DERMATOLOGY

occurred. The immediate clinical impression in one-third of the patients was that of prostatic carcinoma (by palpation). Tissue was obtained by endoscopic resection in It majority, but by open perineal biopsy in six patients. A majority of the patients had a restricted stream, and one or more resections were necessary to allow free urination. Histologically, it seems that the course of events in most cases has been that an ordinary inflammation within the prostatic ducts has followed an infection of the posterior part of the urethra. As inflammation progresses, some ducts rupture, thus permitting extrusion of the exudate into the stroma, culminating in a type of foreign body reaction consisting of inflammatory cells and foreign-body giant cells. Neither in this series, nor in those of others, have organisms of any kind been grown on culture; nor has there been any evidence of a viral cause. When the obstructive element has been removed by resection the condition resolves fairly rapidly, and the prognosis is good. An important lesson to learn is that no patient with a condition clinically suspected to be carcinoma should be started on a permanent anti-androgen therapy until the case is histologically proved.