Grading of Severity of Atopic Dermatitis in North Indian Children

Severity of atopic dermatitis (AD) was assessed in 80 children (up to 12 years), 48 boys and 32 girls, using grading system as suggested by Rajka and Langeland. Thirty three (41.25%), 44 (55%) and 3 (3.75%) patients had mild, moderate and severe disease respectively. Mean severity scores were 3.5, 5.7 and 8.3 respectively in these 3 groups. Boys had a more severe disease than girls. Patients with early (0-3 months) and late onset (6-9 years) of disease had maximum severity, mean severity scores being 5 and 5.3 respectively. Patients with moderate AD had a more prolonged course than those with mild disease. Family history of atopy had no impact on the severity of AD, although personal history of atopy was common in patients with moderate AD. Face was equally affected in mild and moderate disease groups. Extensors were more commonly affected than flexors in mild disease group.

A Study on the Role of Neem, Haldi, Sajina and Garlic oil (Nutriderm oil ^® ) in Pyoderma and Infective Dermatitis

Seventy cases of pyoderma and infective dermatitis were studied. These included, as control, 10 patients who applied 1% gention violet only. Other 60 patients (30 impetigo, 20 infective dermatitis, 10 falliculitis & furuncle) were treated with application of Nutriderm oil for 2 weeks 83% of impetigo, 75% of infective dermatitis and 50% of folliculitits and furuncle were cured after 2 weeks of treatment, free of side-effects. Neem, Haldi, Sajina and Garlic oil (Nutriderm oil) in judicial combination can act as an inexpensive substitute for topical antibiotics and corticosteroids.

pH-Mapping of Prepubertal Skin of Indian Subject

pH-mapping of skin was made by measuring the skin surface pH in 61 normal Indian subjects (35M, 26F) in the prepubertal age group at 21 different sites from scalp to sole at an ambient temperature 25-320C and a relative humidity 60-65%. The pH values at axilla, umbilicus, palm, fingerfolds, foot, sole and cheek were found to be consistently higher than those at scalp, forehead, retroauricular and popliteal fossae, anterior arm, anterior forearm, posterior neck, back, dorsum of hand, anterior leg and anterior thigh. In each site, the mean pH of male skin appeared to be lower than that of female. The highest pH recorded was in axilla (5.98 for male, 6.00 for female), irespective of sex. The lowest value however was in anterior neck (4.59) for male and in antecubital fossa (4.83) for female.

While the origin of the skin pH is yet to be definitely known, it was observed that a high density both sweat gland and bacteria flora leads to a high pH and a high concentration of sebaceous gland and of bacterial flora to a lower pH.

Autologous Punch Grafting in Vitiligo : A Six Year Study

A 6-year study (1989-1995) on atologous punch grafting was performed in 410 different sites of 184 resisitant, stable and localised vitiligo patients at Calcutta Skin Institute. Grafting was undertaken by skin biopsy punch and curved scissors keeping of distance of 1-2 cm between adjoining grafts, the donor site graft being 0.5 mm to 1 mm larger than the recipient one. 12 cases were halo nevus, the central mole of which was excised and subsequently grafted.

The grafts were well accepted in 385 (93.9%) sites and rejected in 20 (4.9%) sites due to secondary infection and in 5 (1.2%) for poor care in immobilisation by the patients. Spontaneous pigment-spread was seen in 77 (18.8%) sites, predominantly on face, neck and upper trunk. Post-surgical psoralen with sun-exposure contributed to pigment-spread in 295 (71.9%) sites. Pigment-spread was not seen at all in 13 (3.2%) sites, mainly located on bony prominences (tibial surface and maleoli), fingers and feet. Perigraft hyperpigmentation was seen in 29 (7.1%) sites, especially on sun-exposed area.

Excellent pigment-spread was seen in 8 (66.7%) cases of halo nevus; 3 (25%) showed sinking pits and 1 (8.3% remant of mole.

Raised graft surface (cobblestoning) was observed in 171 (41.7%) sites of which 81 (19.8%) later got corrected spontaneously. Pigment-spread was not uniform in 36 (8.8%) sites. Keloidal growth at donor sites was seen in 12 (2.9%) cases.

This simple, unique, economic, outdoor-based, effective and cosmetically acceptable procedure may be a positive answer to many refreactory vitiligo patients.

A Comparative Study of Efficacy of Gamma Benzene Hexachlordie Lotion and Benzyl Benzoate Emulsion

In a clinical study, the efficacy of gamma benzene haxachloride lotion was evaluated in 50 adult patients in scabies using 2% concentration and in 24 children under 8 years of age using 1% concentration. Use of other scabicidal preparation was 25% benzyl benzoate emulsion for a comparison with second group of patients of the same size. Two applications for 1 day of 2% gamma benzene hexachloride lotion proved to be far more effective a scabicidal drug (68% cure) in adult and 1% gamma benzene hexachloride (91.7% cure) in children compared to benzyl benzoate emulsion.

Squamous Cell Carcinoma Arising From a Burns Scar and Presenting As a Cutaneous Horn

A 34 old woman presented to the Dermatology O.P. with a burns scar of duration more than 3 decades. She had developed a horny excrescence from this scar for the past 6 months. Histopathology of the base of the lesion showed evidence of a squamous cell carcinoma. This case is reported to stress the need for long term follow up of all cases of burns scars due to potentially lethal complication of malignant transformation.

Hemorrhagic Chickenpox

A case of chickenpox in a boy of 16 years is described for its uncommon presentation with hemorrhagic vesicles, gum-bleeding without being preceded by any prodromal symptom and unassociated with any immunosuppressive disorder.