Melasma in the people of Sub-Himalayan region of Eastern India

To determine the spectrum of the factors influencing melasma in the people of Sub-Himalayan region of Eastern India especially Mongoloid in origin [Nepalese]. Hundred [94 females and 6 males] new cases of melasma, of Eastern part of sub-Himalayan region, were subjected to detail history taking regarding family, occupation, and daily activities. A thorough clinical evaluation followed by investigation was done. Fifty cases were in the age group of 21-30 years, whereas according to the onset of disease 54 cases were in that age group. Sixteen cases had the age of onset 11-20 years, of these 75% had positive family history. Overall family history was observed in 40% of cases. By occupation 70 cases were housewives and the duration of sun exposure was more than 2 hours in 80% of cases. Twenty two patients were oral contraceptive pill users and 6 cases were pregnant women. The people suffering from melasma of Eastern sub-Himalayan region, have genetic predisposition especially in early onset disease. Quantum of UV exposure not only depends on the duration but also reflected sun light from snow covered hills. Sunscreen is used as preventive measure

Carbon baby syndrome: two case reports

Carbon baby syndrome, also known as universal acquired melanosis is one of the causes of diffuse hyperpigmentation of skin and mucosa with only a limited number of reported cases in the literature. We here report, two cases of universal acquired melanosis in two siblings of a family. They developed progressive darkening of skin and mucosa from 5 and 4 months of their lives, respectively. The colour change was insidious, asymptomatic, progressive and generalised. Histopathology showed increased pigmentation of epidermal basal layer. According to clinicohistological assessment, the cases were diagnosed as carbon baby syndrome with familial clustering

Adult-onset Gunther's disease [congenital erythropoietic porphyria] in a 37-year-old man: a case report

A 37-year-old man presented with multiple blisters and ulcerations over the sun exposed skin of 2 years duration. His clinical, radiological, hematological features, fluorescent microscopy of urine and histopathology of subepidermal blister with PAS-positive material deposited in the upper dermis in a perivascular and periadnexal distribution were suggestive of congenital erythropoietic porphyria, was treated with beta carotene and advised to avoid sun exposure by using sun protective clothing. We repot this case because of its rarity

Metastatic adenocarcinoma of unknown primary origin

Cancer of unknown primary [CUP] origin is the diagnosis when metastatic cancer is found but the primary site cannot be determined. The peculiarity of our case is eleven months after the occurrence of two lesions of florid cutaneous metastases, the primary tumor or metastasis to a second organ could still not be identified despite thorough investigation

Extramammary Paget's disease: presenting in an unusual site

Extramammary Paget's disease [EMPD] is a rare neoplasm with only a limited number of reported cases in literature. It is mainly composed of intraepidermal Paget cells and possesses variable clinical behaviour and histological appearance leading to difficulty in diagnosis. We here report a case of primary EMPD in a 71-year-old male who presented with gradually progressive, pruritic, eczematous lesion in suprapubic region, not responding to topical medications. Histological assessment showed Paget cells infiltration throughout the epidermis with dermal invasion. Using immunohistochemistry, the expression of CK7, carcinoembryonic antigen [CEA] was examined to elucidate cellular differentiation of the carcinoma