Laboratory diagnosis of sarcoidosis

Sarcoidosis is not an uncommon disease. Unfortunately, the awareness amongst clinicians is lacking and due to overwhelming prevalence of tuberculosis, a disease with many similar features, the diagnosis is missed and often delayed. The gold standard investigation finding in the diagnosis of sarcoidosis is the presence of noncaseating tuberculoid granuloma, also known as sarcoid or sarcoid-like granuloma. Some classical chest X-ray findings, clinico-radiological dissociation, suggestive organ lesions, negative Mantoux test (MT), development of MT site granuloma, hypercalcaemia, hypercalciuria and raised serum angiotensin converting enzyme (SACE) value and negative tests for tuberculosis are usually helpful in the diagnosis of sarcoidosis.

A clinicopathological study of pemphigus

A clinicopathological study was conducted on 50 patients of pemphigus of various types attending skin OPD, Assam Medical College in last two years. There were 20 males and 30 females. Pemphigus vulgaris, the commonest type was seen in 42 patients. Majority of the patients 31 to 50 years of age group and were from belonged to lower socioeconomic status. Pemphigus vulgaris was the most severe variety and secondary bacterial infection was the commonest complication. Bacterial pathogen commonly involved was coagulase positive staphylococcus aureus. Oral mucosal involvement was noted in 39 patients. Cutaneous lesions were seen 4.5 months (average) after initiation of oral lesions.

Knowledge about HIV and AIDS among medical entrants - a questionnaire study

A close ended questionnaire study on knowledge attitude and practice (KAP) about HIV/AIDS was conducted amongst first year MBBS students immediately on joining the course. One hundred and fourteen students participated in the study. Overall level of knowledge about AIDS was found to be 72%. Boys were better informed about possible methods of prevention of AIDS than girls. Misconceptions regarding mode of transmission, clinical presentation and prevention existed amongst large number of them. Seventeen percent of boys and 5% of girls approved of pre-marital sex for boys while 14.8% of boys approved the same for girls. Thirteen and half percent of boys admitted sexual experience. Awareness programme should be intensified amongst students to improve the overall knowledge of AIDS.

Role of combination of multiple herbal drugs (septilin) in the prophylaxis of diabetic foot ulcer - a double blind trial

Infections, ischaemia and neuropathy are the major threats to diabetic foot apart from aerobic gram-negative organisms; anaerobic bacteria such as bacteriodes species play an important role in causing infection. Septilin, a polyherbal formulation with various constituents having antimicrobial, anti-inflammatory and immunomodulatory properties was evaluated in patients with diabetic foot ulcers. Septilin was administered at a dose of 2 tablets twice daily for 12 weeks.

After 12 weeks of treatment, about 75% of the patients in Group A had sterile wound swab culture and 24% (approx) had some growth of E. coli and Proteus. There was no growth of Klebsiella in this group. In Group B, about 50% had recurrence of gram-negative infection and about 28% of patients showed gram-positive isolate in additioin to gram-negative culture. Two patients in Group B were dropped from the study due to high blood sugar levels.

Trachyonychia in children : a study in fourteen patients

Fourteen patients, 8 girls and 6 boys with trachyonychia have been reported. Their ages ranged from 5 to 12 years; mean 8.5 years. All of them had retarded growth of nail plates with roughness, fragility, blackish discoloration, longitudinal ridging of all the 20 nails of fingers and toes. Six patients had thickening of the nail plates while 8 had thinning. In one patient each oil drop sign and splinter haemorrhages were seen; two patients each had associated lichen planus and psoriasis and one each atopic dermatitis, vitiligo and alopecia areata. Personal history of atopy was obtained in 6 patients. Nail biopsy carried out in 5 patients revealed nonspecific histology. Radiological examination of fingers and toes revealed no bony or joint abnormality. The nail changes remained almost static during a 4 year follow-up period.

High incidence of Henoch Schonlein purpura

Henoch Sconlein pupura was suspected in 18 cases from July 1997 to July 1999. Histopathology and immunofluorescence confirmed the diagnosis. The incidence in India is not known. However, an incidence of 1.2 million is reported from Sujjolk UK. We report an incidence of 3 per million from July 1997 to 1998 and 7 per million from July 1998 to 1999.

Cutaneous cryptococcosis masquerading molluscum contagiosum in a patient with HIV disease

Cryptococcosis, though quite rare, occurs throughout the world. Even more rare is to have cutaneous cryptococcosis. We describe in this case report, a case of cutaneous cryptococcosis in a HIV seropositive individual who had skin lesions over the face and trunk resembling molluscum contagiosum. The skin lesions provided the first evidence of disseminated cryptococcosis.

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Cockayne syndrome : a report of two siblings in a family

DM Thappa, Karthikeyan, RH Kumar, S Nadrajan, S Elangovan

Family cases of Cockayne's syndrome are very rare. We report two siblings in a family affected with this syndrome and highlight the significance of cutaneous features of this syndrome.

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Linear Psoriasis

Arun Agarwalla, Arun Joshi, Sudha Agrawal, Mary Jacob, Vijay K Garg, Amarnath Thakur

Linear psoriasis, inflammatory linear verrucous epidermal naevus (ILVEN), Lichen straitus, linear lichen planus and invasion of epidermal naevi by psoriasis have clinical and histopathological overlap. We report two young male patients of true linear psoriasis without classical lesions elsewhere which were proved histopathologically. Seasonal variation and good response to topical antipsoriatic treatment supported the diagnosis.

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Reiter's syndrome with secondary amyloidosis

S K Sayal, S Sanghi, G K Prasad

A 35-year-old male had arthropathy of large joints, psoriasiform skin lesiHassan, Imran Majid

A 40-year-old male farmer with Brauer-Buschke-Fisher keratoderma is being reported in view of the rarity of this condition.

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Disseminated anogenital herpes simplex with encephalitis

Sukhjot Kaur, Gurvindar P Thami, Amrinder J Kanwar

A case of Herpes simplex encephalitis secondary to primary anogenital herpes simplex is being reported for its rarity. Despite intravenous acyclovir therapy, it had a fatal outcome.

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Juvenile pityriasis rubra pilaris

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Familial milia

Rashmi Sarkar, Gurvindar P Thami, Sukhjot Kaur, Amrinder J Kanwar

Milia occuring in six individuals of a family is being reported for its rarity as familial occurrence. Differentiation from eruptive form of milia is being emphasized.

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Painful bruising syndrome

G Kalla, Renu Roy, Renu Purohit, Anush Garg

Painful bruising syndrome (PBS) is a distinctive but rare clinical entity. We are reporting a case of PBS in a 26-year-old hysterical woman who responded excellently to oral cyproheptadin