Sir Cytotoxic chemotherapeutic agents has many systemic affect specially involving rapidly proliferating organs, such as skin, hair, and the gastrointestinal tract manifesting as exfoliative dermatitis, alopecia, and diarrhea, respectively. We are presenting here effect of chemotherapy on nail which is a “skin” appendage. A 19-year-old tribal boy from rural Maharashtra was diagnosed as Acute Myeloid Leukaemia (M4) and was on combination chemotherapy as cytarabine and daunorubicine (cycles of 3-week intervals). This time he came for 3rd cycle. On physical examination his nails had transverse line parallel to the lunula across the entire nail bed with no palpable ridges which were white and nonblanching..........

Lymphoma is a cancer that starts in cells called lymphocytes, which are part of the body’s immune system. In most lymphomas and leukemias, cutaneous involvement occurs through hematogenous dissemination. One can see several eponyms in cutaneous lymphomas. However, some of them are no longer used in the current nomenclature. For example, In the World Health Organization (WHO) and European Organization for Research and Treatment of Cancer (EORTC) classification of cutaneous lymphomas, Woringer- Kolopp disease (WKD) is classified as a relatively indolent variant of mycosis fungoides (MF), whereas Ketron-Goodman disease (KGD), which is not classified yet, is generally considered an aggressive lymphoma with bad prognosis similar to the aggressive CD8-positive cutaneous T-cell lymphoma, the cutaneous γ/δ-positive T-cell lymphoma and the tumor stage of MF [1]. In Table I [1-24], we listed selected eponyms in dermatology literature linked to cutaneous lymphomas.

Introduction: Proteinases and proteinase inhibitors have been described to play a role in autoimmune skin blistering diseases. We studied skin lesional biopsies from patients affected by several autoimmune skin blistering diseases for proteinases and proteinase inhibitors. Methods: We utilized immunohistochemistry to evaluate biopsies for alpha-1-antitrypsin, human matrix metalloproteinase 9 (MMP9), human tissue inhibitor of metalloproteinases 1 (TIMP-1), metallothionein and urokinase type plasminogen activator receptor (uPAR). We tested 30 patients affected by endemic pemphigus, 30 controls from the endemic area, and 15 normal controls. We also tested 30 biopsies from patients with bullous pemphigoid (BP), 20 with pemphigus vulgaris (PV), 8 with pemphigus foliaceus, and 14 with dermatitis herpetiformis (DH). Results: Contrary to findings in the current literature, most autoimmune skin blistering disease biopsies were negative for uPAR and MMP9. Only some chronic patients with El Bagre-EPF were positive to MMP9 in the dermis, in proximity to telocytes. TIMP-1 and metallothionein were positive in half of the biopsies from BP patients at the basement membrane of the skin, within several skin appendices, in areas of dermal blood vessel inflammation and within dermal mesenchymal-epithelial cell junctions.

Introduction: Psoriasis is a chronic inflammatory skin disease that affects about 2% of general population. Cllinicaly, disease can present with cutaneous and nails lesions. Nail abnormalities can be seen in up to two-thirds of patients with psoriasis and both fingernails and toenails may be affected. Objective: The objectives of our study were to evaluate the frequency and clinical presentations of nail abnormalities in patients with psoriasis. Also, we aimed to find correlation between nail changes and some clinical parameters. Methods: One hundred and ten patients with psoriasis were included in this study. A detailed history and examination was recorded for all study subjects, including the age and gender of the patients, type of psoriasis, duration, and extent of disease. Finger and toe nails were clinically examined and nail changes were noted. In the case of clinicaly suspected of fungal infection, further mycological investigations were performed. Results: Nail abnormalities were present in 67 patients (60.9%) with psoriasis. Nail pitting was the most common lesion observed on fingernails, followed by discoloration of nail plate. Subungual hyperkeratosis of nail plates were significantly more frequent on the toenails. Positive mycological culture was in 14 (20.8%) psoriatic patients with nail involvement. Also, positive correlation between nail abnormalities and duration of psoriasis was found. Conclusions: Nail involvement is common in patients with psoriasis and accompanies skin lesions on the body surface. Pitting and subungual hyperkeratosis are the most frequent nail abnormality in psoriatic patients.

The term “eponym” originates from the Greek word “eponymous”, which means “named after”. An eponym was a simple way to describe tumors and tumor like lesions that initially were not well understood [1]. Most of the tumors in the skin and soft tissues are named according to its histopathological features under the microscope. Nevertheless, few of them are named eponymously. With the exception of Evans tumor which is currently best known as Low-Grade Fibromyxoid Sarcoma, the eponyms linked to the tumors in the skin and soft tissue maintain their position in the medical literature over the years. In this communication which is based, essentially [1], we aimed to highlight on selected eponyms in dermatology literature linked to the skin and soft tissue tumors, which we listed it in in Table I [1-10].

The term “eponym” originates from the Greek word “eponymous”, which means “named after”. Dermatology literature is rich in eponyms [1]. In this communication, we aimed to highlight on selected eponyms in dermatology literature linked to the vascular tumors, which we listed it in in Table I [1-7].

We want to refresh the memory of our readers with some of the eponyms present in dermatopathology literature linked to the neural tissue, which we listed it concisely, in Table I [1-13]. The notes presented in the table are only inclusive and by no means conclusive, and are only intended to define only each eponyms.We utilized the information available for each eponyms from Wikipedia. However, the readers are free to refer to the references below for further reading about each eponyms.

Latin America refers to territories in America where the Spanish or Portuguese languages prevail: Mexico, most of Central and South America, and in the Caribbean, Cuba, the Dominican Republic, and Puerto Rico – in summary, Hispanic America and Brazil [1]. By this definition, Latin America is coterminous with Ibero-america („Iberian America”) [1]. Latin America has an area of approximately 21,069,500 km2, almost 3.9% of the Earth’s surface or 14.1% of its land surface area. As of 2010, its population was estimated at more than 590 million [1]. Many medical conditions derive their names from either Greek or Latin. In this manuscript, we are reviewing, some selected examples of eponyms, in dermatology literature, linked to the Latin America (Tabl. I) [2-14]. We want also to point out that many scientists in other parts of the world and particularly in USA, for whom medical diseases were eponymously named, were originated from latin America. Just an example is, Bannayan–Riley–Ruvalcaba syndrome (BRRS), which is a dominant autosomal disorder characterized by cutaneous lipomas, macrocephaly, intestinal polyps, and developmental delay [15]. It is named after American physicians. One of them, Rogelio H. Ruvalcaba (born in 1934) received his MD degree from the Universidad de Guadalajara, in Mexico and immigrated to USA...

Eponyms are used almost daily in the clinical practice of dermatology. And yet, information about the person behind the eponyms is difficult to find. Indeed, who is? What is this person’s nationality? Is this person alive or dead? How can one find the paper in which this person first described the disease? Eponyms are used to describe not only disease, but also clinical signs, surgical procedures, staining techniques, pharmacological formulations, and even pieces of equipment. In this article we present the symptoms starting with (J) and other. The symptoms and their synonyms, and those who have described this symptom or phenomenon.

A histiocyte is a type of cells and it is a part of the mononuclear phagocyte system.It is derived from bone marrow and develops into macrophage (CD68), or dendritic, Langerhans cell (CD1a). Histiocytes have common histological and immunophenotypical characteristics. Their cytoplasm is eosinophilic and contains variable amounts of lysosomes. They bear membrane receptors for opsonins, such as IgG and the fragment C3b of complement. They express CD45, CD14, CD33 and CD4 . There are many histiocytic disorders, and our aim is to highlight on selected eponyms linked to them, which we listed in Table I [1-7]. Last but not least we want to stress on one thing, that, It is important to remember, not only the names of the scientists behind the eponyms but also to realize the great contributions made by those scientists. Hand, Christian, Schüller, Letterer, and Siwe represent far more than names to attach to eponyms [1].

Introduction: The pattern of skin diseases in any community is influenced by genetic constitution, climate, socioeconomic status, occupation, education, hygienic standards, customs and quality of medical care. The burden of skin disease also has an impact on the Quality of Life of adolescents. This study aims to investigate the level of awareness and assess the prevalence of different types of skin diseases among adolescents in Mauritius. Material and Methods: 500 adolescents and young adults of both sexes and aged between 11-23 years were recruited. A questionnaire was used to elicit information and to assess the knowledge status of skin diseases and to determine possible risk factors. In addition, a validated questionnaire based on Quality of Life Index was used to determine the psychosocial effect of adolescents suffering from skin diseases. Data was analysed using IBM Statistics SPSS version 20 and Microsoft Excel 2007. Results: Incidence of skin diseases was 22.9% in males and 24.7% females respectively. Acne was the most common skin problems in both gender followed by fungal infection (2.9%) in males and eczema (2.4%) in females. Climatic conditions (e.g summer), consumption of oily and spicy foods, sports practice and familial history were correlated positively with prevalence of skin diseases. Conclusion: Acne, eczema and fungal infection were the most common skin diseases identified. The findings also indicate that more respondents between 15-19 years old were more prone to skin diseases.

Introduction: There is little information about diagnosis of concurrent lambliasis in patients with rosacea and urticaria. We used method of polarized fluorescence to diagnose liambliasis, taking into account belonging of macromolecular structures of unicellular parasites Giardia lamblia to the optically active substances with the properties of liquid crystals. Material and Methods: Lambliasis was diagnosed on the basis of feces parasitological research and duodenal contents by methods of light and optic microscopy and polarized fluorescence in 105 patients with rosacea and urticaria. Research results were processed by the method of variation statistics in the Statgraf program by using Student’s criterion. Results: Search results of lamblia in patients with rosacea and urticaria depended on the conditions of its holding, patients’ preparation and from the previously received basic therapy if it consisted absorbents. Due to the fact that the fluorescence polarization as a physical method does not require the use of any generally toxic, dye- fluorochromes, qualitative cyto fluorescent analysis of lamblia in greeting microdrugs enables to distinguish vegetative forms of cysts. Conclussions: Polarized fluorescence method allows optimize the microscopic diagnosis of lambliasis, increasing its sensitivity. Previous preparation for the laboratory examination of Giardia lamblia is needed for the best exposure of vermin for patients with rosacea and urticaria.

Introduction: Topical dobesilate offers the potential for treatment of plaque psoriasis without atrophy or other local side effects associated with the use of topical corticosteroids. Fibroblast growth factor (FGF)-mediated pathways participate in many of the cellular events implicated in the pathogenesis of psoriasis. Thus, targeting FGF signals may be potentially therapeutic. Aims: To study the efficacy of topical calcium dobesilate for the treatment of 50 patients of limited plaque psoriasis. Methods: For the present study, fifty clinically diagnosed cases of psoriasis with limited number of plaques (<5) were selected from the outpatient dermatology department. Lesions were treated with potassium dobesilate for a maximal period of 4 weeks. No other modality of treatment was used other than emollients and oral antihistaminics. Results: The mean duration of disease in our study was 4.74 + 14.64 years in our study. The mean reduction in PASI score with topical calcium dobesilate was statistically significant in our study (p > 0.05).

Introduction: Leprosy is a chronic infectious disease affecting mainly cutaneous and peripheral nervous system. Histopathology is an important tool to diagnosis leprosy in situation where it mimics other clinical condition. This study was conducted to know the correlation between clinical and histopathological diagnosis of Leprosy. Material and Methods: This was a retrospective study and patients were enrolled in whom leprosy was clinically diagnosed or suspected and histo-pathological examinations were carried upon. Results: A total of 71 patients were studied. Of them 48 patients (67.6%) were males and rest 23 (32.39%) patients were females. Mean age of patients at presentation was 37.85 +/- 2.021 years. Clinically in 42 patients (59.1%) type of leprosy could not be specified. Borderline tuberculoid was diagnosed in 7 patients (9.8%), Tuberculoid in 6(8.5%), Relapse in 3(4.2%), lepromatous in 6(8.5%) and Borderline, borderline lepromatous 1(1.4), Indeterminate 1 patient (1.4%). In 7% cases, Hansens disease was considered as differential diagnosis along with other clinical conditions. In 47% cases, data was not available. On histopathological evaluation on skin biopsies, epidermal changes seen were 29.5%. Of the total 71 patient, dermal changes seen were granuloma (42%), dermal infiltrate (11%), adnexal infiltrate (7%), nerve infiltrate (11%), adnexal with nerve infiltrate (6%), perivascular with adnexal infiltrate (20%) and nonspecific (3%). Dermal infiltrates in 46.4% cases constituted of lympho-histiocytes. In 48 patients (69%) leprosy was histopathologically confirmed and in rest 31% cases diagnoses was non-specific in 20 patients (28.1%), vasculitis, Dariers and Fungal infection 1 patient each (1.4%). Borderline Tuberculoid (BT) and TT was the most common diagnosis among leprosy patients around 29.2% each, followed by Indeterminate 25%, LL 8.3%, BL and and Pure neural 4.1% each. When clinical diagnosis and histopathological diagnosis was correlated it was found that the parity was seen in TT as 66.6%, BT 42.9%, LL 16.7%. Where Hansen’s disease was kept as differential diagnosis two patients had leprosy. Conclusion: The study being retrospective the uniformity in clinical diagnosis and histopathological evaluation couldnot be assessed. With the limitations this study still give information about the importance of histopathology to diagnose Leprosy and for proper treatment category and decrease the burden of the disease in the society.

Introduction: Given the rise in the prevalence of skin infections in many countries and the lack of published data pertaining to the prevalence and awareness of skin infection in Mauritius, this survey is the first of its kind to provide data on this issue. The aim of this study is to describe the association of skin infection with various predisposing factors such as socioeconomic status, personal hygiene and level of awareness and to assess the impact of skin infections on quality of life. Material and Methods: A stratified sample of 500 adults was randomly selected for this study. Subjects were administered a questionnaire to elicit information on sociodemographic factors, awareness, family history and prevalence of skin infections. Quality of life was investigated by a validated questionnaire (DLQI). SPSS Software and Microsoft Excel were used to analyse data. Results: Among 500 participants, 166 (33%) cases of skin infections were obtained. Acne was found to be more prevalent (n=59). It was found that skin infection varies with gender and higher prevalence was observed during summer as compared to winter (p=0.017). It was noted that family history and income level were associated with an increase incidence of skin infection (p=0.000). With respect to quality of life, psychological distress was mostly affected. Conclusion: Acne was found to be more prevalent. Respondents with middle income status were mostly affected with skin infection. Those with a family history were more prone to skin infection. The Quality of Life index was found to be an efficient method in assessing the impact of skin infection on the respondents’ lives.

Introduction: Lichen planus is considered to be rare in children. However, it does not appear to be uncommon in Indian subcontinent. Aims: The study was undertaken to analyse the clinical profile of childhood lichen planus. Material and Methods: We selected 30 children with LP for the study. The children selected were below the age of 14 years of age. Results and Discussion: In our study, it was seen that that the maximum onset of disease was between 5-9 years of age and mean age of children with LP was 6.8 years. The commonest type of LP in children was classical LP seen in 60% children, followed by actinic LP in 20% children. LP hypertrophicus and linear LP were seen in 10% patients each. Nail changes were seen in 10% patients.

Introduction: Alopecia areata is a unique, idiopathic disease in which there is patchy hair loss. The variable and uncertain natural history of alopecia areata is accounting for the multiplicity of uncritical claims for a large variety of therapeutic procedures. Aim: to find the therapeutic comparison between tacrolimus 0.1% ointment and minoxidil 2% solution. Material and Methods: Patients attending skin out patient department in Navodaya medical college hospital and research centre, Raichur were screened and the consenting consecutive cases of Aopecia Areata (AA) from December 2010 to November 2011 were chosen for study. There were 75 patients in the study. It is a randomized, single blind, intension to treat study. The eligible patients for the study were randomly allocated into two groups-Group A and Group B (38 in Group A and 37 in Group B). Patients in Group A were treated with 2% Minoxidi solution to be applied twice daily over the alopecia patch, where as Patients in Group B were treated with Tacrolimus 0.1% ointment applied twice daily. Patients were followed up at 2, 4, 6, 8, 10 and 12 weeks. Alopecia Grading Score (AGS) was calculated at baseline and 12 weeks. Regrowth Score (RGS) was calculated at 12 weeks. Results: Total 69 patients completed the study (35 in Group A and 34 in Group B). In our study RGS ≥ 3 was observed in 65.71% of patients treated with Tinoxidil 2% solution and 44.12% of patients treated with Tacrolimus 0.1% ointment. Conclusion: In our study Minoxidil 2% solution had better stimulatory effect on hair growth compared to Tacrolimus 0.1% ointment in the treatment of mild to moderate patchy alopecia areata. The combination treatment may yield a better clinical response than either of the agents used singly.

Introduction: Cicatrical alopecia occurs in otherwise healthy men and women of all ages and is seen worldwide Material and Methods: A study of 40 patients was conducted to study the clinical variants and histopathology of cicatricial alopecia. Results and Discussion: n our study, it was seen that maximum number of cases of cicatrical alopecia were of LPP (27.5%) followed by 25% of DLE, 20% patients had pseudopelade of Brocq, SLE was seen in 5% cases followed by Scleroderma, dermatomyositis, Keratosis follicularis spinulosa decalvans, aplasia cutis, kerion, follicular mucinosis, pemphigus, dissecting cellulitis of scalp/ pyogenic folliculitis and acne keloidalis nuchae in 2.5% cases each. Regarding the morphology of lesions,epidermal atrophy was seen in 90% patients, erythema was seen in 55% cases, follicular pluging was seen in 40% patients, telangiectasias in 27.5% patients, diffuse scaling in 25% patients and mottled hyperpigmentation was seen in 20% patients. In our study, commonest histopathological feature of alopecia was perifollicular fibrosis seen in 65% patients, basal cell vacuolization was seen in 52.5% patients,perifollicular lymphocytic infiltrate were seen in 50% patients, epidermal atrophy seen in 35% patients and hyperkeratosis was seen in 20% patients.

Alopecia areata is a common condition with patchy non scarring hair loss. We report a case of an 11 year old male child with localized patch of hair loss on the frontoparietal region of the scalp since one year. It was a widespread extensive patch of hair loss covering more than 40% of the scalp. On hair shaft microscopy, numerous exclamation mark hairs were present. The patient was put on topical tacrolimus and topical corticosteroids but no response was seen. Since the child was recalcitrant to treatment, methylprednisolone 500 mg/day on three consecutive days in a month was given. After six months 80% regrowth was seen over the affected area of the scalp.

Cutaneous vasculitis can be cause by multiple disorders or can be idiopathic. Many diseases can present with similar findings, therefore histopathologic examination is always require for confirming the right diagnosis. The erythema elevatum diutinum (EED) is a localized vasculitis, classified as a neutrophilic dermatosis. It’s a rare cutaneous condition, distribute on the extensor surface of the extremities, more frequently in the dorsum of the hands, knees and elbows. They have a symmetric distribution and can be asymptomatic, painful; or pruritic, sometimes accompanied paresthesias. The most common clinical presentation is round erythematous papules which become erythemato-violaceous or purpuric plaques. There are not pathognomonic histopathological findings, but can present as a leukocytoclastic vasculitis with perivascular neutrophilic infiltration in the middle and superficial dermis. I presented the case of a 61-year-old female, with erythematous purpuric painful plaques, irregular, symmetric and elevated, located in both thenar regions of her hands and paresthesias. The patient’s presentation is consistent with multiple characteristics of EED such as the description of the lesions, the anatomical location, the symmetric distribution and the histopathological findings of an initial disease. This patient does not have all the clinical progression and outcome, due to the initial stage of the disease.

Granular Parakeratosis is a rare disorder of keratinization usually presented in adults. There are only fews reports in children. We present two cases, one in an adult and the other in a 7-month-old infant.

Kimura’s disease is a benign, but locally injurious disease with a marked predilection for the head and neck. Case Report: We present two cases of this rare disease. Discussion: Of uncertain aetiology, its tendency to present as a discrete, enlarging mass with associated lymphadenopathy makes it a condition of interest to clinicians who see head and neck pathology. Although rare, there are increasing numbers of reports of the condition and it should become part of the standard differential diagnosis.

This paper describe a typical case of Favre-Racouchot syndrome in a 70-year-old farmer. The exact pathogenesis of Favre-Racouchot syndrome remains obscure but apparently extensive exposure to sun and harsh weather is perhaps largely responsible as had been in the described case.

Lichen striatus is an acquired linear inflammatory dermatosis, not frequently reported, with a peculiar clinical aspect, most often described in adults, with a poor response to treatment. We described 4 cases of lichen striatus diagnosed over an 8-month period of time.

Introduction: Erythema nodosum (EN) is the most common type of panniculitis. It may be idiopathic or secondary to various etiologies. However, the occurrence of erythema nodosum in malignant hemopathy had rarely been reported. Case report: A 42 year-old woman presented with a four week history of recurrent multiple painful erythematous nodules developed on the lower limbs associated with arthralgia of the ankles and fever. The clinical features of skin lesions with contusiform color evolution allowed establishing the diagnosis of EN. No underlying cause was found. The skin lesions were improved with non-steroidal anti-inflammatory drugs and colchicine. Three months later, the patient consulted for recurrence of EN associated with fever, inflammatory polyarthralgia and hepatosplenomegaly. The peripheral blood count revealed pancytopenia. A bone marrow examination confirmed the diagnosis of acute myeloid leukemia type 2. Initiation of chemotherapy was followed by the complete disappearance of skin lesions of EN. Conclusion: Paraneoplastic erythema nodosum is a rare entity. In the literature, a few cases of association with leukemia have been reported. Exploration for solid neoplasms or hemopathy in case of recurrent EN or resistance to conventional treatment should be systematic.

We report a 66-year-old male who presented with a blackish discolored ulcerated nodule over the right flank of 2 months duration. Biopsy of the lesion revealed ulcerated epidermis with fungal hyphae of Aspergillus overlying dense, angiocentric atypical lymphoid infiltrate involving the dermis, and extending into sub cutis with geographic areas of necrosis. The patient had three episodes of cutaneous recurrence over a three year period. The cutaneous lymphoid infiltrates showed similar immunohistochemical profiles: LCA+, CD3€+, CD20- and CD56-. CD30 was positive in a small percentage of cells. P53 proliferation marker was strongly positive. There was no evidence of systemic involvement by the neoplastic lymphoid and fungal infiltrates. This is one amongst the rare reports of cutaneous aspergillosis with primary cutaneous NK/T cell lymphoma nasal-type.

Very interesting case published in Krishnanand G. et al has touched the problem of lymphoproliferation on many levels. It has illustrated the need to remain vigilant in the diagnosis of both proliferative and infectious skin conditions. Extensive necrosis and purulent inflammation may frequently be dismissed as an infectious or benign inflammatory process in case of lymphoma. Extremely rare coincidence of aspergillosis and NK/T cell lymphoma was described just two times before (pubmed database). Relation to HIV infection was noted in one publication and patient died because of oportunistic infection because of invasive aspergillosis after tumor recurrence [1]. What more, in between described by European Organization for Research and Treatment of Cancer/Mycosis Study Group (EORTC/ MSG) 2,821 patients with other hematological malignancies (including 597 who had undergone HSCT) the aspergillosis was diagnosed in 23 cases only (pulmonary one, fatal in the course in most of cases) [2]. The case of Krishnanand G. et al is even more interesting because aspergillosis was probably cut out by wide local excision and there were no recurrence in spite of introduction of metotrexate and lack of antifungal treatment. This need a comment of experienced microbiologist.........

Introduction: Necrobiotic xanthogranuloma (NXG) is a rare histiocytic disease which most frequently involves periorbital areas. NXG is associated with paraproteinemia with a ratio over 80%. However, a few cases of NXG without paraproteinemia (isolated NXG) have also been reported. Main observation: A 58-year-old Japanese woman complained about asymptomatic dermal nodules on the bilateral lower eyelids. The histopathological examination revealed granulomatous inflammation. Paraproteinemia was not detected either in the serum or in the urine. The size of the nodules has been constant, and she has been under careful follow-up without any systemic therapies. Conclusions: NXG is frequently associated with paraproteinemia, which may develop later. Patients with NXG need careful follow-up including repeated blood tests.

Fixed drug eruption (FDE) usually appears as a solitary or a small number of pruritic, well circumscribed, erythematous macules that evolve into edematous plaques; these lesions typically resolve after discontinuation of the offending drug, leaving hyperpigmentation at the site of lesions. Fixed drug eruption has been mentioned previously as a disease model for elucidating the mechanism of how skin inflammation is caused by skin-resident T cells, a multistep process that results in eventual tissue damage. In this article we discuss the utility of dermoscopy as an additional tool which gives significant information aiding us to infer these complex processes seen in FDE and thus to confirm the diagnosis.

Introduction: Staphylococcal scaled skin syndrome (SSSS) presents generalized form bullous impetigo caused by Staphylococcus aureus (S. aureus) infection, typically seen in infants and children. SSSS may occur also in adults; however, the majority of adult cases are those with immunosuppression. Atypical clinical features of impetigo in adults sometimes make it difficult to diagnose correctly. Case Report: A 74-year-old healthy woman was hospitalized, complaining of extensive desquamative erythema and a number of erosions. She was administered oral antiviral drugs under suspicion of herpes zoster prior to 10 days. Initial diagnosis on the admission was toxic epidermal necrolysis (TEN) due to antiviral tablets; however, steroid pulse therapy resulted in no effect. Bacterial culture yielded coagulase-positive methicillin-resistent S. aureus, producing exfoliative toxin B. A biopsy specimen showed subcorneal splitting of the epidermis. The diffuse erosions gradually improved over 10 days by the treatment with intravenous antibiotics. Conclusions: The differentiation between streptococcal scaled skin syndrome (SSSS) and TEN is sometimes difficult. It is important to remind SSSS when we suspect TEN, even in healthy adults.

Varicella is common and highly contagious and affects nearly all susceptible children before adolescence. Progressive varicella syndrome is a severe complication of primary Varicella Zoster Virus (VZV) infection, with visceral organ involvement, coagulopathy, severe hemorrhage, and continued vesicular lesion development. We report a rare case of progressive varicella syndrome with varicella gangrenosa in a previously well female child of ten months. She presented with history of recurrent vesiculo-bullous skin lesions involving the chest, back and extremities since two months with dry gangrene of 1st, 3rd and right great toe. VZV Polymerase Chain Reaction (PCR) of vesicle fluid was positive. Workup for immunodeficiency state was negative. She responded dramatically to intravenous acyclovir.

Introduction: Cytophagic histiocytic panniculitis (CHP) is a rare panniculitis which may occur alone or as a part of systemic manifestation of Hemophagocytic syndrome (HPS). It is described as a chronic histiocytic disorder of the subcutaneous adipose tissue with lymphocytic and histiocytic infiltration showing hemophagocytosis. It may also be noted in bone marrow, spleen, lymph nodes and liver. Treatment includes glucocorticoids, cyclosporine and combined chemotherapeutic medications. Observation: A 34 years old lady, presented with multiple nodules over the body since 2 years. Hematological investigations revealed that patient had a rare HbE hemoglobinopathy and was treated for that. Skin biopsy showed CHP and subsequently on hematological and biochemical tests, a diagnosis of HPS was given and patient was referred to a hemato-oncologist. Conclusion: Cytophagic histiocytic panniculitis is a rare and fatal form of panniculitis with multisystem involvement. Awareness of this cutaneous manifestation may help physicians in the early diagnosis of HPS. We report this interesting case of CHP with a brief review of literature. To best of our knowledge this is the first case of Hemophagocytic syndrome associated with HbE hemoglobinopathy.

The cutaneous manifestations of hemophagocytic lymphohistiocytosis are varied and non-specific. Many patients with the disease have a non-specific rash that is often vaguely termed maculopapular although it has also been described as ranging from erythroderma to generalized purpuric macules and papules, and morbilliform eruptions [1]. Deep subcutaneous infiltration by histiocytes/lymphocytes giving rise to erythromatous nodules described as cytophagic histiocytic panniculitis by Swati Sharma, et al [2] is yet another skin manifestation of hemophagocytic lymphohistiocytosis [3]. Hemophagocytic lymphohistiocytosis is a rare but potentially fatal disease of normal but overactive histiocytes and lymphocytes that affects all age groups although most reports describe the entity in infants. Fever, hepatosplenomegaly, pancytopenia, lymphadenopathy and rash often comprise the initial presentation. There are two forms of the disease, namely one that is hereditary (or primary) and the other which is acquired (or secondary). Primary hemophagocytic lymphohistiocytosis is a heterogeneous autosomal recessive disorder found to be more prevalent with parental consanguinity, and is typically seen in infancy and early childhood [4]

Localized involutional lipoatrophy (LIL) is a rare distinctive idiopathic form of localized lipoatrophy. The characteristic histopathologic feature of LIL are diminutive fat lobules composed of small adipocyte resembling fetal fat tissue. LIL is not a well-known disorder, there have been only a few reports on LIL in the English literature.We report a case of localised involutional lipoatrophy in a 25 year old lady with bilateral depressed lesions on both arms.

Resumen La calcifilaxis es un síndrome clínico caracterizado por una calcificación vascular progresiva que ocasiona la aparición de lesiones violáceas, frecuentemente dolorosas, en la piel de pacientes con insuficiencia renal crónica, diálisis o trasplante renal, asociado usualmente a niveles elevados de hormona paratiroidea. Se presenta el caso clínico de una mujer de 44 años, diabética con insuficiencia renal crónica, en hemodiálisis desde hace 2 años, que fue diagnosticada de calcifilaxis tras sospecha clínica y biopsia de lesiones cutáneas. Abstract Calciphylaxis is a clinical syndrome characterized by progressive vascular calcification that causes the appearance of purplish lesions, often painful, in the skin of patients with chronic renal failure, dialysis or kidney transplantation, usually associated with elevated levels of parathyroid hormone. We report a case of a 44-year-old diabetic woman with chronic renal failure on hemodialysis for 2 years. She was diagnosed with calciphylaxis after clinical suspicion and biopsy of skin lesions.

Résumé Introduction: L’histoplasmose à Histoplasma capsulatum var. duboisii est une affection rare en Afrique. Les lésions cutanées localisées sont les plus fréquentes. Nous rapportons une forme disséminée chez un enfant immunocompétent. Observation: Une élève de 8 ans est hospitalisée pour des nodules cutanés, généralisés, associés à des douleurs ostéo-articulaires très intenses de la quasi-totalité des articulations. L’examen a noté une malnutrition aiguë modérée, des nodules sous cutanés, multiples, des papules rosées, à surface plane, des papules ombiliquées, des tuméfactions nodulaires très douloureuses de plusieurs articulations, de multiples adénopathies fermes, mobiles, une atteinte osseuse multiple à la radiographie, une hépatosplénomégalie et des ulcérations secondaires douloureuses. L’histologie d’un nodule cutané et d’une papule ombiliquée a mis en évidence H.capsulatum var. duboisii. Après l’échec d’un traitement au fluconazole, l’évolution a été favorable sous l’amphotéricine B. La patiente a bénéficié de la collaboration Nord-Sud et de l’aide des structures sociales. Conclusion: Cette observation nous a permis de décrire les particularités cliniques et socio-économiques, les difficultés diagnostiques et thérapeutiques d’un cas d’histoplasmose africaine disséminée et de démontrer encore l’efficacité de l’amphotéricine B. Abstract Introduction: Histoplasmosis due to Histoplasma capsulatum var. duboisii is a rare affection in Africa. Localized cutaneous lesions are the most common form. We report a disseminated form in an immunocompetent child. Case report: An 8-year-old student has been hospitalized for generalized, cutaneous nodules associated with very severe osteo-articular pains of almost all the joints. The examination has noted a moderate acute malnutrition, multiple and sub-cutaneous nodules, pinkish and plan papules, umbilicate papules, very painful nodular tumefactions of several joints, multiple, firm and mobiles adenopathies, hepatosplenomegaly and secondary painful ulcerations. Multiple bones have been affected at the radiography. Histology of a cutaneous nodule and an umbilicate papule has identified H.capsulatum var. duboisii. After the failure of treatment with fluconazole, the evolution has been favourable with amphotericin B. The patient has benefited from collaboration North-South, the help of social structures. Conclusion: This observation allowed us to describe clinical and socio-economic characteristics, diagnostic and therapeutic difficulties of a case of disseminated African histoplasmosis and has demonstrated the effectiveness of amphotericin B.

There are many photo-protective measures adopted for protection from the solar radiation especially the UV radiation spectrum, sunscreens being the main agents. Besides the traditional approach of topical use of sunscreens, both chemical and physical, a new approach has emerged to use systemic agents in the form of vitamins and minerals. In this review, we are describing the major aspects related to sunscreens and anti-oxidants as photo-protective measures.

Polymprhouos light eruption is the most common idiopathic photodermatosis. It is a sun induced cutaneous reaction characterized by onset itchy erathematous papules, plaques, vesicles or erythema multiforme type of lesions after brief exposure to sunlight. Sun-exposed areas of the body or rarely the partially covered areas are commonly involved. PLE is more common in temperate climates than in tropics. It begins usually at the onset of summer and moderates as the summer progresses. In most patients it usually runs a benign course. Diagnosis is mainly on clinical grounds. Therapy involves avoidance of sun-exposure and use of sunscreens. Cases not responding to simple measures require PUVA (Psoralen and Ultraviolet A) or UVB (ultraviolet B) therapy. Other alternative suggested therapies with variable success include oral hydroxychloroquine, beta-carotene, thalidomide and nicotinamide.

We report a male patient of 7 months old with redish papule on his scalp (Fig. 1a, b) the rest of the clinical examination was normal. Personal and family history non contributory. The lesion of the scalp began 4 months ago asymptomatic but began to grow and bleeding for that reason his pediatrician sent to us to evaluate him. The diagnosis of nevoxantoendothelioma was done and a biopsy was performed. The histogical slides showed a lesion become enlarged as a consequence of the accumulation of masses of viral material purplish red bodies of mollusccum contagiosum was seen (Fig. 2). Molluscum contagiosum is caused by a virus that is a member of the poxvirus family. The infection can get in a number of different ways. This is a common infection in children although it is rare under the age of one year and occurs when a child comes into direct contact with a lesion. It is frequently seen on the face, neck, armpit, arms, and hands but may occur anywhere on the body including mucous membranes except the palms and soles.......