A new occlusive patch test system comparable to IQ and Finn chambers.

Background: A good patch test system should have good adhesion and contact, and minimal leakage; Finn and IQ patch test system have these properties but are expensive. Aims: To develop a new cost‑effective occlusive patch test system that had good contact with the skin and was non‑irritant. Methods: The system (designated Chamber X) was fabricated using a semi‑permeable tape and a flexible virgin plastic chamber. Chamber X was developed by (i) selecting adhesive tape based on its non irritancy and adhesive potential (ii) testing plastic chamber material for its skin irritancy (iii) testing the assembled system against Finn, IQ and locally available chambers for irritancy, contact, leakage and occlusivity. Results: Chamber X showed better occlusion than IQ, Finn and locally available chambers and was comparable to, (P > 0.05) IQ and Finn in terms of irritancy, contact and leakage. Conclusions: The results demonstrate that the Chamber X offers a cost effective patch test system comparable to IQ and Finn chambers in terms of safety, adhesion, leakage and occlusivity.

Interface dermatitis.

Interface dermatitis includes diseases in which the primary pathology involves the dermo-epidermal junction. The salient histological findings include basal cell vacuolization, apoptotic keratinocytes (colloid or Civatte bodies), and obscuring of the dermo-epidermal junction by inflammatory cells. Secondary changes of the epidermis and papillary dermis along with type, distribution and density of inflammatory cells are used for the differential diagnoses of the various diseases that exhibit interface changes. Lupus erythematosus, dermatomyositis, lichen planus, graft versus host disease, erythema multiforme, fixed drug eruptions, lichen striatus, and pityriasis lichenoides are considered major interface diseases. Several other diseases (inflammatory, infective, and neoplastic) may show interface changes.

Assessment of age in foetus: A medicolegal aspect.

A Medicolegal case of embryo/foetus was received from the department of forensic medicine for the assessment of age of the foetus. The report for the assessment of age was prepared on the basis of gross appearance, radiological and histological examinations. On radiological examination of the limb tissue, the age of the foetus /embryo was approximately 3 months. The ossification centres for metatarsal bones were visible which appear at the 10th week of intrauterine life. Also on USG the femur length was found to be 10 mm which also suggests the age to be around 3 months. The smooth junction between the epidermis and dermis suggests age of the embryo/foetus to be less than 3 months because the epidermal ridges and dermal papillae become prominent at the end of 3rd month. From the basal layer of epidermis down growths were seen which were suggestive of growth of hair follicles. Hair follicles become prominent by the 10th week of intra uterine life which again reveals that the age of foetus is around end of 3rd month. From the observations, the age of the foetus was found to be more than 2 and half months but less than 3 months i.e. between 10-12 weeks.

Idiopathic eruptive macular pigmentation or acanthosis nigricans.

A 21-year-old male presented with numerous asymptomatic dark brown to brown black pigmented macules and barely raised plaques on the face, trunk and extremities, developing over a period of 2 year. The surface of most lesions had a velvety raised surface similar in appearance to acanthosis nigricans and a biopsy from one of the lesions showed pigmented papillomatosis. This case fulfils all the criteria for idiopathic eruptive macular pigmentation (IEMP) with papillomatosis, and the clinical appearance of acanthosis nigricans in most lesions suggests that IEMP is a form of eruptive acanthosis nigricans.

U. B. Narayan Rao and the origins of the IJDVL.

Dr. U. B. Narayan Rao L.C.P.S (Bom) (born 23 rd November 1895, died 14 th June 1960) had a busy general practice in Bombay. He adopted dermatology and venereology as his specialty in the 1930's and started the Indian Journal of Venereal Diseases in 1935, the first of its kind in the subcontinent. This journal went on to become the official mouthpiece of the Indian Association of Dermatologists and Venereologists in 1955 and was then known as the Indian Journal of Dermatology and Venereology. Dr. Narayan Rao also played an important role as a founder member of the Bombay Association of Dermato-Venereologists as well as the Indian Association of Dermatologists and Venereologists. Activist, indefatigable worker dedicated to the cause, nationalist, and patriot, generous, dynamic and aggressive, with a flare for arguing; negotiating and convincing, and winning friends in the process, were some of the attributes that may be mentioned of this remarkable person who contributed so much to our specialty.

Incidental finding of skin deposits of corticosteroids without associated granulomatous inflammation: report of three cases.

Three cases are described in whom deposits of depot steroids were seen in skin biopsies done for diagnostic purposes. In the first case the skin lesion was clinically suspected to be due to the steroid injected more than a year ago and a diagnosis of pseudo-morphea due to steroid injection was made by the clinician. The other cases had clinical diagnoses of dermatofibroma and morphea with no clinical suspicion of previous steroid injection. The steroid deposits were present in the subcutaneous fat in all three cases. Histologically the findings were distinctive with collections of acellular, amorphous, fuzzy basophilic material surrounded by lipophages and disrupted adipocytes (in Case 2) and without any significant inflammatory infiltrate or granulomatous reaction (in Cases 1 and 3). The absence of inflammatory and granulomatous responses were the findings at variance with the cases described earlier in the literature.

Idiopathic eruptive macular pigmentation with papillomatosis: Report of nine cases.

Nine patients, seven males and two females aged 6-14 years, presented with extensive, asymptomatic, brown-black macules and mildly elevated, pigmented lesions of a few months' duration. The sites affected were the face, trunk and proximal extremities. The skin lesions were discrete and individual lesions were less than 2 cm in size. The clinical diagnoses rendered by the referring physicians were lichen planus pigmentosus, urticaria pigmentosa, erythema dyschromicum perstans and postinflammatory hyperpigmentation. Histology in all nine cases showed papillomatosis of the dermis with prominent pigmentation of the basal layer (pigmented papillomatosis) without any significant dermal inflammation. Two cases had spores of Pityrosporum ovale in the thickened horny layer, one of which also had, in addition, bacterial colonies in the stratum corneum. The pigmentation resolved on its own over several months. This presentation is similar to the previously described idiopathic eruptive macular pigmentation with the additional histological finding of papillomatosis that is being described for the first time and may be nosologically related to acanthosis nigricans and confluent and reticulate papillomatosis.