Three patients with severe acne vulgaris, not responding with long courses of doxycycline, minocycline and erythromycin were given oral clarithromycin in pulsed regimen. The patients were given 7 days course of clarithromycin 250mg twice daily, which was repeated after a gap of 10 days. Such 3 courses were given. The lesions responded significantly. No significant side effect was noted. Pulse clarithromycin therapy seems to be a good alternative and effective tool in the management of severe acne vulgaris.

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The aetilogy of male pattern baldness (MPB) is not clearly found yet. The present study has been designed to determine if three is a significant statistical coincidence between MPB and pityrosporm group of fungal infection. This cross-sectional study covers 50 men with the diagnosis of MPB who visited the dermatology clinic of Qaem hospital of Mashhad Medical University as the case group and 43 men with no evidence of MPB as the control group. A questionnaire was filled out for each person of the two groups and mycological sampling was done from three parts of the case group scalp (bald, balding, intact areas) and two parts of the control group scalp (vertex and parietal). All the data were analysed using the software SPSS 10.00 and Chi-square, Pearson Chi-square and Friedman tests. Results showed that there was no difference between different degrees of infection in the intact area (p>0.05). Among the three parts of the case group scalp, bald area had the highest degree of infection (p<0.001). The degree of infection in the bald area of the case group scalp was higher than that of the vertex area of the control group scalp (p<0.001), while there was no difference between the degrees of infection in the intact area of the case group scalp and the parietal area of the control group scalp (p>0.05). This study supports some previous studies that claimed that there might be coincidence between MPB and pityrosporum fungal infection.

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A topic desmatitis is a fairly common disorder in the paediatric population. One hundred children were evaluated for epidemiology and clinical pattern with reference to age, age of onset, history of atopy, seasonal variation, type, distribution and extent of eczema etc. The results were tabulated, analysed and compared with data from previous studies. Findings such as onset at a very young age, a male preponderance, summer aggravation, facial dermatitis in preschool children, more acute presentation less disease severity and other regional variations are discussed.

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Seventy children up to the age of 12 years who were suffering from dermatophytosis, candidiasis or pityriasis versicolor were studied clinically and mycologically. Dermatophytosis was the major group, which constituted 52.86% of children. It was followed by candidiasis that constituted 40% of children and pityriasis versicolor was the least, being 7.14% of children. Amongst the clinical types of dermatophytosis, tinea capitis was the commonest (32.43%) followed by tinea corporis (27.03%). Candidial intertrigo was the commonest (42.86%) from of candidiasis, followed by diaper dermatitis (32.14%). Most susceptible age group was school going children. Peak incidence of infection was during the months of June to September. T rubrum was the commonest dermatophyte isolated in culture. C. albicans was the most common species of candida isolated in culture.

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A clinical and mycological study of 500 cases of superficial mycoses was conducted. Two hundred fifty two samples from various sites, viz., skin, nail and hair were positive on culture. The most prevalent clinical type was tinea corporis (36.2%) and the most prevalent aetiological agent was Trichophyton rubrum (62.3%). Nondermatophytic filamentous fungi and candida species were also isolated in 17 (6.74%) cases. It was concluded that along with dermatophytes, nondermatophytic fungi are also emerging as important causes of superficial mycoses.

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Fifty patients in each group with matched age, sex, duration of disease and possible extent of disease were evaluated for response to treatment with PUVASOL and oral minipulse after six months. Effects of both the treatment regimens. At the end of six months, 32 patients showed pigmentation, 12 showed no response and 6 deteriorated in those receiving PUVASOL, while 29 showed pigmentation, 17 showed no response and 4 continued to progress on therapy with oral minipulse. In both regimens, the rate and extent of improvement were unrelated to age, sex, duration and activity at presentation. Lesions on the face and neck responded maximally, while acral, mucosal, genital lesions and lesions with associated leucotrichia responded poorly to either regimen. Minor side effects were noted with both the therapeutic modalities. However, none were severe enough to discontinue therapy.

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A topic dermatitis (AD) in children has been shown to be associated with growth impairment in a few recent studies. There however, has been no report published on the growth pattern of children who have ‘pure’ AD, i.e., not accompanied by bronchial asthma. The objectives of our study were :I) To examine the growth pattern of children suffering from ‘pure’ AD and ii) to ascertain the relationship, if any, of selected disease parameters with growth attainments of children. A total of 108 children (63 males and 45 females), aged 1-5+ years with ‘pure’ AD were aross-sectionally examined for selected anthropometric parameters including height, weight, mid- upper arm circumference and biceps and triceps skin fold thickness. Fifty eight (54%) subjects weighed below the 10th centile and 23 (28%) were below the 10th centile for height of the NCHS standards. Boys showed relatively worse growth performance than girls from 1-4 years of age. There was no significant correlation between disease severity of extent and growth attainments. Our findings point to an impaired somatic growth in pre-school children with AD, boys faring worse than the girls, and to no association of growth performance with severity or extent of the disease

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A 30 year old man presented with multiple ulcers with necrotic base over scalp, neck, presternal region. Neither any systemic disease was associated nor any abnormality by laboratory investigation was found. Patient responding well to dapsone and corticosteroid. It was designated as a case of malignant pyoderma.

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A total number of thirty cases of exfoliative dermatitis was taken up for clinical evaluation with particular emphasis on the cause of the disease and to study systemic involvement. Eczema (46.6%) was the most common cause followed by psoriasis (16.6%). Elderly males were commonly affected with a mean age of 50.9 years.

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Necrobiosis lipoidica, a disorder initially thought to be a complication of diabetes, may also occur in non-diabetics. A 55 year old woman with histologically confirmed necrobiosis lipoidica, who did not have diabetes on presentation or during subsequent follow up, is reported. A good response to topical clobetasol propionate followed by betamethasone dipropionate was noted. A brief review of the literature has been included.

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A 30 year old male agricultural labourer presented with generalized itchy lesions over the back and extremities of 5 days duration. Cutaneous examination revealed multiple erythematous linear to serpentine lesions (numbering about 40) about 1-2 mm in width and ranging in length from 7 to 9 cm. The patient had eosinophilia and classical skin lesions, which responded very well to albendazole therapy. All these features supported the clinical diagnosis of dissenmintal cutaneous larva migrans.

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Six cases of pyoderma gangrenosum encountered with in a period of 2 years are described here with their clinical presentations and associations. Three patients were cases of superficial granulomatous pyoderma and three were of ulcerative type. Rheumatoid arthritis was found to be the associated disease in one of the cases of ulcerative type. Response to therapy was satisfactory in all of them expect in one case of ulcerative pyoderma gangrenosum who was resistant to most of the available therapeutic modalities.

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Benign adnexal tumours of the skin, excluding pilosebaceous tumours were identified in 24 patients between the ages of 9 and 70 years with a mean age of 34 years; 17 women and 7 men. Most lesions (n = 13) occurred on the face and scalp. Apocrine hydrocystoma and eccrine acrospiroma were the commonest tumors with apocrine and eccrine differentiation respectively. Few uncommon tumors with included were chondroid syringoma, syringocystadenoma papilliferum. Excisional biopsy is the treatment of choice.

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Angiolymphoid hyperplasia with eosinophilia is a disease of the occident. It is mainly seen in middle aged women. It presents as multiple small pink or purple popular or nodular eruptions, in the head and neck area. Lesions of angiolymphoid hyperplasia with eosinophilia are often confused with lesions of Kimura’s disease, which is more common in young males. We report a case of angiolymphoid hyperplasia with eosinophilia in a 34 year old female. The patient is responding to monthly intralesional triamcinolone acetate along with cryotherapy with liquid nitrogen. This case is being reported due to its rarity in Indian patients.

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Olmsted syndrome is a rare congential palmoplantar keratoderma with progressive periorificial hyperkeratotic lesions, alopecia areata, deafness, lental and nail changes. Only a few cases of this syndrome have been reported so far. Our case is a seven year old boy with massive palmoplantar keratoderma, perianal and periorifical hyperkeratotic plaques and autoamputation of digits. Alopecia areata, hyperkeratosis of elbows and knees and nail changes were also present. His physical and mental developments were normal. Routine laboratory tests were normal. The case is being reported for its rarity.

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A case of eccrine angiomatous hamartoma on the wrist in a 15 year old girl is presented for its rarity. Histopathology revealed increased number of normal eccrine structures and numerous capillary channels in the dermis.

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The appearance of spontaneous blisters that are usually confined to the hands and feet is a rare but specific event in diabetes mellitus. We present a case of diabetic bulla in a 60 year old male diabetic patient for its rarity.

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Cutaneous metastasis from visceral malignancy is uncommon. We report a 54 year old female operated for adenocarcinoma caecum who developed multiple cutaneous metastatic nodules while on chemotherapy.

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A 27 year old female presented with itchy lesions over the trunk and extremities of six month duration. She had typical lesions of scabies in hands, besides crusted hyperkeratotic lesions over the lumber and gluteal areas, and was found to have underlying HIV infection. The case is reported for unusual presentation and its rarity.

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