Multiple nodules on the face and trunk in metastatic adenocarcinoma of unknown primary origin.

Metastatic cancer of unknown primary (CUP) may unexpectedly manifest on the skin and subcutaneous tissue, prompting the patient to first visit a dermatologist. We describe an interesting case of cutaneous metastases from poorly differentiated adenocarcinoma of an unknown primary site in a 57-year-old man. The CUP had an unusually long period of indolence between presentation as a solitary axillary lymph node metastasis and rapid cutaneous dissemination. The possible causes of such a presentation are reviewed, and the management is briefly discussed. Diagnosis of unusual cutaneous manifestations of occult systemic malignancies could pose a diagnostic challenge to dermatologists.

Pyoderma gangrenosum: an Indian perspective.

BACKGROUND: Pyoderma gangrenosum (PG) is an uncommon, idiopathic, neutrophilic skin disease sometimes associated with systemic diseases. To our knowledge, there have been no case series of PG reported from India. AIM: To study the clinical features, associated systemic diseases and treatment methods in our case series. METHODS: In total, 18 cases of PG diagnosed at our institution in Mangalore were evaluated in a prospective study. RESULTS: Ulcerative PG was the most common variant, seen in all except one case. Paediatric patients constituted less than a quarter (27.77%) of the patients. Systemic diseases were associated with the disease in over half of the patients (55.55%). The pathergy test was positive in seven patients (38.88%), and all but one had associated systemic disease. Corticosteroids were mainly used for management. CONCLUSIONS: PG is a rare disease in India, but paediatric PG cases were relatively common. Ulcerative PG was the commonest type, and over half of the patients had associated systemic diseases. There were a significant number of patients with associated systemic disease who had a positive pathergy test.

Rhinoentomophthoromycosis with mutilation.

Rhinoentomophthoromycosis is a rare subcutaneous zygomycosis. We report a case of rhinoentomophthoromycosis with mutilation, which is an even more unusual phenomenon, and discuss the clinical features and management of this rare dermatosis.

Topical formic acid puncture technique for the treatment of common warts.

BACKGROUND: Warts are a common chronic skin disorder that can be cosmetically disfiguring and, depending on the location, cause inhibition of function. The presence of dozens of topical and systemic treatments for warts is a testament to the lack of a rapid, simple, uniformly effective, inexpensive, nonscarring, and painless treatment. AIM: The purpose of this study was to determine the efficacy and safety of 85% formic acid application, an inexpensive therapy, for the treatment of warts. METHODS: A placebo-controlled, nonrandomized, open trial was performed in 100 patients with common warts attending Father Muller's Medical College Hospital, Mangalore. Fifty patients received 85% formic acid application and 50 patients received placebo (water) using a topical application/needle puncture technique every other day. RESULTS: Ninety-two per cent of patients who received formic acid application showed complete disappearance of warts after a 3-4-week treatment period, compared to 6% in the placebo group. CONCLUSIONS: The results show that 85% formic acid application is a safe, economical, and effective alternative in the treatment of common warts with few side-effects and good compliance. A multicenter trial is needed to examine the efficacy and safety of this treatment.

Use of the FBX dosemeter for the calibration of cobalt-60 and high-energy teletherapy machines.

The doses from the cobalt-60 teletherapy machines were measured using the FBX and secondary-standard dosemeters of Farmer-Baldwin type. The FBX dosemeter contained 0.20 mM ferrous ammonium sulphate, 5.0 mM benzoic acid and 0.20 mM xylenol orange in 0.05 N sulphuric acid. The values were compared with the values from a Fricke dosemeter and a graphite chamber used as primary standards. The values of the FBX, Fricke and graphite chambers agreed. There were, however wide differences among the different secondary-standard dosemeters themselves and with the FBX dosemeter. The FBX dosemeter was used for the measurement of central axis depth dose distributions for 5, 8, 10, 20 and 30 MeV electron and 42 MV x-ray beams.