Ocular manifestation, complications and aetiological factors in Stevens Johnson syndrome/toxic epidermal necrolysis

To describe the ocular manifestations of Stevens-Johnson Syndrome/Toxic Epidermal Necrosis among inpatients at a tertiary care hospital. The retrospective observational descriptive study was carried out at the Aga Khan University Hospital, Karachi, and comprised data on age, gender, aetiology and ocular findings related to patients diagnosed with Stevens-Johnson Syndrome/Toxic Epidermal Necrosis between January 2000 and December 2011. SPSS 19 was used for statistical analysis. There were 87 patients; 48[55.2%] of them being males. The overall mean age was 33.2 +/- 22.2 years, ranging from 1 month to 84 years. The most common aetiology was idiopathic 20[23%] followed by non-steroidal inflammatory drugs and anti-epileptics 11[12.6%] each. Besides, 84[96.6%] patients had oral mucosal involvement whereas 45[51.7%] had ocular and 27[31.0%] had genital-mucosal involvement. Glassroding was performed in 16[18.4%] patients due to minor conjunctival adhesions. Ocular manifestations of varying severity were frequent, with drugs being the most common aetiology

Multiple autoimmune syndromes associated with psoriasis: a rare clinical presentation

Autoimmune diseases are known to have association with each other but it is very rare to see multiple autoimmune diseases in one patient. The combination of at least three autoimmune diseases in the same patient is referred to as multiple autoimmune syndrome. The case we are reporting features multiple autoimmune syndrome with five different conditions. The patient had type 1 diabetes mellitus, autoimmune hemolytic anemia, systemic lupus erythematosus, vitiligo, and psoriasis. Psoriasis has rarely been reported previously under the spectrum of autoimmune syndrome. Although the relationship of autoimmune conditions with each other has been explored in the past, this case adds yet another dimension to the unique evolution of autoimmune pathologies. The patient presented with a combination of five autoimmune diseases, which makes it consistent type three multiple autoimmune syndromes with the addition of psoriasis. The current case is unique in this aspect that the combination of these five autoimmune disorders has never been reported in the past.

Exuberant ulcerated lesions of secondary syphilis on the palms - an unusual presentation

Ulcerated lesions in secondary syphilis are rare. Exuberant tissue is seen in condylomas of syphilis, which occur in flexural and occluded areas of the body and not in open areas such as palms. We report a case of secondary syphilis that presented with ulcerated exuberant lesions on palms, which on initial examination gave an impression of lesions of Orf and Milker's Nodule

Reticulated multifocal fixed drug eruption due to mefenamic acid - a new morphological pattern

Fixed drug eruption is a heterogeneous pattern of cutaneous reaction to certain drugs. Different morphological patterns of fixed drug eruption can occur. We describe a new morphology of fixed drug eruption showing a reticulated pattern as a result of ingestion of mefenamic acid and discuss the possible mechanism underlying such an appearance