To the Editor.—
I should like to add some observations to the excellent report of Lindelöf and Eklund,1 in which reference was made to the first reported case of a carcinoma following grenz-ray therapy (Table 2, case No. 1). This malignancy had occurred 15 years after irradiation, and I had the opportunity to observe the patient involved for an additional 28 years. During this time, seven actinic keratoses and three more squamous cell carcinomas (one of which penetrated to the bone and lead to the loss of one finger) occurred within the irradiated areas. The patient also had multiple actinic keratoses in sunexposed, but not irrradiated, areas, a lentigo maligna, which was radically removed, and a seminoma in 1972.Another patient with multiple malignancies after grenz-ray therapy, a woman now 63 years of age, was first seen in 1945 with a severe flexor type of psoriasis involving her face, which was also very seborrheic. She was resistant to external therapy with tar and anthralin, and after several Goeckerman treatments had failed, grenz-ray therapy was started in 1953. The psoriasis was controlled with