Pachyonychia congenita-like nail changes treated successfully with a combination of vitamins A and E: a case report.

A 20-year-old man presented with thickening, subungual hyperkeratosis and discoloration of all the nails of both hands and both great toes since birth. No other ectodermal abnormalities were found. Treatment with vitamins A and E in high doses along with a moisturizing ointment topically for one year resulted in complete resolution of all nail abnormalities.

Therapeutic efficacy of intralesional triamcinolone acetonide versus intralesional triamcinolone acetonide plus lincomycin in the treatment of nodulocystic acne.

BACKGROUND: Intralesional triamcinolone is an established therapy for cysts of acne. However, intralesional antibacterials have not been used earlier. AIM: To compare the efficacy of intralesional triamcinolone with that of a combination of intralesional lincomycin and intralesional triamcinolone in nodulocystic acne. MATERIAL AND METHODS: Ten patients of nodulocystic were injected with intralesional triamcinolone acetonide (2.5 mg/ml), while nine patients were given lincomycin hydrochloride (75 mg/ml) in addition to the intralesional triamcinolone. They were followed up 48 hrs, one week and one month later. RESULTS: At one week, 7 patients (70%) treated with injection triamcinolone showed 66% improvement, whereas all 9 (100%) patients treated with lincomycin and triamcinolone showed 100% improvement which was stable at one month. CONCLUSION: A combination of intralesional triamcinolone and lincomycin is superior to intralesional triamcinolone alone in the treatment of nodulocystic lesions of acne.

Topical 20% KOH--an effective therapeutic modality for moluscum contagiosum in children.

Topically 20% KOH aqueous solution once daily at bedtime was applied in 27 children having molluscum contagiosum by their parents, till lesions showed signs of inflammation or superficial ulceration. 24 children (88.9%) completed the trial and complete clearance was achieved after a mean period of 17 days. No recurrence was observed during follow up period. Thus in this open trial topical 20% KOH aqueous solution has proved to be convenient, easy to apply at home, safe and inexpensive alternative therapeutic modality for the treatment of molluscum contagiosum in children.

Congenital melanocytic nevus studded with strawberry haemangioma on the scalp.

A six-month-old male infant presented with congenital melanocytic nevus (CMN) studded with strawberry haemangioma on the right side of scalp since birth. Both lesions were gradually increasing up to the present size. The case is being reported for its rare occurrence.

A study of behavioural changes and clinical evaluation of leprosy in school going children of leprosy parents.

Seventy-seven school going children in age group 5-15 years having one or both parents affected with leprosy and staying away from their parents in charitable ashram cum school for the last 6 months to 6 years time were examined for any behavioural changes and signs and symptoms of leprosy. None of these children showed any behavioural changes or signs and symptoms of leprosy.

Tattooing with electrocauterization: a cosmetically acceptable therapeutic modality for a single halo naevus.

Two cases of single lesion halo naevus were treated with tattooing followed by electrocauterization resulting in good cosmetic acceptability. Tattooing with electrocauterization should be tried as a new therapeutic modality in a single lesion halo naevus especially on exposed parts of the body to avoid the unavoidable psychological trauma.

Skin grafting in chronic leg ulcers--a dermatologist's domain.

A case of chronic leg ulcer for the last two years in a 50-year-old male, not responding to conventional therapeutic modalities had shown faster healing and excellent cosmetic results by undertaking split skin thickness grafting in the hands of a dermatologist.

Intraoral giant condyloma acuminatum.

A case of intraoral giant condyloma acuminatum is reported in a 50- year- old Indian. He did not respond to topical application of podophyllin 20% but responded partially to electric cauterisation. Surgical excision was done to get rid of the warty growth completely. Since there were no skin or genital lesions and no history of marital or extramarital sexual contact the lesion was probably acquired from environmental sources. Nonsexual transmission should be considered especially when the lesions are extragenital.

Chemical peeling--evaluation of glycolic acid in varying concentrations and time intervals.

Thirty-one patients with melasma, 4 with superficial post acne scarring and one each with xeroderma pigmentosum and epidermal naevus were studied to know the efficacy of glycolic acid for chemical peeling in varying concentrations and time intervals such as 35% (4 minutes), 52.5% (3 minutes), 70% (2 minutes) at varying intervals upto 6 months. These patients were in the age group of 17-44 years. These patients were followed up regularly. Results showed significant improvement when peeling was done with 52.5% glycolic acid for 3 minutes in melasma, 70% glycolic acid for 2 minutes in superficial post acne scarring.

Relationship between clinical conditions and CD4 counts in HIV-infected persons in Pune, Maharashtra, India.

BACKGROUND: A decade after the detection of human immunodeficiency virus (HIV) infection in India, a steady increase in the number of patients with acquired immunodeficiency syndrome (AIDS) has been observed. The therapeutic options for patients with AIDS in developing countries include chemoprophylaxis and identifying and treating opportunistic infections. CD4 counts help in clinical monitoring and making decisions about initiating antiretroviral therapy or chemoprophylaxis. Flowcytometry is expensive and available only at specialized laboratories. Therefore, the possibility of using clinical indicators to predict low CD4 counts and disease progression needs to be explored. METHODS: This cross-sectional study was conducted among 137 HIV-infected persons investigated at an HIV reference centre in Pune. The study methods comprised pre-test counselling, informed consent, blood withdrawal and clinical evaluation. Serum samples were tested for HIV and CD4 counts were estimated on FACSort. RESULTS: Study participants commonly reported with oral candidiasis, herpes zoster, pulmonary tuberculosis, lymphadenopathy, weight loss, rash, diarrhoea and fever. CD4 counts were significantly lower among men, symptomatic patients and those with oral candidiasis, weight loss and multiple clinical conditions. The sensitivity of most of the clinical conditions was low, the specificity was high and the positive predictive value of oral candidiasis and weight loss for low CD4 counts was > 75%. CONCLUSION: The presence of oral candidiasis and weight loss were highly predictive of low CD4 counts and these can be considered as markers of HIV disease progression. Absence of clinical conditions was found to be a good predictor of high CD4 counts. Larger systematic natural history studies may help in identifying clinical conditions that could have a prognostic significance among HIV-infected people.

Adherence of Streptococcus pneumoniae to buccal epithelial cells of smokers & non-smokers.

In vitro adherence of Streptococcus pneumoniae to buccal epithelial cells was assessed among smokers (51.9 +/- 20.8) and non-smokers (24.7 +/- 9.6) and found to be significantly higher (P less than 0.001) in smokers. The higher incidence of respiratory tract infection in smokers may be related to the enhanced adherence and better colonization of this bacterium in the throat.