Herpes Iris of Bateman in a 14-Year-Old

Erythema multiforme (EM) is an acute self-limited polymorphous eruption, probably mediated by deposition of the immune complex in the superficial microvasculature of the skin. Most common causes include infectious agents followed by drugs and contact dermatitis. Approximately 50 % cases are idiopathic.We report a case of a 14-year-old girl with vesiculobullous form of erythema multiforme eruptions with typical target lesions. Patient had recurrent episodes of herpes labialis for the past 4 years and recurrent erythema multiforme like lesions for the past 2 yrs. Serological investigation specific for herpes simplex type 1 virus concluded the etiological factor in this patient. There are only few case reports in India with Herpes Iris of Bateman kind of erythema multiforme lesions with positive infective trigger, and hence reported for its classical findings in this patient.

Ross Syndrome - A Rare Disorder of Sweating, Areflexia, and Tonic Pupil.

Sweating is a physiological process that is essential to maintain the temperature of the human body. Any derangement with this process leads to not only physical disturbances but can also cause psychological and social disturbances. Localized hyperhidrosis can have many causes. It can be a normal physiological response to local heat and pressure or it may be secondary to some pathological conditions causing local vasomotor disturbances (peripheral neuropathy or spinal injury) or sometimes it's secondary to neurological problems like tumour, inflammation and damage affecting the central nervous system, autoimmunity, viral infections and genetic disorders. Classically, Ross syndrome was described in 1958; it is a triad of Adie's pupil, areflexia and segmental hypohidrosis or anhidrosis.1 Anhidrosis is secondary to damage to the postganglionic cholinergic fibres that supply the sweat glands and in compensation, to the absent sweating in the affected segments there is over sweating elsewhere.2 Most of the times it is this excessive sweating that bothers the patient the most, in our case report we describe a patient who had excessive sweating over the left trunk and left lower limb which was, in fact, anhidrosis on the opposite side.Ross syndrome is a rare entity, (defined a clinical trial of segmental anhidrosis or hypohidrosis, areflexia, and atonic pupil. It is a progressive and complex disorder of Thermoregulation. The first component of the triad defines Harlequin syndrome and the last two defines Holmes-Adie syndrome). Ross syndrome has an unpredictable course. Usually, it presents with the absence of sweating in a particular area of the body which causes heat intolerance to the patient. There are only a few cases in the literature, here we present to you a case of Ross syndrome presenting with hyperhidrosis on the left side of the trunk and left lower limb. We intend this case report to inform academics and clinicians of various modalities about this entity, especially to the dermatologists, physicians and neurologists as patients usually present with this complex disorder to them.

Comparison of Conventional Radiotherapy with Accelerated Fractionation Radiotherapy in Squamous Cell Head and Neck Cancers – A Prospective Study

Introduction: Head and neck carcinoma is the most commoncancer. Radiotherapy along with concurrent chemotherapyhas long been the standard nonsurgical therapy for locallyadvanced disease. State of the art regarding radiation dosefractionation has evolved from once daily treatment to hyperfractionation and accelerated fractionation. The aim of thestudy was to assess the treatment response by locoregionalcontrol and radiation toxicity resulting from conventional andaccelerated fractionation radiotherapy in squamous cell headand neck cancers.Material and methods: In both arms,25 patients wererecruited for the study .Six fractions per week of radiationwere given in Accelerated fractionation (arm A) and fivefractions in the conventional group (arm B).All patientsreceived a radiation dose of 66 Gy /200 cgy/#/in 33 fractions.No chemotherapy was administeredResults: During and immediately after the end of radiationtreatment, the patients were assessed for locoregional controland radiation toxicity .78% of the patients in acceleratedfractionation arm and 72% of the patients in conventional armshowed complete response .Radiation toxicities were slightlyhigher in accelerated fractionation compared to conventionalfractionation radiotherapyConclusion: Improved locoregional control was observed inthe accelerated arm .The radiation toxicities were higher inthe accelerated arm but they were acceptable and controllable.Overall accelerated fractionation is a better choice of radiationtreatment in squamous cell head and neck cancers.