a ee to the contiguous sweat gland ducts at sites where the latter penetrated the epidermis. A mir: row zone of parakeratinosis and amorphous debris was still present between the stratum granulosum and the loosely laminated stratum corneum, Dermis The capillary loops in the dermal papillae, although present, were not uniformly distinet. Pericytes remained in increased number but fewer lymphocytes were present. Generally, there appeared to be slight telangiectasis of the capillaries in the pars papillaris and the superficial pars reticularis (Plate 3.24). There was some edema of the pars papillaris (Plate 3.22). Scattered pigment laden chromatophores were irregularly distributed in the papillary layer (Plate 3.23). In some cases hair shafts in the superficial pars reticularis were quite narrow, atrophic, and occasionally absent; in others the hair shafts appeared normal. Small hair follicles (Plate 3.22) and secretory sweat ducts in some cases showed mild atrophy. Biopsies of three pigmented mild lesions were taken from two of the white Rongerik Americans. Only one of the three gave evidence of damage, which was nominal and confined to the epidermis. 3.2.5 Symptomatology and Treatment On the day of exposure, itching and burning of the skin was prevalent. This subsided and for a period of 10 to 14 days or longer there was neither subjective nor objective evidence of skin injury. Itching and burning reappeared either prior to or in the early pigmentation stage. With the deeper legions there was also pain. Pain was rather marked with the foot lesions. During the painful period some of the foot lesions were also hot and presented a brawny edema. A common complaint was a tenderness in the great toes medial to the nails. However, visible lesions in this area were infrequent. This symptom usually preceded the appearance of gross lesions elsewhere on the feet. Many of the individuais who developed painful foot lesions were observed walking on their heels for several days. The painfulness of the foot lesions may have resulted from their greater severity, and may have been accentuated by the dependent nature of the foot. Some of the lesions of the neck and axilla were painful when turning the head or raising the arms. The acute reaction and pain subsided after a few days. There were no constitutional symptoms. The treatment of skin lesions was largely non-specific. Most of the superficial lesions were treated with calamine lotion with one per cent phenol, which in most cases relieved the itching, burning or pain. A few of the painful hyperpigmented lesions not relieved by calamine with phenol were treated with pontocaine ointment, with apparent success. When the epithelium desquamated the itching was relieved by daily washing with soap and water and the application of a water soluble vanishing type ointment which kept the injured skin soft and pliable. Raw areas, which became secondarily infected, were treated by washing with soap and by the appli- cation of aureomycin ointment. Bullous lesions of the feet were left intact as long as no symptoms were present. If painful, the bullae were aspirated with sterile (echniques to remove the clear straw-colored fluid. A single aspiration was adequate since the bullae did not refill. One foot lesion developed an extensive, raw weeping ulcer. Prophylactic penicillin was piven for two days, during which time the lesion developed healthy granulation tissue. Someof the lesions of the skin of the foot remained thickened, less pliable, and painful after desquamation. This was relieved by the use of vaseline or cocoa butter to soften the tissues. One persistent ear lesion did not heal after desquamation. This was treated with warmboric acid compresses und washing with surgical soap to remove the eschar. Granulation tissue formed, and epithelium was slowly growing in from the edges of the ulcer when the initial observation period was terminated 74 days after exposure. Upon resurvey six months after exposure healing was com- plete, with a depigmented scar remaining as evidence of the previous ulcer. 3.3 EPILATION The incidence of and time of appearance of epilation in the Rongelap and Ailinginae groups is illustrated in Tables 3.1, 3.2 and Fig. 3.1. Epilation was first observed on the 14th poust- 39 — en) ea --