Nail changes in alopecia areata: incidence and pattern.

One hundred consecutive patients with alopecia areata were examined for presence of nail abnormalities. Nail changes were seen in 44/100 (44%) of patients with most frequent occurrence in multifocal variety (30/44=68%). The commonest abnormality observed was superficial pits seen in 28 (64%) patients. Presence and severity of nail changes may indicate a more severe and recalcitrant disease.

Hypopigmented pityriasis versicolor developing on a pre-existing Becker's Naevus.

A 24-year-old male presenting with pityriasis versicolor developing on a pre-existing lesion of Becker's naevus is being reported for its rare occurrence.

Pattern of childhood STDs in a major hospital of East Delhi.

Of the 1418 patients with STDs, who attended the STD clinic between January 1996 to December 2000, 50 (3.4%) were children below 14 years of age. Boys (29) were more than girls (21). Syphilis was the most common STD found in these children (46.8%), followed by vulvo-vaginal candidiasis (19.2%), condylomata acuminata (10.6%), gonorrhoea (8.5%), herpes progenitalis (6.4%), chancroid (4.3%), perianal candidosis and perianal molluscum contagiosum (2.1 % each). Three children had more than one STD. A history of sexual abuse could be elicited in 30 children (60%), none of the children were positive of HIV. All children with symptoms pertaining to their genitourinary system should be evaluated thoroughtly for sexual abuse.

Glibenclamide induced photosensitivity.

A 54 - year-old man with diabetes mellitus developed photodermatitis following ingestion of second generation sulphonylurea, glibenclamide. The case is being reported to highlight the infrequently reported side effect of glibenclamide.

Comparative efficacy of ketoconazole and fluconazole in the treatment of pityriasis versicolor: a one year follow-up study.

Pityriasis versicolor can be treated by a single or multiple dosage regime of ketoconazole as well as by fluconazole. The therapeutic efficacy of these two drugs has not been compared. One hundred and eighty patients with moderate to extensive pityriasis versicolor confirmed by KOH and Wood's lamp examination were randomly assigned to one of the four oral antifungal regimes: Ketoconazole 400 mg single dose (Category I), Ketoconazole 200 mg daily for 10 days (Category II), Fluconazole 400 mg single dose (Category III) or Fluconazole 150 mg per week for 4 weeks (Category IV). Follow up was done at 2 and 4 weeks and then at 3, 6 and 12 months after the treatment in each group. KOH and Wood's lamp examinations were repeated each time. After four weeks of treatment, clinical cure was observed in 66.6% (Category I), 73.3% (Category II), 80% (Category III) and 59.9% (Category IV) of patients. Mycological cure after four weeks of treatment was observed in 53.3% (Category I), 73.3% (Category II), 82.2% (Category III) and 64.4% (Category IV) of patients. After twelve months of follow-up, maximum relapses were observed with Category I. No relapse was seen in Category III patients. The time period of relapse varied from three to ten months. In conclusion, single dose 400 mg oral fluconazole provided the best clinical as well as mycological cure rate with no relapse during twelve months of follow-up.

Clinico-myocological profile of tinea capitis in North India and response to griseofulvin.

There is a paucity of literature on tinea capitis from North India. The response to griseofulvin has not been studied as well. We studied 153 consecutive patients of tinea capitis for clinical patterns, causative dermatophytic species, clinico-etiological correlation, and response to griseofulvin. Culture and sensitivity were done on all patients. All patients were treated with griseofulvin for 6-8 weeks; non-responders were further treated with fluconazole. Ninety percent of the patients were less than 15 years of age, 75% belonged to poor socioeconomic groups and 19% had a family history of tinea capitis. The seborrheic variant was the commonest clinical pattern seen in 47.8% of patients, followed by grey patch, black dot, kerion, and alopecia-areata-like tinea capitis in 35.9%, 8.5%, 6.5% and 1.3% of patients, respectively. Only 66% of patients had a positive culture. T. violaceum was the commonest dermatophytic species isolated in 38% patients. M. audouinii, T. schoenleinii, T. tonsurans, M. gypseum, T. verrucosum and T. mentagrophytes were isolated in 34%, 10%, 9%, 3%, 3% and 3% of patients, respectively. Of the isolates 94% were susceptible to griseofulvin, and 100% were susceptible to fluconazole. By using griseofulvin for 6-8 weeks 97.4% of the patients were cured; nonresponders required therapy with fluconazole for cure. To conclude, tinea capitis is still a disease of younger people of poor socioeconomic status. T. violaceum and M. audouinii are the most common responsible dermatophytes. The response to griseofulvin was excellent, and it should be used as a first line therapy.

Pentazocine induced widespread cutaneous and myo-fibrosis.

We report a case of extensive subcutaneous and muscle fibrosis in a 26-year-old Indian woman caused by repeated intramuscular pentazocine injections over five years to highlight the extent and sequelae of this avoidable condition.

Preliminary studies on serum lipids, apolipoprotein-B and oxidative stress in xanthelasma.

Serum lipid profile, apolipoprotein-B (apo-B), malondialdehyde levels(MDA) and superoxide dismutase (SOD) activity were assessed in 12 cases of xanthelasma with and without coronary artery disease (CAD)/hypertension (HTN) and results are compared with healthy controls. Dyslipidemia was found in 65% cases of xanthelasma as compared to 20% healthy controls. Xanthelasma patients had significantly high malondialdehyde (MDA) levels (p<0.01) and significantly decreased (p<0.05) SOD activity as compared to controls. Among xanthelasma patients, xanthelasma with CAD/HTN showed higher total cholesterol (236±32.7 vs 188±24.7 mg/dl), low density lipoprotein cholesterol (157±35.5 vs 113±16 mg/dl) and Apo-B (120.5±9.4 vs 114±19.2 mg/dl) levels as compared to xanthelasma without CAD/HTN. Results of our study indicate that xanthelasma patients with increased apo-B, MDA and decreased SOD need cardiovascular monitoring.

Scleredema adultorum of buschke associated with non-scarring alopecia of scalp.

A 3 year old boy presenting with scleredema of Buschke confirmed histopathologically is being reported for its unusual association with reversible non-cicatricial alopecia of the scalp.

Keratosis punctata palmaris et plantaris.

A 30-year-old man presented with multiple keratotic papules on palms and soles. The lesions started at the age of 15 from soles. Family history was positive with members in preceding two generations being affected. Cutaneous examination revealed multiple discrete hyperkeratotic papules of variable size on palms and soles. Parakeratosis was absent in histopathology and this ruled out the diagnosis of porokeratosis punctata palmaris et plantaris.

Leopard syndrome: a tropical rarity.

This is a case report of a classical presentation of the Leopard syndrome from the Indian subcontinent. The male patient had progressively increasing generalised multiple lentiginosis, ocular hypertelorism, pulmonary stenosis, short stature, cryptorchidism, and pectus excavatum. The case is documented for its rarity in this part of the world and typical clinical presentation.

Is the heredity of reticulate acro pigmentation of Kitamura always autosomal dominant?

Reticulate acropigmentation of Kitamura (RAK) in three patients and their families is described. In one family, 2 women and 2 men were affected out of 9 individuals. In the other family, 6 women had lesions of reticulate acropigmentation out of total of 27 over three generations. In the third family, one man was affected. All of the cases had palmar pits; onset of lesions was after puberty in all the cases. The apparently different hereditary patterns in these three families are striking, and autosomal dominant inheritance appears unlikely in every case.

Hypopigmented pityriasis versicolor on Becker's naevus : Hope for new method of treatment ?

A case of hypopigmented pityriasis versicolor superimposed on pre existing Becker's naevus associated with congenital melanocytic naevus is being reported for its rarity. The possible role of dicarboxylic acid and other free radicles produced by Pityrosporum ovale in treating Becker's Naevus is also suggested.

Lymphangioma circumscriptum of scrotum of late onset.

Lymphangioma circumscriptum is the commonest type of lymphangioma which is characterised by small, grouped vesicles resembling frog spawn. An interesting case of thin walled lymphangioma circumscriptum is reported which started at a late age of 45 years and limited to scrotum in a 70-year old man.

Eruptive mollusca contagiosa in an immunocompetent Indian adult.

A 35-year old Indian woman with eruptive onset of mollusca contagiosa with no underlying immunodeficiency who responded to etretinate therapy is reported.

Papillon - lefevre syndrome with mental retardation.

A 9-year old boy, born of consanguineous parents, presented with keratoderma of palms and soles associated with severe enamel hypoplasia and mental retardation. A clinical diagnosis of Papillon - Lefevre was supported by histopathology.