Introduction: The geriatric population is composed of persons over 65 years of age and very few studies are available on the dermatologic diseases in this group. This study was done to study the spectrum of cutaneous manifestations and prevalence of physiological and pathological changes in the skin of elderly people. Material and Methods: Two hundred consecutive patients aged more than 65 years of age attending the outpatient clinic or admitted as inpatients in the Department of Dermatology at Vydehi Institute of Medical Sciences and Research Centre were subjects for the study. A detailed history of cutaneous complaints, present and past medical ailments was taken. A complete general physical, systemic examination and dermatological examination was done and all findings were noted in a pre designed proforma. Skin changes observed due to ageing were classified as physiological and pathological. Findings were collated in a master chart and results analyzed. Results: Out of 200 patients studied, 71% were males and 29% were females. Pruritus was the single most common complaint elicited (44%). Among the physiological changes, xerosis was the commonest (93%). Among the pathological changes skin tumours, eczemas, infections were the common findings. Conclusions: The geriatric dermatoses are different in different populations as some of the skin changes seen in western skin and Indian skin are not identical.

Introduction: The Sexually transmitted diseases (STDs) are a global health problem of great magnitude. The pattern of STDs differs from country to country and from region to region. The increased risk of the transmission of HIV is known to be associated with the presence of sexually transmitted diseases (STDs) and despite the presence of the National STD Control Program in India the number of people with STDs remains high. Aim: The aim of our study was to study the profile of patients in a STD clinic in North India and to study various sexually transmitted infections in both male and female patients. Material and Methods: A prospective study of the patients attending STD clinic in a district hospital in North India from December 2009 to December 2012 was done. A total of 2700 patients attending the STDclinic in three years from December 2009 to December 2012 were taken up for the study. Results: The commonest sexually transmitted infection in males was herpes genitalis (30%) followed by 20% cases of genital warts. 10% patients had gonorrhoea, genital molluscum contagiosum, syphilis and genital scabies each and 5% patients had nongonococcal urethritis. Only 5% of the total patients had chancroid, donovanosis and LGV. The commonest sexually transmitted infection in females was vaginal discharge seen in 40% patients, lower abdominal pain in 20% patients, herpes genitalis in 15% patients followed by 20% cases of genital warts and syphilis each. Genital molluscum contagiosum was seen in 5% patients only. Conclusions: The treatment of STD’s is important as both non-ulcerative and ulcerative STDs increase the susceptibility to or transmissibility of HIV infection and as such, an increase in STD prevalence as revealed by clinic attendance in this study was bound to facilitate the spread of HIV/AIDS. Perhaps it is high time health planners adopted a more aggressive and result oriented HIV/AIDS/STD awareness campaign strategy.

Introduction: Pemphigus is life threating blistering of autoimmune disease of the skin and mucous membrane characterised by autoantibodies (auto ABs) against desmoglein-3 (DSG-3). Desmosomal adhesions, protein expressed on the surface of epidermal keratinocytes. Aim: The present study was to assess the incidence rate of pemphigus, to evaluate the clinical course along with clinical manifestations, Complications and Metabolic factors of patients with pemphigus and to investigate the disease severity and induction of remission during the clinical course and whereas to assess the oxidative stress and antioxidant status in pemphigus patients in our hospital. Material and Methods: A prospective study was conducted over a period of January 2012 to December 2012 at dermatology department, MGM Hospital, Warangal. The data was collected from 32 cases of Pemphigus on the basis of Age, Sex, Social Habits, BMI, Histopathological forms, Clinical manifestations and Drug therapy. This hospital is 1200 bedded government hospital provided Outpatient and Inpatient care for Indian citizen especially in Telangana region free of cost. Results: Of the 32 pemphigus patients, 75% were diagnosed with Pemphigus Vulgaris (PV), 12.5% with Pemphigus Foliaceus (PF) and 12.5% with Bullous Pemphigoid (BP). The male to female ratio was approximately 1:1.3. The mean age of onset was 40.8 years in Pemphigus patients. The Onset of disease was 29.85. 34% of patients with Pemphigus had both the mucosal and skin involvement during the clinical course while 25% at the onset of disease. The most common complication was found to be increase blood sugar (40%). Most commonly prescribed adjuvant is dapsone. Majority attained the complete remission and remaining of them attains partial remission. Oxidative stress levels were higher and antioxidant status levels were lower in study subjects when compared to controls. Conclusions: PV is the most common subtype of Pemphigus in our Hospital and usually affects females more than males. Our study reveals that mucosal and skin involvement is common. Corticosteroids and dapsone as adjuvant is majorly prescribed. Most of patients attain complete remission and remaining of them achieves partial remission. Oxidative stress levels were higher and antioxidant status levels were lower in our study subjects when compared to controls.

Introduction: Herpes zoster (Hz), which presents as localized, painful cutaneous eruption is a common clinical problem, particularly among adults of above 50 years of age and immunocompromised patients. It results from reactivation of varicella zoster virus. Aim: To analyze the clinical pattern of herpes zoster with special emphasis to the precipitating factors and incidence of post herpetic neuralgia. Material and Methods: 100 clinically diagnosed cases of herpes zoster, attending the Dermatology department of MVJ Medical College and Research Hospital Bangalore, India from a period of June 2010 to May 2012 were included in the study. The clinical pattern of herpes zoster with special emphasis to the precipitating factors and incidence of post herpetic neuralgia were analyzed. Results and Conclusion: The study showed a male preponderance. Age group varied from 8-80 years. 42% of the total patients presented during summer season when the incidence of varicella is also high. Past history of chicken pox was present in 68% of the patients. 11% of the patients were on immunosuppressive treatment. 8% of the patients had associated diabetes mellitus and 7% showed HIV seropositivity. Thoracic dermatomal involvement was seen in majority of patients. Most commonly observed complication was post herpetic neuralgia which was encountered in 36% of the patients and most of these patients were (77%) were above the age of 60years.

Introduction: Dermatology is a specialty, which not only deals with dermatological problems with outpatient but also inpatients referrals. The importances of Dermatologist in hospital setting are rising due to changing condition of medical care. Since no peer-reviewed articles are available for dermatological problems in a neurological set up, we conducted this study to know about pattern of skin disorders in neurological patients. Material and Methods: The present study was a prospective study in a neurological setup, which included data from hospital dermatology consultation request forms over a period of one year. The data included demographic profile of the patient investigation where needed, neurological diagnosis and final dermatological diagnosis. The data was analyzed using SPSS. Results: A total of 285 patients who were requested for consultation were included in the study. Face was the commonest site of involvement (19.6%). Laboratory examination of referred patients revealed abnormal blood counts in 2% cases, renal function tests in 0.7% and urine in 0.4% cases. CT scan showed abnormal findings in 65.6% patients. The most common drug used in these patients was phenytoin (29.1%). The most common dermatological diagnosis was Infection and Infestation (34.7%) followed by eczema (46.6%). Drug rash was seen in 3.9% cases. Out of which one had phenytoin induced Steven Johnson syndrome. Skin biopsy was done in 5 patients. Topicals was advised in 80%. Upon discharge 10% of inpatients didn’t require any follow-up. The patients who were followed up after 4 weeks, about 48% had their symptoms resolved with topicals and oral treatment as required. About 38% required more than two follow ups due to chronic course of the diseases. Conclusions: This present study discussed about various manifestations of skin disorders in a neurological set up and emphasizes the role of dermatologist in treating skin problems both in outpatient as well as inpatient scenarios.

Introduction: Wart is a common disease which is caused by a group of viruses called Human Papilloma Virus. The most prevalent type of wart is common wart and the most prevalent site of involvement is hands. Complete recovery, no recurrency and effectiveness in all patients are not obtained by any of therapeutic methods, so in this study we decided to compare therapeutic effects of 5 Fluorouracil (FU) with cryotherapy in treatment of common warts of backhand. Material and Methods: In this study, in a one year period from March 2012 to March 2013, 60 patients that referred to dermatology clinic of Sina hospital included the study with the diagnosis of backhand wart .Patients were divided into two groups of treatment, one treated with cryotherapy (30 patients) and one threated with 5 FU (30 patients). Age and gender of patients, number of lesions and duration of involvement were documented. Treatment by topical 5 FU was implemented for 4 weeks, twice a day for 4 hours each course. Second group was treated by cryotherapy (liquid nitrogen spray, two sessions with a two-week interval between sessions). Their response to treatment was evaluated as good, moderate and weak. Results: There was no difference in age, gender and mean of duration of involvement and number of lesions between two groups. Response to treatment was considerably better in 5 FU group (p=0.02). Also rate of relapse and complications were lower in 5 FU group of treatment, with a statistically significant difference compared to the cryotherapy group (P<0.001). In separate evaluation of complications only scar formation was equal in two groups and pain and bullae formation were lower in 5 FU group with a statistically significant difference (P<0.001 both). Conclusions: According to limited studies in this field, results of this study could be the base of more comprehensive studies in evaluating the efficacy of 5 FU in treatment of common warts. Appropriate therapeutic response in addition to lower rates of relapse and complications by 5 FU treatments can make a major change and lower the psychosocial burden of this disease dramatically.

We refer to the study conducted by Asghariazar R et al comparing the efficacy of 5-fluorouracil against cryotherapy in the management of backhand resistant common warts [1]. We congratulate their success in reporting such a high-quality study. We would humbly like to offer a few pieces of advice, which might further augment the clinical relevance and the scientific content for future studies along similar veins.

Phaeohyphomycosis refers to infection of tissues by dematiaceous fungi which occur most commonly due to traumatic inoculation of fungi. A host reaction to these fungi can ultimately lead to the formation of a cystic cavity or abscess. Here we present a 71 year old woman who presented with a nodular swelling over the left elbow. A surgical excision was performed. On histopathological examination she was found to have a subcutaneous phaeomycotic cyst.

Son múltiples las patologías que pueden afectar al cordón umbilical, entre ellas se hallan las de tipo infeccioso, las relacionadas con anomalías del desarrollo, patologías degenerativas, relacionadas con la dinámica del cordón umbilical, de tipo vascular, tumorales y del amnios. El pólipo umbilical es una anomalía infrecuente por persistencia de parte o todo el conducto onfalomesentérico, histológicamente formado por mucosa intestinal o urinaria. Entre las patologías infecciosas se mencionan las verrugas umbilicales, que son proliferaciones epiteliales benignas, causadas por la infección del virus del papiloma humano. Se presentan dos casos de patologías umbilicales en niños, el primero en un lactante de sexo femenino de 1.5 meses con un pólipo umbilical, y el segundo caso un escolar de sexo masculino con una verruga umbilical, una localización infrecuente, tratada exitosamente con electrocoagulación. Hacemos además una revisión de las patologías más frecuentes de esta localización en pacientes pediátricos.

Carcinoma erysipeloides (CE) is a relatively rare variant of cutaneous metastasis more often observed in breast cancer than in other carcinomas in women. Clinically, it appears as a well-defined, warm and tender inflammatory erythematous plaque, thus mimicking Erysipelas, Cellulitis or post mastectomy complications of lymphedema and acute radiation dermatitis. We report a case of CE in a women previously treated for infiltrating ductal carcinoma by modified radical mastectomy, chemotherapy and radiotherapy. An early and accurate differential diagnosis of this disease gives the opportunity to diagnose and halt the systemic spread of the cancer.

Congenital self-healing reticulohistiocytosis (CSHRH) is a benign type of Langerhans cell histiocytosis (LCH) also known as Hashimoto-Pritzker disease. Clinically it presents with skin lesions at birth or in neonatal period, usually without any systemic involvement. Lesions often heal spontaneously in period of weeks to months. We report a case of CSHRH presenting with skin lesions at birth, describing need to make an early diagnosis and to have a multidisciplinary approach with regular follow-up, in managing this rare type of LCH.

Subcutaneous panniculitis-like T-cell lymphoma is a distinct variant of cutaneous T-cell lymphoma, characterized by primary involvement of the subcutaneous fat in a manner mimicking panniculitis. It accounts for less than one percent of all non Hodgkin lymphoma. We describe two such patients who presented with cutaneous nodules. A 28 year old male presented with a one and a half month history of multiple subcutaneous nodules over the thighs, abdominal wall and chest. A clinical diagnosis of panniculitis was made. An excision biopsy of one the nodules was performed and the histopathology revealed subcutaneous panniculitis-like T-cell lymphoma. The other patient was a 44 year old male who underwent excision of a subcutaneous mass in the right thigh and on histopathological examination a diagnosis of subcutaneous panniculitis-like T-cell lymphoma was made. The patients received one cycle of CHOP (cyclophoshamide, vincristine, doxorubicin and prednisolone) regimen, followed by systemic steroids and were advised follow up.

We report a case of chronic herpes simplex in a 27 year old lady presenting with a history of persistent verrucous ulcer in the natal cleft of nine months duration. The patient was diagnosed and treated initially as a case of Tuberculosis Verrucosa Cutis (TVC) based on the chronicity of the ulcer, negative HIV serological tests and histopathological findings. The diagnosis had to be revised as the lesion was increasing in size and the patient was not responding to treatment even after completing antituberculous treatment for six months. Repeat histopathological examination and immunohistochemistry showed DNA of herpes simplex. Based on this finding a repeat HIV serology was sent which was positive. The ulcer healed after a course of acyclovir. The case is being reported to highlight the importance of considering chronic herpes simplex infection in a case of chronic genital ulcer. In addition this case reminds us the nature of HIV infection to mislead the diagnosis by altering the natural course of the disease process.

Introduction: Both scarring and non-scarring alopecias exist; however, rare cases demonstrate features of both classes. Case Report: We describe an interesting alopecia case with amalgamated clinical, histologic and immunopathologic features of scarring and non-scarring alopecia. Specifically, the case displays combined features of alopecia areata (AA) and of central centrifugal cicatricial alopecia (CCCA). A 36 year old female presented with symmetric, round, patchy hair loss on her scalp. Methods: Biopsies for hematoxylin and eosin (H&E) examination, as well as for special stains, direct immunofluorescence (DIF) and immunohistochemistry (IHC) were performed. Results: The H&E biopsy revealed focally diminished hair follicular units, and sebaceous gland damage. Perifollicular concentric fibrosis was confirmed by Verhoeff elastin special staining. Antibodies to micelles were noted. Positive IHC staining for CD4, CD8, CD45 and multiple proteases and protease inhibitors was noted around selected follicular unit remnants. Conclusion: We present a rare alopecia, combining histologic features of CCCA with additional, selected immunologic features of AA.

Subcutaneous panniculitis–like T-cell lymphoma (SPTCL), originally described as lymphoma of the cytotoxic T lymphocyte, is characterized by a tendency to infiltrate the subcutaneous tissue. The rapid clinical course and aggressive multidrug chemotherapy was the treatment of choice by many years – but it has been changed since 2008. SPTCL term is used only in relation to disease with TCRαβ phenotype, while TCRγδ+ panniculitis-like T-cell lymphomas have become classified by WHO and EORTC as primary cutaneous γδ T-cell lymphoma – PCGD-TCL.

„Black heel” (calcaneal petechiae) is a lesion affecting the back or posterolateral aspect of the heel. The cause is assumed to be trauma. The patients does not remember when the lesions occurred. We describe two patients with classical case of black heel (talon noir) (BH). One man were alpinist and second were dancer. The patients does not remember when the lesions occurred and they noticed it accidentally. Black heels, characterized by speckled bluish-black areas of macular pigmentation occurring at the border of the heel, have been observed in two young male.

A 14 year old boy presented with fever and generalized flushing of skin of 1 week duration. His vital signs were normal. Examination revealed generalized blanching macular erythematous rash. Systemic examination was unremarkable except for tender hepatomegaly. Investigations revealed leucopenia, thrombocytopenia and normal hemoglobin with mildly elevated liver transaminases. NS 1 (Non-structural protein-1) antigen and IgM antibody titer for Dengue ELISA was positive suggesting dengue fever. He was managed symptomatically and he recovered.

A 51 years old woman was reffered to our dermatology clinic with one year history of numerous skin coloured papuels which gradually worsened with time.phiysical examination revealed that the papules were follicular with 1-2 mm diameter.some papules had dark black keratinous material on their surface, giving them a comedo like appearance (Fig. 1). The lesion were located in right lower quadrant of abdomen.

Everyone dreams of a beautiful and flawless face but true beauty is God given gift. Plastic surgery and various filler techniques can just highlight certain features and are just the temporary procedures. Features that further enhance the attractiveness of a beautiful face are the hair, skin, and teeth. These areas are the easiest to routinely enhance.

Molluscum contagiosum and warts are two fairly common skin infections caused by DNA viruses i.e. poxvirus and human papilloma virus (HPV) respectively. Both the conditions are benign and mostly self-limited. However in immunocompromised individuals, these infections can have varied atypical presentations like larger, more extensive, recalcitrant and refractory lesions. These atypical presentations in a non-immunocompromised individual are, however, quite rare. We present one such case with atypical presentation of molluscum contagiosum and warts (verruca vulgaris).

Molluscum contagiosum and warts are two fairly common skin infections caused by DNA viruses i.e. poxvirus and human papilloma virus (HPV) respectively. Both the conditions are benign and mostly self-limited. However in immunocompromised individuals, these infections can have varied atypical presentations like larger, more extensive, recalcitrant and refractory lesions. These atypical presentations in a non-immunocompromised individual are, however, quite rare. We present one such case with atypical presentation of molluscum contagiosum and warts (verruca vulgaris).

Psoriasis is a chronic, recurrent inflammatory skin disease which affects around 2% of the population and is characterized by erythematous and scaly macules and papules of greatly varying degree of involvement. Ciclosporin (Cs) is a therapeutic agent rarely used in the treatment of erythrodermic psoriasis as a monotherapy [1].

Herpes zoster is a neuroectodermal viral infection which afflicts one or more closely grouped, spinal or cranial nerves, resulting in unilateral radicular pain and vesicular eruption limited to a dermatome innervated by that nerve [1]. Bilateral involvement is rare, bilaterally symmetrical involvement is extremely rare. We hereby report a case of bilaterally symmetrical herpes zoster in an old immunocompetent female.

Squaric acid dibutylester (SADBE) is frequently used for the treatment of alopecia, but sometimes unwanted side effects occur. Herein we report a case which developed vitiliginous lesions induced by topical SADBE application in a patient with autoimmune thyroiditis. A 60-year-old female visited our department, complaining of diffuse alopecia of the scalp. She was suffering from chronic autoimmune thyroiditis over several years, and taking thyradin (90mg per day). After obtaining written informed consent, topical application of SADBE solution was started.

Bullous pyoderma gangrenosum (PG) is a rare subtype of PG, which frequently involves extremities. We herein report two cases of bullous PG in association with other systemic diseases, such as hematological malignancy and inflammatory bowel disease.

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 (M) and other. The symptoms and their synonyms, and those who have described this symptom or phenomenon.

A case of Bullosis diabeticorum (BD) affecting unusual sites involving anterior abdominal wall and axilla in a female with newly diagnosed type 2 diabetes mellitus (T2DM) without antecedent trauma and drug intake is being reported for its rarity. Dermatologists must be made aware of this under diagnosed possibility in diabetes whose status is unknown after considering direct immunoflurescence studies to exclude other similar histological and immunological entities.

A newborn, male gender, born at term, APGAR 10, was addressed to us for occipital alopecia observed since birth (Fig. 1). Mother was a young health person of 25 years old, primipara and the birth was non-Caesarian delivery. Alopecia was confirmed in the occipital area, with no signs of inflammation or other dermatological problems on the whole body.

Streszczenie Alergiczne kontaktowe zapalenie skóry jest klasycznym przykładem późnej reakcji nadwrażliwości typu IV, którą mediują limfocyty efektorowe CD4+ Th1. Rozwój alergicznego kontaktowego zapalenia skóry (ACD) jest następstwem ekspozycji na działanie małocząsteczkowych substancji (hapteny). Obecnie ACD jest jedną z najczęstszych chorób zawodowych. Występowanie alergii kontaktowej na co najmniej jeden czynnik w krajach Europy Zachodniej i Ameryki Północnej dochodzi do 19,5% dla różnych grup wiekowych. Klasyczna egzematyczna postać ACD manifestuje się jako rumień, naciek, nadmierne rogowacenie, obrzęk i pęcherze, którym towarzyszy świąd. Modelem zwierzęcym ACD jest reakcja nadwrażliwości kontaktowej (CS). Składa się ona z dwóch następujących po sobie etapów: indukcja (faza aferentna) i wywołanie (faza eferentna). W trakcie pierwszego kontaktu z haptenem powstają swoiste limfocyty efektorowe (Tef), które są rekrutowane do miejsca ponownej ekspozycji na hapten. W tym artykule przedstawiono mechanizmy immunologiczne leżące u podstaw ACD, opierając się na modelu CS