of
cyproterone acetate 100 mg daily for 10 days per month and
topical minoxidil 2% (Regaine®, Pharmacia).
After only 3 months of therapy, she sought a second
opinion from a hair treatment studio and was prescribed an
extemporaneous solution containing minoxidil 4% together
with retinoic acid 0.025% in a propylene glycol base. After
using the new solution for 10 days her scalp became
erythematous, scaly and developed superficial erosions.
Cessation of the solution led to improvement within 1 week,
however, rechallenge 2 weeks later led to a recurrence of her
symptoms after 24 hours. She was reviewed at the hair
treatment studio. In view of the persisting erythema, the
minoxidil/retinoic acid preparation was stopped and she was
dispensed an unlabelled extemporaneous preparation that
she was told contained saw palmetto. She began applying the
saw palmetto immediately. Within 2 weeks of using the
Correspondence: Dr Rodney Sinclair, Department of Dermatology,
St Vincent’s Hospital, 41 Victoria Parade, Fitzroy, Vic. 3065, Australia.
Email: sinclair@svhm.org.au
Rodney D Sinclair, FACD. Rica S Mallari, MD. Bruce Tate, FACD.
Manuscripts for this section should be submitted to Dr
M Rademaker.
Submitted 23 January 2001; accepted 25 April 2002.
saw palmetto solution she developed a recurrence of the
acute dermatitis on her scalp with secondary generalization
to the rest of her body. This rash was treated with betametha-
sone dipropionate (0.5 mg/g) cream and settled within
2 weeks.
Patch testing was conducted to the extended (50 allergens)
Skin and Cancer Foundation Victoria 1999 standard series
(Chemotechnique®, Malmo, Sweden, in Finn chambers on
Scanpor) as well as other possible allergens (Table 1).
Readings were taken at 48 and 96 hours.
Strong positive reactions were recorded for 1% minoxidil,
2% minoxidil and 2% Regaine®, 4% minoxidil with and
without retinoic acid, the extemporaneous minoxidil/
retinoic acid solution and the saw palmetto solution. In view
of the uniform response to the various concentrations of
minoxidil, testing on volunteers to exclude an irritant
reaction was not conducted. We believe the reaction to saw
palmetto represented an allergic contact reaction; however,
without testing on controls an irritant response cannot be
excluded.
Patch testing also showed an incidental positive reaction to
nickel.
DISCUSSION
The use of topical minoxidil together with retinoic acid
(tretinoin) was first advocated in 19861 to enhance the
efficacy of topical minoxidil. Retinoic acid, an all trans-
retinoic acid, promotes and regulates epithelial cell growth
and differentiation, and increases percutaneous absorption 2
by affecting cell membrane fluidity and lipid composition of
membranes.3,4 It was believed that certain retinoids may
increase the rate of hair growth, prolong the anagen phase of
the hair cycle, play a role in converting vellus to terminal
hair and act synergistically with minoxidil to produce a more
dense hair regrowth for regressing hair follicles than either
compound used alone.5
Combination treatment has subsequently fallen out of
favour because of local irritation, systemic side-effects such
as headaches, fluid retention6 and postural dizziness, an
explosive eruption of pyogenic granulomas on the scalp, 7 and
failure to demonstrate superior efficacy.8 A double-blind
study in 92 patients showed no augmentation of hair growth
312 Book Reviews
Table 1 Additional allergens tested (other than used in the Skin and
Cancer Foundation, Victoria, extended standard series 1999) used to
patch test this patient
Allergen (% in petrolatum) Reaction (at 96 hours)
Propylene glycol 10% –
Propylene glycol 15% –
Ethyl alcohol 95% – produced by the retinoic acid predisposed to the sensitization
Extemporaneous minoxidil/retinoic acid ++
solution (neat)
Regaine® 2% ++
Saw palmetto 1% ++
Minoxidil 1% ++
Minoxidil 1% and retinoic acid 0.025% ++
Minoxidil 2% ++
Minoxidil 2% and retinoic acid 0.025% ++
Minoxidil 4% ++
Minoxidil 4% with retinoic acid 0.025% ++
Retinoic acid 0.025% –
–, no reaction; ++, strong reaction, oedematous or vesicular.
with minoxidil plus retinoic acid versus minoxidil plus
placebo despite increased systemic absorption of minoxidil.9
Saw palmetto (Serenoa repens) is a low-growing palm tree
that is endemic to all counties of Florida, USA. Tinctures
from its fruit and crushed seeds have been used for the relief
of prostate gland swelling. A saw palmetto fruit pharma-
ceutical extract, permixon, has anti-androgenic effects and
has been used to relieve symptoms of benign prostate hyper-
trophy. It also has been used as a so-called natural treatment
for androgenetic alopecia.10 It is believed to have an inhibi-
tory activity against the 5α reductase enzyme, responsible for
conversion of testosterone to dihydrotestosterone. While this
therapy has been modelled on finasteride therapy for male
androgenetic alopecia, we were unable to find published
data on the extent of inhibition of 5α reductase or the clinical
response of alopecia to saw palmetto. While any effect of this
agent is thought to be minimal, the treatment has become
fashionable among those seeking a ‘natural’ alternative to
conventional evidence-based treatments.
Our patient was found to be probably allergic to the saw
palmetto solution. This has not been previously reported.
She was also sensitive to minoxidil, but not retinoic acid or
Book Reviews
Current Dermatologic Diagnosis and Treatment. Edited
by Irwin M Freedberg and Miguel R Sanchez. Current
Medicine Inc., Philadelphia, 2001. 245 pages, including
appendices. Price: A$202.40. ISBN 0-7817-3531-9.
This book describes 109 dermatology conditions with a
small photograph and quite comprehensive block-form text,
devoting two A4-sized pages to each condition. It is unusual
that diseases are in strictly alphabetical order (from ‘Acan-
propylene glycol. Contact allergic dermatitis to minoxidil is
well documented, albeit rare, with only 13 cases identified
from 1900 patients involved in the minoxidil phase III at a
rate of 0.68%.11
Almost any medicament used on damaged skin will
sensitize some people.12 It is possible that the irritation
to minoxidil. Patients with hair loss should be cautious about
using topical preparations of minoxidil and ‘natural’
remedies that may have unforeseen hazards.
REFERENCES
1. Bazzano GS, Terezakis N, Galen W. Topical tretinoin for hair
growth promotion. J. Am. Acad. Dermatol. 1986; 15: 880–3,
890–3.
2. Ferry JJ, Forbes KK, VanderLugt JT, Szpunar GJ. Influence of
tretinoin on percutaneous absorption of minoxidil from an
aqueous topical solution. Clin. Pharmacol. Ther. 1990; 42:
439–46.
3. Elias P. Epidermal effects of retinoids: Supramolecular obser-
vations and clinical implications. J. Am. Acad. Dermatol. 1986;
15: 797–809.
4. Terezakis NK, Bazzano GS. Retinoids: Compound important to
hair growth. Clin. Dermatol. 1988; 6: 129–31.
5. Bazzano G, Terezakis N, Attia H, Bazzano A, Dover R, Fenton D,
Mandir N, Celleno L, Tamburro M, Jaconi S. Effect of retinoids
on follicular cells. J. Invest. Dermatol. 1993; 101 (Suppl. 1):
138S–42S.
6. Dey R, Donald T. Short and curly. Med. J. Aust. 2000; 172: 48.
7. Baran R. Explosive eruption of pyogenic granuloma on the scalp
due to topical combination therapy of minoxidil and retinoic
acid. Dermatologica 1989; 179: 76–8.
8. Shapiro J, Price V. Hair regrowth. Dermatol. Ther. 1998; 16:
341–56.
9. Fiedler V, Camara C. Topical hair growth promoters in andro-
genetic alopecia. Dermatol. Ther. 1998; 8: 34–41.
10. Sawaya ME. Novel agents for the treatment of alopecia. Semin.
Cutan. Med. Surg. 1998; 17: 276–83.
11. Whitmore SE. The importance of proper vehicle selection in
detection of minoxidil sensitivity. Arch. Dermatol. 1992; 128:
653–6.
12. Wilkinson JD, Shaw S. Contact dermatitis: Allergic. In:
Champion RH, Burton JL, Burns DA, Breathnach SM (eds).
Textbook of Dermatology, Vol. 1, 6th edn. Oxford: Blackwell
Science, 1998; 733–821 (783).
thosis nigricans and confluent papillomatosis’ through to
‘xanthomas and xanthelasma’) without any grouping under
disease process headings. There are seven appendices about
treatments, of which the longest and most useful is an
extended table listing treatments for every infectious agent
which can affect the skin.
There is no index and the names used for some conditions
could make it difficult to find the correct entry to help with
 Book Reviews
patient care. This book could be used in a teaching clinic, but
there are better skin atlases available for this purpose.
Dr David S Nurse
Dermatologic Therapy in Current Practice. Edited by
Ronald Marks and James Leydon. Martin Dunitz Ltd, 2002.
263 pages, including index. Price: A$138.60. ISBN 1-85317-
334-4.
This is a concise book edited by Ronald Marks and James
Leyden, Professors of Dermatology from Cardiff, UK, and
Philadelphia, USA, with chapters by various dermatologists
from around the world. It is a good summary of treatment of
some of the common skin diseases but excludes hair prob-
lems, vitiligo and auto-immune disorders. It would be of use
to registrars in their early years, or GP with an interest in
dermatology.
Topics include eczema, psoriasis, acne, acne inversa (a
term for hidradenitis suppurative I’ve never previously
encountered), nail disease, rosacea, urticaria, ichthyosis and
fungal diseases. There is an update on topical corticosteroids
that is not very useful as it talks about combination therapies
not available in Australia. There is quite an overlap between
the chapters on ‘surgical advances’ (which is mostly on
cosmetic treatments) and cosmetic dermatology, and I am
not sure laser hair removal warrants a whole chapter. There
is a chapter on ‘Novel drugs for treatment of skin cancer’ that
mentions lots of chemotherapy agents which are usually
managed by oncologists and often out of date by the time a
book is printed.
This is not a pharmacology book like the new Wolverton.
It summarizes diseases and their treatments, but does not
deal with the drugs in great detail in most cases. I would
recommend it be purchased by dermatological libraries and
read by first-year trainees as an introduction to therapy of
common skin diseases. It is too basic for most dermatologists
who keep up to date with the literature.
Dr Anne Howard
Teledermatology. Edited by Richard Wootton and Amanda
Oakley. The Royal Society of Medicine Press, London, 2002.
331 pages, including index. Price: A$99.80. ISBN 1-85315-
507-1. (Distributed in Australia by MacLennan and Petty.)
This is the third book in the Royal Society of Medicine’s
Telemedicine series. Its editors are Richard Wootton, who
has recently relocated to Brisbane, Australia, to take up a
Chair at the Centre for On-line Health at the University of
Queensland, and Amanda Oakley, a New Zealand Derma-
tologist who has published widely on teledermatology.
The book is divided into four sections: section one deals
with background and technical matters with important basic
information that is quite relevant to those reviewing papers
313
on teledermatology or those about to undertake research in
this area. The section on Digital Imaging and Digital
Cameras has a wider audience in that these sections are
relevant to any dermatologist considering purchasing a
digital camera for their practice. However, like most publi-
cations dealing with a fast-changing field, the information
contained in this section is likely to become outdated within
a few years. Section two is made up of the current experience
from quite a number of diverse centres throughout the world.
Some of these are quite relevant to dermatology and are quite
interesting, although some of them have less relevance and
can be read rapidly by those specifically interested in
teledermatology.
Section three is on education. This section is perhaps only
peripherally related to the topic of teledermatology as it
includes a description of an on-line dermatology atlas and
also some experience with distance teaching in dermato-
histopathology. This section does not add significantly to the
usefulness of the book. Section four looks to the future and
discusses the important topics of the development of
standards and also the economics of teledermatology., This
book is a useful survey of the state of play of teledermatology
in 2001. It will relatively quickly become outdated but
currently it provides an excellent resource for a clinician
undertaking teledermatology or one who may be interested
in reading publications on this subject.
Dr Stephen Shumack
Statistical Methods in Medical Research, 4th edn. By
P Armitage, G Berry and JNS Matthews. Blackwell Science,
Oxford, 2002. 817 pages. Price: A$193.60. ISBN 0-632-
05257-0.
This year sees the release of the 4th edition of this
important text, considered by many medical researchers to
be 'the bible'. of medical statistics. The authors, P Armitage
from Oxford University, G Berry from Sydney University and
JNS Matthews of Newcastle University, are all experts in the
field and have a respected history of publishing excellent
statistical reference material (of which this is one). The 4th
edition introduces new topics and expands on previous ones.
These are complemented by many new and interesting
examples. In particular, the area of clinical trials has been
given substantially more attention, which now occupies its
own chapter. In addition to benefiting clinicians, a new
chapter covers the important area of laboratory assays that
the medical scientist should find most helpful.
The text is easy to read, which, combined with the use of
realistic examples, makes medical statistics easier to under-
stand. This is balanced nicely by the use of more complex
mathematical models of statistics supplemented by helpful
statistical equations. This should please other statistical
experts in the field. Sections on graphical representation of
data and the appropriate statistical method to use will benefit
most medical researchers in some way. If you are associated
314 Tribute
with medical research in any way, be it clinically, scien-
tifically or commercially, we recommend this text. It will be
an invaluable tool when deciding how best to represent data,
and to justify its significance to other researchers and the
general public/media. Certainly, any medical library should
TRI BUTE
Silver medal recipient 2001
DR ERIC TAFT
It is most appropriate that the presentation of the College
Silver Medal to Dr Taft should take place at this graduation
ceremony, as he was the architect of College training pro-
grammes and the College examination.
Eric graduated from Melbourne University in 1945 and,
following his residency at Melbourne’s Prince Henry Hospi-
tal, he undertook physician training in the UK, with a special
interest in gastroenterology. He was a resident at St Charles
Hospital in London in 1950. He obtained the membership of
the Royal College of Physicians in Edinburgh. On returning
to Australia, he undertook training in dermatology and
obtained the Diploma of Dermatological Medicine of the
University of Sydney in 1956.
Since that time he continued an academic and clinical
career as the head of the Dermatology Department at Prince
Henry’s Hospital from 1957 to 1988. During his senior medi-
cal staff lifetime at Prince Henry’s Hospital, he served on
virtually every committee and, in particular, as chairman of
the library subcommittee and, in a long-term involvement
with the undergraduate board of studies, he was able to
greatly improve the quality and quantity of dermatological
literature and journals and more than double the time allo-
cated to dermatological undergraduate teaching.
He achieved the unique honour for a dermatologist when
he became chairman of the hospital senior medical staff, a
post he held for two terms. Currently, he is consultant
dermatologist to the Monash Medical Centre.
Eric became an active member of the Dermatological
Association of Australia, the national organization which
Obituary
DR PATRICK BURNHAM FOX, 1918–2002
Pat Fox has died, and for this we are the poorer. For
all who knew him he was a luminary, a raconteur,
and it is a matter of great sadness that Alzheimer’s
have a copy, but considering the importance of using correct
statistical methods in medical research, a personal copy
would be most useful.
Mr Scott Byrne and Professor Ross Barnetson
preceded our College. His abilities were soon recognized and
led to the election as Secretary of the Association from 1960
to 1964. This was a crucial time, when skillful negotiation
was needed to resolve the many issues leading to the forma-
tion of College in 1966.
Eric became the first Chief Censor of College with the task
of establishing the academic standards of the new college. To
determine world’s best practice, he travelled overseas and in
the USA was invited to sit as an observer at the American
Board Examinations.
With Eric’s drive the Board of Censors organized our first
written papers and the clinical examination in Sydney in
1971. He established the pattern of examinations and accred-
itation of training programmes which has subsequently been
built on these firm foundations. He served as Chief Censor
from 1966 to 1973.
He established the first full-time salaried training positions
in our specialty in Melbourne, which were initially funded
by drug companies and subsequently, with David Nurse, the
first registrar posts were created under the aegis of the
Hospitals Commission of Victoria.
From 1975 to 1977, Eric was the College President and
guided College with tact and wisdom.
In 1969, Eric was elected to Fellowship of the Royal College
of Physicians of Edinburgh and in 1977 to Fellowship of the
Royal Australasian College of Physicians. He was the first
chairman of the Victorian Faculty of College.
In 1980, for his services to medicine, particularly derma-
tology, Eric was recognized with Membership of The Order
of Australia.
Dr John A Brenan
robbed these gifts from him in his final years. Throughout his
career, a consultation with Pat was an opportunity for an
anecdote, and the only complaint of his patients would be
that the surgery would be finished before the story was
complete.
 Obituary
Pat was born in Masterton, New Zealand, the second son
of five children. He grew up in Hastings and received his
secondary school education as a boarder at St Patrick’s,
Silverstream. He excelled at sport and with two fellow
students won an international shooting competition, using
.303 Lee Enfield rifles, held amongst all the secondary
schools of the British Empire. From school he entered the
seminary at Greenmeadows in Hawkes Bay, but after 2 years
the discovery of more earthly pleasures persuaded him to
abandon a calling to the priesthood and convert to medicine.
Denied overseas service in the Armed Forces during World
War II by the government policy of insisting medical students
complete their studies, he graduated M B ChB (Otago) in
1944. He remained a committed, practising Catholic
throughout his life.
While in Dunedin, Pat represented Otago University, the
province of Otago and New Zealand universities at rugby,
playing hooker with a vigour that might be described as
highly competitive. He had New Zealand University blues in
rugby, shooting and water polo. His early postgraduate years
were spent in Auckland, where his family now lived, and
where he met Rosemary Garland before travelling to the UK.
He obtained dual membership of the Royal College of
Physicians (Edinburgh and London) in 1949 and pursued his
studies in dermatology, particularly in Edinburgh. Rosemary
had followed him to the UK and in 1949 they married. They
returned to New Zealand in 1951.
Pat commenced private practice and took up a visiting
consultant’s post at Auckland Hospital, where he gave
30 years’ service to the public health system. He continued in
his private practice until retirement in 1992. Pat’s dermato-
logic skills were recognized within the wider medical com-
munity, and by his faithful patients with a flourishing
practice, as well as by his dermatology colleagues, who
always appreciated his educated, common sense approach to
the specialty. He was a foundation Fellow of the Australasian
AN NOUNCEM ENT
TH E N I E LS HJORTH PRIZE
The International Contact Dermatitis Research Group will
endow the Niels Hjorth Prize to the best original, unpub-
lished paper, written in English and focusing exclusively on
contact dermatitis (can be experimentally or clinically
oriented).
The prize entails —_C 3000: —_C 1500 for the grant itself
and ——C
_
1500 for travelling expenses and oral presentation.
315
College of Dermatologists (1967) and became FRCP
(Edinburgh) (1972) and FRACP (1977). His attitude and say-
ings will survive him in the practice of those who learned
from him and those who they in turn have taught. Of a
suspect pigmented lesion: ‘No-one ever died from a surgical
scar’. His compassionate approach to the elderly: ‘They are
never too old to do the right thing’.
Pat was, dermatologically, a Renaissance man with skills
in dermatologic medicine, surgery and radiotherapy. His
practice commenced before the introduction of topical
steroids, when inflammatory dermatoses that are now
relieved in days of outpatient therapy required weeks of
inpatient therapy, and Auckland Hospital had two derma-
tology wards. His large hands and large stitches cured many,
and the occasional white cat with a squamous cell carcinoma
on its nose that sought refuge after treatment behind the
radiotherapy unit in his rooms simply added colour to his
already rich vocabulary.
Pat always wore well-tailored suits with a white shirt to
work. He suffered from recurrent polyneuritis and always
maintained his physical fitness to combat this. He enjoyed
swimming and was President and Patron of the Parnell
swimming club. His interest in rugby was lifelong and he
coached the Auckland University rugby team to win the
premier club rugby competition. He lived the outdoor life,
with duck shooting and fly fishing among his leisure
pursuits; his golf swing never quite came right, which
remained a great consternation to him. His long partnership
with Rosemary ended with her sudden death in 1999; their
five children and their families survive him. His coffin left St
Michael’s church to the tune of ‘Bye Bye Blackbird’.
Dr Leicester Hodge
Reprinted with permission from the New Zealand Medical
Journal.
Deadline for submission of papers is 1 March 2003. Please
send six copies to the Chairman of the International Contact
Dermatitis Research Group, Professor J-M Lachapelle,
Department of Dermatology, Louvain University, UCL 3033,
Clos Chapelle-aux-Champs 30, B-1200 Brussels, Belgium.
Tel: +32 2764 3335; Fax: +32 2764 3334.