Sexually transmitted infections (STIs) are more dynamic than other infections prevailing in the community. It is important that such dynamic epidemiological changes in STIs are acknowledged and kept track of in a vast and populous developing country like India, particularly in this HIV era. It is with this aim that the authors have reviewed the relevant literature in STI epidemiology in India during the past 25 years. Admittedly, there has been heterogeneity of data to account for the subcontinental dimension of this country. But a basic pattern in the changing epidemiology is discernible. Like the developed countries, in India too the bacterial STIs like chancroid and gonorrhea are declining, while viral STIs like HPV and herpes genitalis are on an upswing. The overall decline in the prevalence of STIs has to be interpreted with caution, however. This may partially reflect the improved facilities of treatment in the peripheral centres that obviates the need of many patients in attending the STD clinics in the tertiary centres. Also, the improved pharmacotherapy of many of the bacterial STIs may result in partial clearance and non-reporting of many of these infections.

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Background and Aims: Treatment of plane warts is problematic, methods such as cryotherapy and cauterization is associated with high recurrence rate, risk of scar, pain and high cost. Topical tretinoin causes irritant contact dermatitis that limited its use. Citric acid was used in treatment of warts in traditional medicine of Iran. We evaluated the efficacy of 50% citric acid solution in water in treatment of plane warts and compared it with 0.05% tretinoin lotion. Materials and Methods : This study was a double blind; prospective, case-control study.Seventy-five patients with bilateral plane warts who signed informed consent were included. Exclusion criteria were pregnancy, breast-feeding, suffering from any systemic disease and the use of any other drug due to treatment of warts in past six weeks. The patients randomly used citric acid or Tretinoin lotion to lesions at each side of the body. Randomization was performed by coin-flipping. Patients were examined at three weeks interval for six weeks and number of warts were recorded in the proforma, which included the name, sex, address and code of the drug that was used in each side of the body and side effects. The results were analyzed by Chi-square test statistically. Results: After six weeks 64.4% of the lesions in citric acid treated group disappeared versus 53.7% of the lesions in tretinoin treated group. This difference was significant ( P value Conclusion: On the basis of this study, the treatment of plane warts by 50% citric acid is strongly suggested. This modality is superior to tretinoin lotion due to higher efficacy and low incidence of side-effects and lower cost.

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The present article reviews various evolutionary events that resulted in skin color variation among humans. Skin of the early man is presumed to be colorless as that of the chimpanzees. During the course of evolution, hairless state of skin with sweat glands would have occurred for the purpose of thermoregulation. Thermoregulation was very important for brain development and function. In due course, pigmentation occurred in the naked skin of man in order to offer photo-protection. The physiological demand of vitamin D ₃ and folate in human system and the effect of sun-light in their synthesis and metabolism would have further established some changes in the skin color of man in various geographic locations. Although genetics and physiological adaptations have determined human skin color in different groups/races, during the course of civilization, humans have developed a deep desire to change skin color. Current scientific research on development of novel agents for modulation of skin color is likely to benefit in pigmentary disorders and also in psychological well being through the use of cosmetics.

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Androgenic alopecia (pattern baldness) is a condition in which there is androgen mediated progressive miniaturization and loss of hair follicles in a genetically susceptible individual. A 47-year-old male patient with advanced degree of hair loss (Norwood 6 category) wanted to go for full hair restoration surgery. Due to the limited availability of donor hair in the scalp, a small session with 700-chest hair was performed. On follow-up at eight months it was observed that chest hair grew and formed a cosmetically acceptable forelock.

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This study was done amongst 2550 consecutive skin patients in our male OPD. Infective dermatoses was seen in 36.41% and allergic diseases in 29.88% of our patients. New cases of leprosy accounted for 5.64% of our cases, which we consider is a disturbing trend. Occupational dermatoses was seen 15.24% of our cases. Farmers and agricultural labourers comprised the largest segment (37.72%) of our patients.

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Context: Psoriasis is a chronic proliferative inflammatory skin disease with unknown etiology. The loss of scale from the surface observed in the course of psoriasis may be related to lipid disorders in epidermis and in serum. Moreover a predisposition to occlusive vascular disease and increased cardiovascular morbidity has been reported. Aims: In this study, the serum lipid levels of psoriatic patients were investigated to detect any relation in this respect. Materials and Methods: 60 psoriatic and 120 nonpsoriatic individuals were included in this case control study and were analogized for sex, age and body mass indices. Total cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) levels were measured. Statistical Analysis Used: Collected data were analyzed by statistical tests of Chi square, Mann Whitney and Kruskal Wallis applying SPSS software. Results: Total cholesterol, triglyceride and LDL-C were found to be significantly higher than in normal control group ( P <0.05). No significant statistical difference was observed between HDL level of the two groups. Conclusions: We concluded that psoriatic patients should be evaluated for hyperlipidemia and obstructive vascular diseases. Administrating lipid-lowering medicines for patients particularly cases with severe disease may be beneficial prognosis.

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The presentations of acute angioedema vary and depend upon the organs involved. Acute episodes of angioedema can be life-threatening if it involves the larynx leading to the obstruction of upper airways and it is a major cause of death. Angioedema involving the lips, cheek and tongue are common with bizarre presentations. Angioedema of the gastro intestinal tract frequently mimic an acute abdomen resulting in unnecessary surgical intervention and increased morbidity. Here we present an unusual case of angioedema involving the external urethra resulting in severe discomfort and burning sensation during micturition. He was later investigated and diagnosed as idiopathic urticaria with angioedema and promptly responded to antihistamines.

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Context: Atopic dermatitis is a common disease that is diagnosed by use of Hanifin, Lobitz and Rajka's criteria based on patient history and clinical features. However these criteria are not suitable for population-based studies. Aims: The purpose of this study is to develop a minimum list of diagnostic criteria for atopic dermatitis that is sensitive, specific, reproducible, noninvasive, applicable to adult Thai population and easy to perform in population-based studies. Settings and Design: This study was conducted at Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University, Bangkok, Thailand. Materials and Methods: The new cases of typical mild to moderate atopic dermatitis and exactly age-matched and sex-matched controls presenting with an inflammatory skin disease other than atopic dermatitis were selected from Department of Dermatology, Faculty of Medicine Siriraj Hospital. Each subject was examined with reference to 31 clinically diagnostic features of atopic dermatitis proposed by Hanifin and Rajka. One hundred and forty patients (70 cases and 70 controls) were studied. Statistical Analysis Used: Sensitivity and specificity of each criterion was calculated using the dermatologist's diagnosis as the standard. Regression techniques were then used to derive a minimum set of diagnostic criteria. Results: Using multiple logistic regression techniques, a minimum set of diagnostic criteria for atopic dermatitis was derived: visible flexural dermatitis, history of flexural dermatitis, duration of rash >6 months and visible dry skin. Conclusions: A minimum list of diagnostic criteria for atopic dermatitis was derived that should be of use in Thai population-based studies.

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Sebaceous hyperplasia of forehead, presenting as pin-sized translucent vesicles in a young girl is presented. The lesion was clinically mistaken for lymphangioma circumscriptum. Microscopic examination of punch biopsy of skin helped to arrive at a proper diagnosis.

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Background: Skin diseases are common in childhood and they are common reasons for pediatric visits to the hospital. In spite of this high occurrence, there are very few prospective studies addressing this issue. Aims: The present study was directed at determining the spectrum of dermato-pathological lesions encountered in a large general tertiary care hospital, over a two-year period. Materials and Methods: 107 cases formed the total sample studied, in a part prospective and part retrospective study. A detailed clinical history was recorded on a proforma prepared for the purpose and gross photographs were taken wherever possible. Results: Skin biopsies accounted for 7.29% of the total surgical pathology load, 55.44% of the total pediatric biopsies and 10.82% of the total number of skin biopsies. The age and sex distribution pattern revealed that the maximum number of biopsies (62.61%) were of older children, with a male preponderance (57.94%). The anatomic distribution pattern indicated predominant involvement of the limbs (59.82%). The maximum numbers of cases were of infectious nature (24.29%); the most frequently encountered being borderline tuberculoid Hansen's disease (8.4%). A positive correlation with the clinical diagnosis was obtained in 56.07% cases. Conclusions: Histopathology contributed to the diagnosis in a significant number of (82.23%) cases, indicating its importance and utility.

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Melanoacanthoma is a benign mixed tumor of melanocytes and keratinocytes. It has been regarded as a rare variety of Seborrheic keratosis. A 50-year-old male presented with multiple asymptomatic pigmented growths on the lower abdomen, inner thighs, external genitals and perianal areas. Histopathology revealed features of melanoacanthoma. The case is being reported for unusual sites of occurrence of an uncommon cutaneous tumor.

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A 29-year-old male patient presented to us with multiple swellings on his left leg associated with localized sweating and occasional throbbing pain. Based on the clinical features and histopathology, a diagnosis of Eccrine angiomatous hamartoma was made. The patient showed good response with regression of lesions after four intralesional injections of ethoxysclerol (polidocanol). We present this as a case of late onset eccrine angiomatous hamartoma with multiple lesions, responding to treatment with intralesional ethoxysclerol.

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