Eighty male patients with AGA, not treated in the previous 6 months were enrolled in this randomized, double blind, placebo controlled trial to assess the safety and efficacy of finasteride, 1mg daily, on hair growth. Patients were randomized into 2 groups: Group 1 received 1 mg of finasteride daily and Group 2 received a placebo for a period of 12 months. Efficacy was assessed by hair counts, photographic records, patient's self-assessment questionnaire and clinical assessment. Safety was assessed by history taking and laboratory parameters. A total of 39 patients completed the study. Finasteride was rated superior to placebo with respect to all efficacy measures. At the end of study, finasteride treated patients had a mean increase of 20.56±4.73 hairs compared to a decrease of 9.56±5.53 hairs in placebo treated patients. Photographically, 69.56% of finasteride treated patients were rated as improved at 12 months compared to only 6.25% of placebo treated patients. Ten (25%) of finasteride treated patients developed adverse effects (5-decreased libido as well as erectile dysfunction, 4-erectile dysfunction, 1-decreased libido). Finasteride in comparison to placebo was effective in promoting hair growth in male patients of AGA. However, the side effects to the drug were high in this study.

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Keloids and hypertrophic scars are abnormal responses of body to skin injuries. Overproduction of compacted fibrous tissue is the basic cause of these lesions. In this study the result of treatment of these skin conditions with bleomycin tattoo are compared with cryotherapy and triamcinolone injection. This study involved 45 patients with hypertrophic scar or keloid. Patients were divided into two groups consecutively. Group A (23 patients) was treated with bleomycin tattoo and the group B with cryotherapy and triamcinolone injection. There were four therapeutic sessions one month apart. All patients were followedup for three month after the end of treatment .The therapeutic response was determined as reduction of lesion size or flattening relative to initial size. Therapeutic response was 88.3±14% in group A and 67.4 ±22.5% in group B (p<0.001). In group A 69%, but in group B only 49% of patients were asymptomatic after the end of treatment. In group A there was no relation between therapeutic response and lesion size (p=0.58) but in group B lesions those were smaller (<100mm2) had better therapeutic response than larger ones (p=0.007). It was concluded that bleomycin tattoo is more effective in treatment of hypertrophic scar and keloid than traditional treatment, cryotherapy plus triamcinolone injection especially in larger ones.

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A 15 year old boy with clinical, hematological and biochemical profile of congenital erythropoietic porphyria with hemolytic anemia is being reported in view of the rarity of this condition.

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Pityriasis rosea is an acute inflammatory dermatosis of unknown etiology with a self-limited course. Fifty patients of pityriasis rosea attending out patient department of our hospital were selected for the study and the data was analysed. In the present study out of 50 cases, 30(60%)were males and 20(40%)were females, giving male: female ratio 1.5:1. Majority of the patients 16(32%) were seen in the age group of 11-20 years. Precipitating factors include wearing new garments in 10(20%) patients, drugs in 5(10%) and both new garment and drug in 1(2%) patient. Thirty five (70%) patients presented with herald patch and the distributions of secondary eruptions were mainly on the trunk among 47(94%) patients. Classical pityriasis rosea (62%) was the commonest morphologic type, followed by atypical pityriasis rosea (38%) which include absence of herald patch (30%), localized pityriasis rosea (4%) and inverse pityriasis rosea and papulo -vesicular pityriasis rosea (2%) each.

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A 63-year-old woman presented with an asymptomatic slowly growing lesion on the nose of 5 years duration. On cutaneous examination, the nose and adjacent left cheek showed a single, large, ill-defined, indurated annular plaque with distinct margin. Close examination of the edges of the plaque revealed thread like raised border. A biopsy from the edge of the plaque showed buds and irregular proliferations of tumor tissue attached to the undersurface of the epidermis and masses of epitheliometous basal cells in the dermis surrounded by clear-cut spaces and dermal fibrotic changes. The peripheral cell layer of the tumor formations showed palisading. These histologic features were consistent with basal cell carcinoma. We, herewith report this case of overlap of superficial spreading BCC with morphea-like basal cell carcinoma for its rarity and unique features.

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Drug eruptions confined to intertriginous areas are rare and unusual cutaneus manifestations of amoxicillin sensitivity. We describe here three such cases of intertriginous drug eruptions. Two of these patients had developed fexural exanthematous rash and mild systemic symptoms following amoxicillin administration while in the third it was due to, hitherto unreported, celecoxib. Their possible patho-mechanism in the light of current knowledge is also discussed.

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Evidence of growth retardation was recorded in cases of severe atopic dermatitis before the advent of corticosteroid therapy and can therefore be attributed to the disease. The present study is an attempt to confirm the validity of such claims in Indian scenario. A total of 100 children with atopic dermatitis and 100 age and sex matched controls were evaluated for growth status and compared at the department of pediatric dermatology, Institute of c0 hild h0 ealth. Significant proportion of children with atopic dermatitis showed growth retardation with respect to their weight and height as compared to the controls. Statistically significant association was observed to exist between growth retardation with both the surface area of involvement of the disease and the severity of atopic dermatitis while no such association was found to exist with either sex or personal history of atopy .Our study shows that growth retardation occurs more frequently in patients with atopic dermatitis as compared to nonatopic children from the same population. This shows that there may be an association between growth and the disease process. In our study we also found that the growth retardation occurring in cases of atopic dermatitis is associated with the severity of the disease as well as the surface area of involvement.

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Epidermolysis bullosa (EB) pruriginosa is a rare distinct variant of dystrophic EB. It is characterized by extremely pruritic, lichenified or nodular lesions predominantly over legs, milia formation and albopapuloid lesions on the trunk. Toe nail dystrophy is a consistent finding in adult patients. The rarity of intact blisters, prominent nature of some of the scars and the marked lichenification with severe pruritus lead to a confusion with commoner disorders, like lichen simplex chronicus, lichen planus hypertrophicus and dermatitis artefacta. We present a rare and interesting case of EB pruriginosa where the diagnosis was confirmed with help of characteristic histopathology.

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A 42 year old male had pemphigus vegetans of Hallopeau of groin and perianal area for the last 4 months. He also had lesions on scalp and mouth. Histology showed intraepidermal eosinophilic abscess.

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A 58 year old male presented with multiple areas of painless purulent discharge from the buttocks. He had pallor and dermatological examination revealed multiple subcutaneus nodules and discharging sinuses over the buttocks with hyperpigmentation and indurated puckered scarring. Examination of the pus revealed 'sulphur granules' and Gram stain showed narrow bacillary forms and elongated hyphae with occasional branching. Skin biopsy revealed granular colonies in which 'ray fungus' were seen. In brain-heart glucose agar in anerobic environment, white spidery colonies of Actinomyces israelii were grown at 37o C in 4 days, confirming primary cutaneus actinomycosis. He was managed with capsule doxycycline with regression of pus discharge in 6 weeks and therapy is planned for 18 months.

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A 23-year-old male developed right hemifacial atrophy following marphea profunda. Facial asymmetry due to residual atrophy was treated with autologous fat harvested from buttocks with marked cosmetic improvement.

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A 12 year old boy presented with pain and stiffness in large joints with tautness of skin, dysphagia and respiratory distress of 1 year duration. There was osteopenia on X-ray of limbs. Histopathology revealed features of morphea. There was no history of Raynaud's phenomenon.

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P₅₃ tumor suppressor gene mutation is one of the most common genetic alteration in human malignancies. This study was done to determine the prevalence of the P₅₃ antigen expression by sex, age, type of melanoma, thickness of the lesion and site of the antigen expression either cytoplasmic or nuclear. Paraffin embeded block of 50 patients (45 primary and metastatic)with documented diagnosis of melanoma deparaffinized and immuno stained with DO-7 monoclonal antibody. The lesions were divided depending on the degree of the staining as follow: 1. no staining, 2. mild (less than 10%), 3. moderate (10%-50% staining), 4. severe (more than 50%). Fifty four percent of evaluated patients were female and 46% were male. Forty percent of lesions were graded as no staining, 36% of lesions showed mild staining, 14% moderate and 10% severe staining site of expression was excusively in the cytoplasm. There was no meaningful statistical deference between severity of staining and the age group, sex, type and thickness of melanoma. (p value was 0.532, 0.488, 0.626, 0.954 respectively).

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