Relationship between duration, protein loss through scaling and serum protein levels in exfoliative dermatitis

Forty patients of exfoiliative dermatitis (ED), 35 of which were male and 5 female, constituted the study sample. The mean duration of ED were 10, 15 and 5 days for ED secondary to psoriasis, eczema and others, and drug reactions respectively. Fourteen (35%) patients had reduced serum protein levels of which 12 (30%) had reversal of albumin to globulin ratio. Normal serum protein levels were maintained upto 12.8 g of daily protein loss through scaling. In ED secondary to psoriasis, a mean duration of 15 days and protein loss of 16g per day through scaling were found to have significant (p<0.01) lowering of serum protein levels. In ED due to eczema and drug reactions, it was not significant. Total serum protein level was inversely proportional to the amount of protein loss through scaling and duration of the disease.

Pattern of skin disorders in Kashmir valley

A retrospective analysis of 166739 freshly diagnosed cases who had attended the Dermatology, STD and Leprosy outpatient department of SMHS Hospital (Associated teaching hospital of Govt. Medical College, Srinagar) during a period 12 years, was undertaken. Scabies, fungal infections and pyodermas were the major groups of skin diseases. Sexually transmitted diseases and leprosy followed by cutaneous tuberculosis were the rarest among the skin disorders.

Clinical presentation and treatment outcome in systemic lupus erythematosus

The frequency of occurrence of ARA criteria and other constitutional symptoms in SLE and the effect of various treatment modalities on these criteria were studied. Immunological features and arthritis were the commonest findings. Addition of an immunosuppressant made little difference to the clinical outcome.

Digital blood flow in systemic lupus erythematosus by photoplethysmography

Digital vascular status in 10 patients of systemic lupus erythematosus (SLE) suffering for 1 to 5 years and in 5 control (normal) subjects was assessed by a highly sensitive, non-invasive technique called photoplethysmography (PPG). Six patients (Group A) showed clinical signs of digital involvement whereas 4 patients (Group B) had no such sign. PPG recordings were done by applying the PPG probe serially to the distal phalanges of all the digits of four limbs with Velcro-strap at an ambient temparature of 27 to 31 ° C and humidity 60 to 65%. Diminished capillary flow was seen in all the SLE patients but control subjects showed normal flow. On average, 12 digits (60%) in Group A and 8 digits (40%) in Group B patients showed reduced blood circulation. Degree of vascular impairment had no bearing upon the duration of the disease. The PPG has objectively shown digital vascular impairment in all SLE patients having no correlation with the extent of clinical manifestations and the duration of the disease.

Serum lipid profile in leprosy patients in Kashmir valley

Serum lipid profile was evaluated in twenty leprosy patients (paucibacillary and multibacillary cases) and twenty age and sex matched healthy controls. The serum lipid profile of the two groups showed no statistically significant difference.

Pityriasis rubra pilaris in the Indian scenario

Pityriasis rubra pilaris (PRP) is an uncommon idiopathic papulosquamous disorder characterised by circumscribed follicular keratosis, palmoplantar keratoderma and frequently erythroderma. Seven patients of PRP (five females and two males) in the age range of 2 to 50 years seen over a 2-year period,are presented with their clinical features, triggering factors, associations and laboratory investigations. The clinical type of PRP was adult onset classical variety in three, juvenile circumscribed variety in two and adult onset atypical variety and juvenile classical variety in one each. The triggering factors were upper respiratory tract infection with nutritional deficiencies in two and folliculitis in one. The associated diseases were diabetes and depression with hypothyroidism in one each. The histopathology was consistent with PRP in all. Four patients were managed with oral vitamin A while one each was put on methotrexate, etretinate and topical steroids and they showed a good response. More number of cases should be studied over a longer period to substantiate the suggested immunologic mechanism of PRP.

Haemorrhagic SLE in a young male

Systemic lupus erythematous (SLE) is a systemic autoimmune disease that tends to occur in early adult life. The peak age of onset of the first symptom or sign in females is about 38 years and later in men, at about 44 years. Females outnumber men in this illness in a ratio of about 8 : 1. Cutaneous lesions in males have not been properly investigated and some studies in males with SLE have shown that the illness may present with atypical skin lesions. A case of SLE in a 20 year male who developed sudden onset of haemorrhagic vesiculobullous butterfly rash is described.

Giant molluscum contagiosum

A case of giant molluscum contagiosum (GMC) with AIDS is described here. Such GMC lesions usually occur in the late stages of HIV disease and are considered to be a marker of AIDS..

Monilethrix

Monilethrix is a rare structural hair defect leading to dry, beaded, brittle hair with characteristic thinning of hair in a rhythmic node internode pattern. We report a case of monilethrix in a healthy four year old child with no family history of similar disorder.

Monilethrix

Monilethrix is a rare heritable disorder characterized by a structural defect of the hair with increased fragility. We hereby report a case of monilethrix in a nine year old male child in view of the rarity of this condition.

Pellagra in an alcoholic

Pellagra is a nutritional disorder that occurs due to niacin deficiency. In the present day context, in western world, pellagra is confined to individuals who have improper food intake, such as psychiatry patients, alcoholics and recluses. Herewith, we report a case of pellagra occurring in a 60 year old male who was a chronic alcoholic.

Congenital erythropoietic porphyria - a report of two cases

Two classical cases of congential erythropoietic porphyria, a rare autosomal dominant disorder, are described.

Pretibial epidermolysis bullosa

A 34 year old Nepalese male presented with 10 year history of recurrent itchy erythematous papules, plaques and vesicles healing with scarring and milia on his shins. He also had dystrophic toenails since childhood. Family and past history were not contributory. Histopathological findings were consistant with the clinical diagnosis of pretibial epidermolysis bullosa (PEB). The patient was treated with oral vitamin E with some relief.

Confluent and reticulate papillomatosis

A 17 year old South Indian female born of consanguineous marriage presented with a widespread non-itchy eruption over scalp, face, below breasts and flexural aspects of limbs including axillae, inguinal regions and popliteal fossae since 3 months of age. The eruption consisted of individual small, flat, brownish black hyperkeratotic papules, which at some places, coalesced to form a reticulate pattern. Histopathological examination of biopsies from the axilla and forearm showed typical hyperkeratosis and papillomatosis without acanthosis. The dermis demonstrated a mild perivascular infiltrate. On the basis of the clinical and histopathological findings, a diagnosis of confluent and reticulate papillomatosis of Gourgerot and Carteaud was made. Partial response to doxycycline in our case points towards this being a keratinization disorder where microflora may be playing an exacerbating rather than a primary role.

Bilateral recurrent massive earlobe keloids : a case report and review of the literature

Earlobe keloid secondary to ear piercing is a recognized complication and may be unsightly and often cause significant distress to the patient. The size of the keloid may vary considerably; althorgh usually small, large lesions weighing up to 38 g have been reported. This article describes a case of bilateral recurrent massive keloid of earlobes and review of literature.

Unusual presentation of carcinoma tongue with distant skin metastases

Cutaneous metastasis from head and neck cancers is uncommon. More rarely, it is found as the initial presentation. Herein, we report an old lady with carcinoma tongue, who had cutaneous metastasis at the time of initial presentation.