To the Editor.—
I feel that I should share with my colleagues in dermatology an observation relative to the treatment of problem acne. All of us have seen the adult female acne patient who has closed comedonal or papular acne extending from the corner of the mouth to the chin area, sometimes in a slightly fan-like distribution from the corner of the mouth to the chin area and the proximal area of the cheek. This type of acne has often been recalcitrant to standard methods of therapy, and many of us have been under the impression that it is caused either by chemicals from cosmetics, such as lipsticks (as per Dr. Kligman), or hand-to-face activity in this area.Having accumulated a number of such patients ranging in age from the early 20s to the 40s, all of whom were adamant in their denial of hand-to-face activity, and many of whom