Cutaneous neonatal lupus erythematosus with unusual features.

A three month-old boy was brought by his mother with complaints of multiple reddish lesions on his trunk and face since birth. The patient had erythematous annular plaques with scaling on his extremities, palms and soles with periorbital erythema and edema giving the characteristic "eye mask" or "owl's eye" appearance. His mother did not have history of any illness. Hemogram, liver and renal function tests were within normal limits. A skin biopsy was suggestive of subacute cutaneous lupus erythematosus. Immunological work-up was positive for antinuclear antibodies (ANA) (1:40) with anti-Ro titers of 3.4 and 3.47 (>1.1 = clinically significant titre) in the mother and child respectively, although negative for anti-La antibodies. The child's electrocardiogram and 2D echocardiography were normal. We are presenting a case of anti-Ro-positive cutaneous lupus erythematosus with an uncommon skin manifestation.

Trichophyton violaceum: a rare isolate in 18-day-old neonate.

Trichophyton violaceum, a less common and geographically restricted infection is reported in a 18-day-old neonate. The diagnosis was made by potassium hydroxide of skin scraping examination and confirmed by culture. The patient was treated successfully with miconazole nitrate application. A large family with crowded living was considered the main predisposing factor.

An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in dermatology indoor patients.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen. Indiscriminate and increased use of systemic antibiotics has led to the emergence of MRSA. Infected or colonized ward patients are the main reservoir of infection. Once colonized, the risk of subsequent local and systemic infections is high, especially in the elderly, and in debilitated and immunosuppressed patients. METHODS: We report an outbreak of MRSA in the dermatology ward of a tertiary care hospital and describe measures taken to control it. RESULTS: Ten patients were found to be MRSA positive over a span of three months while screening swabs from wet lesions in indoor patients. On the basis of risk assessment, they were treated with appropriate systemic and topical therapy. One patient died while the remaining nine patients showed a good response to therapy. All the MRSA isolates were found to be sensitive to vancomycin, teicoplanin and linezolid. CONCLUSION: This is the first case report of MRSA infection in dermatology indoor patients in India.

Esophageal involvement in pemphigus vulgaris.

Twenty five patients with pemphigus vulgaris were prospectively studied for esophageal involvement by endoscopic examination. Eighteen (72%) had esophageal involvement; the majority of the lesions were bullae. Histological examination showed acantholysis of the cells and exuberant inflammation.