Alopecia Totalis

Abstract

this was associated with a low serum calcium as her parathyroids had been removed at operation. The psoriasis varies directly with the level ofserum calcium, clearing if it returns to normal. She has also had an epileptiform attack and an abnormal EEG when her serum calcium has been low. Dr H R Vickers: I well remember the case described by Dr Sneddon since she was under my care when I was in Sheffield. I saw a second similar case three years ago who was referred to me by Professor Witts. He was a man with very widespread psoriasis which followed thyroidectomy and he was found to have hypoparathyroidism with low serum calcium. He was treated with calciferol, the serum calcium returned to normal and the psoriasis cleared. I would like to discuss the local application ofvitamin A, since vitamin A in an ointment base will act as a keratolytic agent and beneficial results when used on scaling skin may be due not to any specific action of vitamin A but to the non-specific keratolytic effect.