Primary cutaneous melanoma of the foot

A 97 years old lady was admitted through the clinic with the history of a painless black lesion in the sole of her left foot. She clearly remembered presence of a nevus at that site since her childhood. The lesion had started to increase in size over the last two years and as it was not painful with no discharge or itching, she decided to delay medical consultation. She had associated osteoarthritis in both knees and angina pectoris, which was well-controlled on medications. Local examination revealed a 2 cm pigmented lesion with an irregular raised surface and irregular margins in the sole of the left forefoot. No intransit lesion could be visualized and the ipsilateral inguinal lymph node were not palpable. Systemic examination did not reveal any evidence of distant metastasis. The patient underwent routine preoperative blood tests including CBC, blood sugar level, renal function profile and ECG which were all essentially normal. The radiological metastatic workup was negative for systemic disease. She underwent excision biopsy under general anaesthesia which on frozen section confirmed malignant melanoma. A wide local lesion with 1.5 cm clearance and excision upto the plantar fascia was done. A split skin graft was placed to facilitate wound closure. Her post operative course was unremarkable and she was discharged next day from hospital. The final histopathology confirmed malignant melanoma Clark level 5 with clear margins of resection

Inhibition of multiplication of leprosy bacilli in nude mice by intermittent dosed new rifamycin derivative krm-1648 combined with sparfloxacin

The inhibition of multiplication of mycobacterium leprae inoculated into footpads of nude mice by the oral administration of new rifamycin derivative KRM-1648 and a new quinolone, sparfloxacin [SPFX]; was examined. When these two drugs were administered alternately at intervals of 3 or 4 days [thus once weekly for each drug] between 3 and 5 months after infection, the use of 0.6 mg/kg of KRM-1648 and 10mg/kg of sparfloxacin were found to be sufficient to prevent entirely multiplication of M.leprae. However with the alternate administration of 0.3 kg of KRM-1648 and 5 mg/kg sparfloxacin the inhibition of multiplication of M.leprae was partial as it was also examined with the administration of 1 mg/kg of KRM-1648 alone or 20 mg/kg/ of sparfloxacin alone once a weekly. However the simultaneous administration of 0.6 mg/kg of KRM-1648 with 10 mg/kg of sparfloxacin once per week entirely prevented the multiplication of M. leprae. Taking these findings into consideration there is possible future use of these type multi drug regimens was discussed

Inhibition of multiplication of leprosy bacilli in nude mice by simultaneous adminstration of new rifamycin derivative krm-1648 and sparfloxacin combined with dapsone

The inhibition of multiplication of mycobacterium leprae inculated in to foot pads of nude mice by oral administration of new rifamycin derivative KRM-1648 and a new quinoline, sparfloxacin [SPFX] combined with dapsone [DDS]: was examined. When these drugs administered simultaneously once weekly, the use of 0.6 mg/Kg of KRM, 10 mg/kg of sparfloxacin and 0.001/ Dapsone, entirely prevented the multiplication of M. leprae even the number of non solid bacilli detected was less than that inoculated into each foot pad. This study revealed the possible future use of this multi-drug regimen in the chemotherapy of leprosy patient