Phototesting in the Idiopathic Photodermatoses among Indians

50 patients with idiopathic photodermatoses were phototested using the solar simulator, with broad spectrum wavebands of the whole spectrum (WS) and the spectrum - ultraviolet B (WS-UVB) to determine the minimal erythema dose. Cases diagnosed as solar urticaria were further tested with visible light. Among the photodermatoses seen in this part of the country polymorphic light eruption (PLE) was the commonest followed by chronic actinic dermatitis (CAD) and solar urticaria. The UVB wavelengths appeared to be more responsible than UVA in PLE and CAD while the UVA and visible wavelengths were responsible for solar urticaria.

Effectiveness of Bacillus Calmette Guerin (BCG) vaccination in the prevention of Tuberculosis of Skin : A case control study

A hospital based pair matched case control study was performed at Government Medical College Hospital Nagpur to estimate the effectiveness of Bacillus Calmette Guerin (BCG) vaccination against tuberculosis of skin. The study included 48 cases of tuberculosis of skin in the age group of 21-34 years and equal number of controls, matched for age, sex and socioeconomic status. The estimates of protective effectiveness and prevented fraction were nonsignificantly higher for the subjects in the age group 21-30 years, males and subjects from lower strata of socioeconomic status. The overall vaccine effectiveness and prevented fraction was estimated to be 60.87 (15.46 - 81.89) and 36.83 (06.40 - 62.89) percent respectively. Results of this study thus indicated that BCG vaccination was moderately effective against tuberculosis of skin, in this population.

A Combination of Amoxicillin and Clavulanic acid in the treatment of impetigo in children

Amoxicillin plus clavulanic acid (ACA) a combination of potentially effective antibiotic against beta-lactamase producing bacteria was compared with that of amoxicillin, erythromycin and co-trimoxazole in an open label, randomized trial in 100 children with mild to severe impetigo.

22% children had mild, 25% had moderate and 53% children had severe impetigo. Pure growth of S. aureus was isolated in 68% children, S. pyogenes in 26% and both staphyto and streptococci in 6% children. In mild to moderate infection 100% children receiving ACA were cured clinically after first week, whereas 7 out of 15(46.6%) children in amoxicillin group, 7 out of 13 (53.1%) children in erythromycin group and 4 out of 12 (33.3%) children in co-trimoxazole group showed clinical cure after first week. In severe impetigo 46.1% children receiving ACA, 20% children in amoxicillin group, 16.6% children in erythromycin group and 7.6% in co-trimoxazole group showed clinical cure on therapy after one week. ACA was well tolerated in children.

Dermatophytosis and Immunodeficiency Virus (HIV) infection

The incidence of Human Immunodeficiency Virus (HIV) antibody through Enzyme Linked Immunosorbant Assay (ELISA) technique was observed to be 2.5% among the 200 patients with dermatophytosis. The incidence was less (1%) in those with chronic disease compared to those with nonchronic disease(4%). The positivity seemed to be more in females screened. The clinical presentation of dermatophytosis in HIV positive patients was similar to that seen in general pupulation. Trichophyton rubrum was the commonest isolate. Unusual widespred lesions and atypical lesions of nails like proximal subungual white onychomycosis were not encountered in the present series.

A regionwise Comparative study of post punch graft Appearence of Repigmentation (AOR) time in cutaneous Achromia

This study included 110 cases of stable and refractory depigmented skin conditions, of which 67 were female and 43 male. Age ranged between 6 and 71 years. A total of 1742 grafts were placed over 177 lesions on 29 regions and the cases were followed up to a maximum period of 2 years. The appearance of repigmentation (AOR) time was noted in different regions of the body. It was observed that exposed parts exhibit better outcome in comparison to covered and shadowed part. AOR ranged between 14 and 39 days, with an overall average being approximately 21.6 days.

Angiokeratoma Circumscriptum

A case of Angiokeratoma circumscriptum in a 13 year old female child is reported with swelling over right knee and presence of verrucous plaques on the same studded with papulonodular lesions since birth.

Scar Sarcoidosis - sparing post surgical scar

Infiltration of old scars by sarcoidal granuloma is not uncommon. However, pathogenesis of scar sarcoid is not clear. Peculiar involvement of road traffic accident scars with sparing of postoperative scar by granulomatous infiltrate in our patient suggests that foreign body contamination is essential in the evolution of scar sarcoid. Scar sarcoid can have systemic involvement at the outset in contradistinction to earlier reports as illustrated in our patient. Corticosteroids are effective in the treatment of these patients.

Naevoid Psoriasis

Naevoid psoriasis is a controversial entity and has often been used synonymously with psoriasiform inflammatory linear verrucous epidermal naevus (ILVEN) by some workers. Two patients having a linear psoriasiform eruption of 3 and 10 years duration respectively are reported. The winter aggravation of the lesions, the characteristic histology and favourable response to treatment led to to the diagnosis of linear psoriasis. These features distinguished it from psoriasiform ILVEN which is a close differential diagnosis.

Subcorneal Pustular Dermatosis in a child with Congenital Hypothyroidism : Association or Coincidental !

Subcorneal pustular dermatosis (SCPD) is a chronic benign relapsing, pustular eruption with distinctive histology1 affecting usually the females in the age group of 40 yrs. Recently, its association with hyperthyroidism has been reported2. We describe a child with congenital hypothyroidism and SCPD.

Fixed Cutaneous Sporotrichosis masquarading as Lupus Vulgaris

Sporotrichosis is reported to be rare in India. Fixed cutaneous variety is the most pleomorphic type of sporotrichosis and it may mimick several other dermatoses resulting in difficulty in making a correct diagnosis. Here we are reporting a case of fixed cutaneous sporotrichosis which resembled lupus vulgaris both clinically and histopathologically.

Lichenoid Sarcoidosis resembling Lichen Scrofulosorum

An old man with lichenoid papular lesions, dyspnoea and bilateral hilar lymphadenopathy resembling lichen scrofulosorum diagnosed as lichenoid sarcoidosis is reported. Differential diagnosis between lichenoid sarcoidosis and lichen scrofulosorum and therapeutic response to corticosteroids is discussed.

Squamous Cell Carcinoma in a plaque of Necrobiosis Lipoidica Diabeticorum

Squamous cell carcinoma developing in a chronic plaque of necrobiosis lipoidica diabeticorum is reported in a middle-aged, non-insulin dependent diabetic. The possible role of hypoxidosis due to poorly vascularized cicatricial structures, in inducing malignant changes is discussed.

Multiple Piloleiomyomata

A case of multiple piloleiomyomata on the dorsum of the left leg in a 32 year old male is presented. The lesions presenting as small painless nodules were thought clinically to be neurofibromata. Piloleiomyomas are rare neoplasms and need to be differentiated from dermatofibroma and smooth muscle hamartoma. Though these lesions have a benign course, they are known for recurrence and when several, total surgical excision is the treatment of choice as was done in this case.

Pilomatricoma in a 18 years female

A 18 year girl presented with an asymptomatic solitary nodule on the lateral aspect of the right elbow. Biopsy proved it to be Pilomatricoma. The lesion was excised. Pilomatricoma is a rare, benign tumour commonly occurring on the face and extremities and composed of cells resembling those of hair matrix, which undergo 'mummification' and may calcify.

Gianotti Crosti Syndrome

A 5 year old male child presented with erythematous papules on extensor aspect of joints of upper and lower limbs. Examination revealed generalised lymphadenopathy and hepatosplenomegaly. Investigations showed lymphocytosis. He was diagnosed as case of Gianotti Crosti syndrome.