Review

Wood's light in dermatology

Pravit Asawanonda, MD, and Charles R. Taylor, MD

From the Department of Dermaioiogy, Massachusetts General Hospital,

Boston, Massachusetts

Correspondence
Charles R. Taylor, MD, Massachusetts General Hospital, 56 Fruit Street.
BAR 410, Boston, MA 02114

Historical aspects aromatic amino acids (predominantly tryptophan and its

oxidative products), nicorinamide adenine dinucleotide
Wood's lamp was invented in 1903 by a Baltimore physicist,
(NAD), and perhaps precursors or products of melanin.-''"^
Robert W. Wood (1868-1955).' The familiar long-wave
I
ulti-aviolet (UV) light, known as Wood's lamp, has become
an invaluable tool in the practice of medicine. The first Technique ,
reported use of this lamp in dermatology occurred in 1915,
While the actual use of Wood's light requires minimal skill,
being recommended for the detection of fungal infection
tbe time needed to execute its proper use can be lost in
ot the bair.- Unlike many other medical devices, which
today's busy clinics. Ideally, the lamp should he allowed
bavc tended to lose their popularity over time. Wood's
to warm up for about i min. The examination room should
lamp has maintained its usefuhiess not only in dermatology,
be very dark. Black occlusive shades or a windowless room
bur ajso in ceramics where it can be used to determine
are preferred. It is also essential that the examiner becomes
repairs.
dark-adapted in order to see the contrasts clearly. Wood's
light examination is notoriously unreliable in darker skin
types as one needs low baseline levels of endogenous
Wood's light physics melanin to detect the subtle pigmentary contrasts enhanced
Wood's lamp's long-wave UV radiation (UVR) emission is by Wood's light-induced fluorescence. Another caveat is
generated by a high-pressure mercury arc fitted with a that tbe user needs to be aware of tbe possible fluorescence
compounded filter made of barium silicate with 9% nickel of topical medicaments, lint, and even soap residue.
oxide, the so-called "Wood's filter." This filter is opaque Tbe use of Wood's light in dermatology occurs predomi-
to all light except for a band between 310 and 400 nm nantly in diagnostic areas involving pigmentary disorders,
with a peak at 365 nm. Fluorescence of tissue occurs when cutaneous infections, and the porphyrias. While its thera-
light of shorter wavelengths, in this case 340-400 nm, peutic uses remain minimal, some recent applications have
initially emitted by Wood's light, is absorbed and radiation involved adjunctive roles in various treatments. This review
of longer wavelengths, usually visible light, is emitted. Tbe addresses the various applications of Wood's light in derma-
output of Wood's lamp is generally low. A typical Wood's tology witb a focus on clinical techniques, mechanisms,
lamp has an output of less than r niW/cm-. and limitations. Tbe emphasis is on new, old, and forgotten
While both epidermal and dermal melanin ahsorh in this applications with the intent of revitalizing respect and
waveband, it is the collagen in the dermis which, upon interest in this useful device.
absorprlon, Huoresces at longer visible wavelengths mainly
in the blue range, thus resulting in the enhanced emission
Disorders off aitered pigmentation
one looks for in using Wood's light. Ir must be remembered
thar, in general, tbe fluorescence of the skin is very poorly Hypopigmentation and depigmentation
characterized. Fluorescence specrra of human skin appear Hypopigmentation or depigmentation in fair-skinned indi-
to change witb chronic sun exposure, perhaps due to viduals can be very difficult to discern. In hypopigmenred
alteration in dermal elastin.'••* Tissue aurofluorescence or depigmented lesions, there is less or no epidermal
appears to derive mainly from constituents of eiastin melanin. Consequently, there is a window through which
(fluorophore unknown), collagen (pyridinoline crosslinks). the Wood's light-induced autofluorescence of derma! colla- 801

© 1999 Blackwell Science Ltd International Journal of Dermatology 1999, 38, 801-807
802 Review Wood's light in dermatology Asawanonda and Taylor

gen can be seen. Due to the abrupt cut-off in the visible examination can greatly help in delineating subtle hypopig-
emission from lesional skin, the margins of tbe hypopig- mentation.''* Given the sometimes argued, but generally
mented or depigmented spots appear sharper under Wood's agreed upon, association of hypomelanosis of Ito with
light. The lesions appear bright blue-white due to autofluo- central nervous system, ocular, and musculoskeletal
rescence. Let us consider tbe examples of vitiligo, tuberous anomalies, once again early detection via Wood's light
sclerosis, and hypomelanosis of Ito. examination seems prudent.

Vitiligo
Wood's light examination can help to locate and delineate Hyperpigmentation
vitiliginous patches which may be less obvious, especially When incident light impinges upon the skin, photons of
in fair-skinned individuals. This procedure is essential in shorter wavelengths, especially UVB (i9o-iio nm) and
documenting an individual's baseline examination. The UVA {320-400 nm), are more easily scattered by the
extent and distribution of the disease has an obvious stratum corneum and tbe epidermis. Contrarily, photons
bearing on therapeutic decisions. Those with extensive of longer wavelengths, such as tbe visible range (400-
disease may give serious consideration towards permanent 800 nm), penetrate more deeply into tbe dermis. Melanin
bleaching with monobenzyl ether of bydroquinone. Those absorbs light very strongly in both the UV and visible
with less involvement may choose repigmenration with regions. Wben Wood's light is illuminated over a heavily
photochemotherapy. While proper camera set-up is needed, melanized epidermis, most of its output is absorbed, while
in special circumstances UV photography is useful in the less darkly pigmented adjacent skin scatters and reflects
documenting the extent of vitiliginous lesions as well lighr as usual, resulting in enhanced contrasts at the border
as their response to treatment. Follicutar repigmentation zone between areas of differing melanization. Variations in
following oral photocbemotherapy can be demonstrated epidermal pigmentation thus become more apparent under
earliest by the use of Wood's light.** Not only are Wood's Wood's light than under ordinary room light. For dermal
lamps helpful in vitiligo, but also they have been useful pigmentation, this contrast is less apparent under Wood's
for the detection of chemical-induced leukodetma'^ and light' ^ because some of the autofluorescence of the dermal
leukoderma associated witb melanoma.'^^-^ collagen takes place both above and below the dermal
melanin, which serves to diminish the amount of fluores-
Tuberous sclerosis cence returned to the eyes.
A detailed skin examination is tbe most sensitive diagnostic
test for the early detection of tuberous sclerosis.' ^ Hypopig- Melasma
mented macules larger than ro mm, especially those with Sancbez etal.^*' reported the use of Wood's light in determin-
a lance-ovate or ash-leaf shape, are tbe first skin findings
ing whether melasma is predominantly epidermal or
in patients with tuberous sclerosis. Finding these lesions
dermal. Epidermal-type melasma shows enhancement of
early on allows dermatologists to alert primary care physi-
color contrast when examined under Wood's light as
cians as to possible seizures or otber clinical problems.
compared to visible light. Conversely, melasma of dermal
Wood's lighr has clearly been sbown to be beneficial in
type, which may have a slight bluish hue in natural sunlight,
locating these lesions. Witb the exception of those lesions
does not demonstrate such contrast enhancement when
with tbe highly characteristic asb-leaf shape, tbe specificity
of this test is not very high as Wood's light-positive seen under Wood's light. The aurhors classified melasma
bypopigmented macules with a variety of shapes are according ro their Wood's light findings into four different
common skin findings in both the pediatric and adult types: epidermal, dermal, mixed, and Wood's light inappar-
populations." The interpretation of Wood's light-positive ent. Patients with mixed-type melasma showed color
skin lesions virithout neurologic findings therefore must enhancement in some areas, but not in others. Melasma in
always be performed cautiously. F.ach case must be decided patients with darker complexions (skin types V and VI)
on its own merits in conjunction witb other clinical findings, was more evident in visible light than under UV light,
a careftil family history, and consultations with other hence the Wood's light inapparent type. The pathology in
providers. this latter group of patients was consistent with dermal-
type melasma. The location of pigmentation was confirmed
Hypomelanosis of Ito histologicaiiy. Wood's light may serve an important thera-
Tbe characteristic cutaneous finding in hypomelanosis of peutic and prognostic function for cases of melasma, as
Ito is whirled or streaked hypopigmentation, which, bow- those involving predominantly epidermal melanin may well
ever, can be easily missed especially in fair-skinned respond more favorably to bleaching agents and other
individuals. When clinically in doubt. Wood's light Topical remedies.

tnternationalJourrjal of Dermatology 1999, 38, 801-807 © 1999 Blackwell Science Lid

Asawanonda and Taylor 's light in dermalology Review 803

Infections Wood's light examination of the face can be useful in

patients who fail to respond to oral antibiotics. Comedones
Bacterial
often show yeilowish-white fluorescence due to compacted
Pseudomonas keratin (Fig. i).
Wood's light examination allows early detection of
Pseudomonas skin infections, especially in burn wounds. Fungal
Pathogenic forms of Pseudomonas produce a pigment
known as pyoverdin or fluorescein which shows green Dermatophytes
Huorescence under Wood's light. Fluorescence is detected Wood's light examination of the glabrous skin, nails, palms,
when the bacteria! count approaches io^/cm-', the number and soles is generally not helpful in the diagnosis of true
required for infection.''' Prompt detection, of course, allows dermatophyte infections due to the lack of fluorescence.
for immediate treatment for this potentially serious infec- Conversely, it is particularly useful in the diagnosis of tinea
tion. Both false positive and false negative rates have been capitis. The characteristic fluorescence is typically seen in
demonstrated to be rather low.^^ In ecthyma gangrenosum, the broken-off hairs and in the intrafoUicular portion when
for example, saline can be injected into the wound and the hair is plucked.^-* Bright-green fluorescence is seen in
then withdrawn. The solution obtained often shows positive Microsporum audouinii and M. canis infections^' (Table i)
fluorescence under Wood's light in a dark room, thus M. distortum, M. ferrugineum, and M. gypseum also
potentially pointing towards Pseudomonas sepsis many fluoresce. Similarly, Trichophyton schoentemii, the cause
hours ahead of confirmatory blood culture results. Wood's of favus, fluoresces a faint blue color. T. tonsurans and
light examination is also useful in other forms of cutaneous T. vcrrucosum do not produce fluorescence upon Wood's
Pseudomonas infections,, including folliculitis, which tends light examination. With the exception of T. schoenleinii^
to occur after immersion in swimming pools, hot tubs, or dermatophytes causing fluorescence are generally members
whirlpools/*^ and toe web infection.^° One caveat is that, of the Microsporum genus. The fluorescence of these
if the patient has cleansed the area recently, fluorescence infected hairs indicates the presence of infection, but does
may not be detected due to the dilution effect. not generally differentiate the causative organisms, except
for the hints gleaned hy the subtle differences in fluorescence
color. The chemical responsible for positive fluorescence is
Erythrasma
a pteridine.^'' False positive findings include lint, which
Erythrasma is a skin infection which may or may not be
appears bright white, scales, ointments, and dried soap.
itchy. It is caused by Cory ne hacterium minutissimum,
which shows coral-red fluorescence upon Wood's light
examination from porphyrins produced by the organisms.** Tinea versicolor
This cutaneous infection is most common in the groin Wood's light examination is very helpful in determining
area, and many individuals have some involvement in the tbe extent of infection by Malassezia furfur. Yellowish-
bilateral fourth web spaces of the feet. By identifying the white or copper-orange fluorescence can be observed in
unique fluorescence pattern, the provider can select the active infections.** Jillson" felt that Wood's light is particu-
appropriate antibiotics more readily, thus avoiding delays larly useful in diagnosing the follicular form of this infection
in diagnosis. in which bluish-white fluorescence may be observed in the
follicles. The author's original description best fits the
Propionibacterium acnes modern day term Pityrosporum folliculitis for which
It has long been known that orange-red fluorescence can Wood's light can be used to distinguish from other types
be seen within comedones on the face |Fig. r). The nature of folliculitis.
of this fluorescing compound was unknown until Cornelius
and Ludwig^' demonstrated that it was indeed a porphyrin.
Disorders of porphyrin metabolism
Coproporphyrin is the major porphyrin produced by
P. acnes,^'-~'^ while protoporphyrin IX is produced to a Wood's light examination is particularly useful in the
lesser extent.^' In fact, for actinic folliculitis, it is presumed diagnosis of the porphyrias as, depending on the disease,
that sunlight activates these porphyrins with resultant the Wood's light user can detect excess porphyrins in teeth,
follicular damage. Facial follicular fluorescence correlates urine, stool samples, and blood (Table 2). In porphyria
well with the P. acnes populations.^^ Johnsson et al.'-^ cutanea tarda, for example, the urine from affected patients
obtained contents of pilosebaceous follicles from indi- shows a bright, pink-orange color when fluorescing under
viduals with and without acne lesions and studied the Wood's lamp. This reaction can be accentuated by adding
emission and excitation spectra of the material. They also an equal volume of 1.5 N FICI to the test tube. Samples
concluded that the spectra were similar to that of P. acnes. from liver biopsies will also show fluorescence in this

© 1999 Blackwell Science Ltd Internationat Journal of Dermatology 1999, 38, 801-607
804 Review Wood's light in dermatology Asawanonda ar)d Taylor

Figure 1 (a) Clinical photograph of a subject taken with ordinary light, (b) The same subject photographed with a UV
fluorescence camera. Note the accentuation of pigmentary lesions otherwise inconspicuous under room light. Also remarkable
is the orange-red fluorescence due ro porphyrins produced by bacteria observed within hair follicles in the nasotabial fold

Figure 2 (a) Clinical photograph taken with ordinar>' light and showing an acne vulgaris patient with both inflammatory
lesions and comedones, (b) The same subject taken under Wood's lighr showing yellowish-white fluorescence within the
comedonal lesions. The absence of porphyrin fluorescence is the result of partial response to treatment

condition due to the accumulation of porphyrins within fluoresce under fluorescence microscopy, while the urine
the liver ceils. In variegate porphyria, the urine fluoresces does not.^^ Alternatively, a biochemical screening test
in an acute crisis, while the stool fluoresces even during employing a mixture of ether, glacial acetic acid, and
periods of remission. Stool samples should be mixed with hydrochloric acid can also be performed.^"* An excess
equal parts of amyl alcohol, glacial acetic acid, and ether of protoporphyrin and coproporphyrin in erythropoietic
for best results. The teeth, urine, and bone marrow fluoresce protoporphyria results in an intense red fluorescence.^^
red in congenital porphyria or Gunther's disease. In erythro- Erythrocyte protoporpbyrin may also be above normal
poietic protoporphyria, the red blood cells transiently levels in lead poisoning and anemic states;''" however.

Intemationat Journal of Dermatology 1999. 3B, 801-007 1999 Blackwell Science Ltd
Asawanonda and Taylor Vtood's light in dermatology Review 805

Table 1 C^haracteristic fluorescence of dermatophytes Lawrence et a/.^' reported the use of Wood's light to
predict the (outcomes of Jessner's and 70% glycolic acid
Organism Color of fluorescence peels for melasma. Given that epidermal melasma, which
theoretically demonstrates contrast enhancement when
Microsporum audouinii Blue-green
Blue-green
examined by Wood's light, should respond more readily to
M. canis
M. terrugineum Blue-green topical treatments and chemical peels, the authors hoped
M. distortum Blue-green they could identify a subset of patients more likely to
M. gypseum {some variants) Dull yellow respond to these peels. In their series, contrast enhancement
Trichophyton schoenleinii Dull blue was observed in 12 out of r6 patients; however, patients
with contrast enhancement paradoxically did not fare better
than patients who did not show such enhancement. It was
Table 2 Characteristic fluorescence observed in the principal hypothesized that this finding could best be explained by
porphyrias assuming that mixed-type melasma, which also shows at
least some contrast enhancement, may be more common
Diagnosis Sample Color of than previously
fluorescence

Erythropoietic porphyrla RBC. urine, teeth Red-pink Detection of semen on the skin
Erylhropoietic RBC. feces, gall Red-pink A little known and potentially useful fact is that semen on
protoporphyria stones the skin shows fluorescence when examined by Wood's
Hepatoerythropoietic RBC. feces, urine Red-pink
light. This fluorescence may be negative or appear very
porphyria
faint after 28 h and the color of the fluorescence is similar
Porphyria cutanea tarda Urine, teces Red-pink
Variegate porphyrta Urine, feces Red-pink to that of urine. While Wood's light examination is not
diagnostic for sexual abuse in any regard, it may help the
RBC, red blood cells. medical examiner locate areas where semen might have
been present, thus directing careful swabbing towards
potentially higher yield areas so that more sensitive laborat-
photnsensitivity does not occur in these two conditions. ory techniques can be performed.^^
Metabolites accumulated in acute intermittent porphyria
(6-aminolevulinic acid {5-ALA) and porphobilinogen) have Fluorescence from medications
not yet become porphyrins and thus fluorescence is not Topically applied tetracycline hydrochloride demonstrates
observed in this condition.-•^'^" a coral red fluorescence which changes to yellow after
a few minutes under Wood's lamp examination. This
knowledge has proved useful for studying the transfer of
Phototesting
topically applied medications to other body sites.'-' The
Jillson" reported the use of Wood's light in photopatch yellow fluorescence of the lunulae'** and the nails^' has
tesing when other higher output irVA sources were not also been observed in patients taking oral tetracycline. This
available. Due to its rather low output, the Wood's lamp fact can be helpful in distinguishing tetracycline-induced
is not recommended for photopatch testing by the British nail pigmentation from other causes of yellow nails.'"*
Photodermatology Group.^^ Irradiation times needed to Interestingly, however, quinacrine hydrochloride (Atabrine)
deliver the ro J/cm^ can easily exceed 2 h. also results in yellow-green nail fluorescence.'^ While little
used in this way, Wood's light could be helpful in monitoring
the compliance of patients taking such oral agents. Wood's
Miscellaneous uses lamp examination of the skin normally yields a negative
Chemical peeling
Matarasso et j / . ' ° reported that, by adding salicylic acid
(at a ratio of i : 5) or fluorescein sodium (ratio i : 15) to To monitor the effectiveness of topjcai applications
2.0% trichloroacetic acid or 70% glycolic acid, fluorescence Protective creams are useful for factory workers when
can be observed during the time of a chemical peel. gloves cannot be used. Recently, Wigger-Alberti et al.^^
Upon Wood's light illumination, salicylic acid yields green reported the usefulness of Wood's light examination to
fluorescence, while fluorescein fluoresces yellow-orange. monitor how workers apply protective creams to their
The authors assert that this technique helps to avoid hands. In this study, r% vitamin A acetate was added to
overcoating of the solution and ensures that all areas are the cream in order to obtain fluorescence when examined
treated evenly. 3° with Wood's light. Their study confirmed that there were

© 1999 Blaokwell Science Ltd international Journal ot Dermatology 1999, 38, 801-807
806 Review lAfood's light in dermatology Asawanortda and Taylor

skip areas on which protective creams were not applied. tools. In short, the great utility of Wood's light stems from
These areas correlated with sites where irritant contact its ease of use, confirming the dictum that simple, helpful
dermatitis usually developed. Recentiy, Gaughan and devices in medicine endure.
Padilla-'" reported the use of fluorescent dye and UV
photography to evaluate the adequacy of sunscreen applica-
tion. In their report, several sites on rhe head and neck References
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understand their risk and applied sunscreen inadequately. lumiere ultraparaviolette. Note preliminaire. Bull Soc Sci
The use of this method for both applications is very helpful Med Biol Montpellier 1925; 6: 375-378.
in educating people about common mistakes. 3 Uffell DJ, Stetz ML, Milstone LM, Deckelbaum LI. In
vivo fluorescence of human skin. A potential marker of
photoaging. Arch Dermatol 19S8; 124: 1514-1518-
Therapeutic use
4 Anderson RR. In vivo fluorescence of human skin. A
Wood's lamp has also been used occasionally as a power-
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patients. While warts are well known to undergo spontan- 5 Fellner MJ, Chen AS, Mont M, et al. Patterns and
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otherwise harmless and painless.•'^ in human epidermis and hair. Int j Dermatol 1979; T8:
722-730.
6 Mustakallio KK, Korhonen P. Monochromatic
Photodynamic diagnosis ultraviolet-photography in dermatology. } Invest
The recent development of photodynamic therapy of Dermatol 1966; 47: 551-356.
cancers has emphasized a long-standing clinical need to 7 Fulton JE Jr. Utilizing the ultraviolet {UV Detect) camera
to enhance the appearance of photodamage ;md other
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fact that 8-ALA-derived porphyrins preferentially accumu-
8 Jillson OF. Wood's light; an incredibly important
late in neoplastic tissues, Fritsch et a!."*^ reported the use diagnostic tool. Cutis 1981; 28: 620-626.
of topical 8-ALA and Wood's lamp to delineate the margin 9 O'Sullivan JJ. Stevenson CJ. Screening for occupational
of recurrent basal cell carcinomas. 20% ALA ointment vitiligo in workers exposed to hydroquinone
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after which the area was illuminated with Wood's light. The 10 Goldman L, Wilson RG, Glasgow R, Rich6eld R.
tumor emitted bright-red fluorescence. These fluorescence- Perilesional leucoderma in metastatic melanoma. The use
positive areas proved to be basal cell carcinomas on of the Wood's light for early detection of this rare
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proved useful in other conditions, including solar ker- 11 Koh HK, Sober AJ, Nakagawa H, et al. Malignant
melanoma and vitiligo-like leukoderma: an electron
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microscopic Study. / Am Acad Dermatol 1983; 9:
extramammary Paget's disease.'*'' This technique, when
696-708.
perfected, will be of great help to physicians taking care 12 Cassidy SB, Pagon RA, Pepin M, Blumhagen JD. Family
of skin cancers. It seems likely that additional specific, studies in tuberous sclerosis. Evaluation of apparently
noninvasive, and useful optical techniques will be developed unaffected parents. yAM/\ 1983; 249: i ?oi-i 504.
in the next decade. 13 Norio R, Oksanen T, Rantanen J. Hypopigmented skin
alterations resembling tuberous sclerosis in normai skin.
J Med Genet 1996; 33: 184-186.
Conclusions 14 Ardinger HH, Bell WE. Hypomelanosis of Ito. Wood's
Wood's lamps are small, durable, inexpensive, safe, and light and magnetic resonance imaging as diagnostic
measures. Arch Neurol 19X6; 43: 848-850.
very easy to use. The greatest use lies in the detection and
15 Gilchrest BA, Fitzpatrick TB, Anderson RR, Parrish JA.
classification of sometimes subtle pigmentary conditions,
Localization of melanin pigmentation in the skin with
together with the detection of dermatophyte and excess Wood's lamp. Br J Dermatol 1977; 96: 245-248.
porphyrin fluorescence. They also provide quick resuits 16 Sanchez NP, Pathak MA, Sato S, et al. Melasma: a
which can be quite valuable in certain situations such as clinical, light microscopic, ultrastructural. and
burn wound infection. Their use seems to have broadened immunofluorescence study. J Am Acad Dermatol 1981;
slightly over time as both diagnostic and investigational 4: 698-710.

InternationalJournat ot Dermatology 1999, 38, 801-807 1999 Blackwell Science Ltd

Asawanonda and Taylor Wood's light in dermatology Review 807

17 Ward CG, Clarkson JC, Taplin D, Polk HC. Wood's ability of Wood's light examination. / Am Acad
light fluorescence and Pseudomonas burn wound Dermatoi 1997; 36: 589-593.
infection./AMA 1967; 202: 27-28. 32 Gabby T, Winkleby MA, Boyce T, et at. Sexual abuse of
18 Polk HC, Ward CG, Clarkson JG, Taplin D. Early children. The detection of semen on the skin. Am } Dis
derecrion of Pseudomonas, burn infection. Clinical Cbitd 1992; 146: 700-703.
experience with Wood's light fluorescence. Arcb Surg 33 Johnson R, Nusbaum BP, Horwitz SN, Frost P. Transfer
1969; 98: 292-295. of topically applied tetracycline in various vehicles. Arcb
19 Amichai B, Finkelstein E, Halevy S. Eariy detection of Dermatol 1983; 119: 660-663.
Pseudomonas infection using a Wood's lamp (letter). 34 Hendricks AA. Yellow lunulae with fluorescence after
Clin Exp Dermatol 1994; 19: 449. tetracycline therapy. Arch Dermatot 1980; 116:
20 Westmoreland TA, Ross VE, Yeager JK. Pseudomonas 438-440.
toe web infection. Cutis 1992; 49: 185-186. 35 Douglas AC. The deposition of tetracycline in human
21 Cornelius CE, Ludwig GD. Red fluorescence of nails and teeth; a complication of long-term treatment.
comedones: production of porphyrins by Br J Dis Cbest 1965; 57: 44-47.
Corynebacterium acnes. J Invest Dermatol 1967; 49: 36 Kierland RR, Sheard C, Mason HL, Lobitz WC
368-370. Fluorescence of nails from quinacrine hydrochloride.
2.1 McGinley KJ, Webster GF, Leyden JJ. Facial follicular JAMA 1946; 131: 809-810.
porphyrin fluorescence: correlation with age and density 37 Czernielewski A, Skwarczynska-Banys E. Oral treatment
of Propioiiihiictcrium acnes. Br J Dermatoi 1980; 102: of acne vuigaris and oil acne with tetracycline.
437-441- Dermatotogica T98Z; 165: 61-65.
21 Johnsson A, Kjeldstad B, Mele TB. Fluorescence from 38 Wigger-Alberti W, Marafiio B, Wernh M. Eisner P.
pilosebaceous follicles. Arcb Dermatot Res 1987; 279: Training workers at risk for occupational contact
190-193. dermatitis in the application of protective creams;
24 Krull EA, Babei DE. Diagnostic procedures of the skin. efficacy of a fluorescence technique. Dermatot 1997;
Part one. / ham Prac 1976; 3: 309-312. 195: 129-133.
25 Halprin KM. Diagnosis with Wood's light. Tinea capitis 39 Gaughan MD, Padilla RS. Use of a topical fluorescent
and erythrasma. yAMA 1967; 199: 177. dye to evaluate effectiveness of sunscreen application.
26 Wolf FT. Chemical nature of the fluorescent pigment Arch Dermatot 1998; 134: 5T5-517.
produced ui M(Vrusporwm-infected hair. Nature 1957; 40 Caplan RM. Medical uses of the Wood's lamp. JAMA
180: 860-861. 1967; 202: 123-126.
27 Halprin KM. Diagnosis with Wood's light. The 41 Fritsch C, Becker-Wegerich PM, Menke H, et ai.
porphyrias. 7AMA 1967; loo: 130. Successful surgery of multiple recurrent basal cell
28 Rimington C", Cripps DJ. Biochemical and fluorescence- carcinomas guided hy photodynamic diagnosis. Aestb
microscopy screening-tests for erythropoietic Piast Surg 1997; 21: 437-439.
protoporphyria. Lancet 1965; i: 624-626. 42 Fritsch C, Stege H, Saalmann G, et al. Green light is
29 British Photodermatology Group. Workshop Report. effective and less painful than red light in photodynamic
Photopatch testing—methods and indications. Br ] therapy of facial solar keratoses. Pbotodermatat
Dermatot 1997; 136: 371-376. Pbototmmunot Ptjotomed 1997; 13: 181-185.
30 Matarasso SL, Glogau RG, Markey AC. Wood's lamp 43 Fritsch C, Goerz G, Ruzicka T. Photodynamic therapy in
for superficial chemical peels. / Am Acad Dermatol dermatology. Arcb Dermatol 1998; 134: 207-214.
1994; 30: 988-992. 44 Becker-Wegerich PM, Fritsch C, Schulte KW, et al.
31 Lawrence N, Cox SE, Brody HJ. Treatment of melasma Carbon dioxide laser treatment of extramammary
with Jessner's solution versus glycolic acid: a comparison Paget's disease guided by photodynamic diagnosis. Br J
of clinical efficacy and evaluation of the predictive Dermatol 1998; 13S: 169-172.

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