Evaluation of Five Different Regimes For the Treatment of Vitiligo.

Response of vitiligo patients to five different regimes was evaluated taking only those patients who had either static or progressively increasing lesions. Selection of the regimen depended upon the clinical characteristics of the disease. Each regime was tried for at least 4 months and if a patient didnot improve with one regime, he was shifted to another regime. A patient was considered to have improved, if the lesions started regimenting or the previously progressive lesions stopped increasing further. Regime I consisted of 150 mg levamisol orally on two consecutive days per week, given to 13 cases, it resulted in improvement in 7 (53.80/o). Regime II consisted of levamisole in the same dose combined with once a day topical massage with 0.1% fluocinolone acetonide acetate cream; it led to improvement in 27 (81.8%) of the 33 cases. Regime III consisted of 3 mg betamethasone orally on alternate days combined with levamisole and topical fluocinolone; given to 32 cases, it was successful in 28 (87.50/o). A combination of 2 mg betamethasone orally alternating with 20 mg 8-methoxypsoralen and sun exposure (regime IV) caused improvement in 17 (85%) of the 20 cases. An oral mini pulse consisting of 5 mg betamethasone orally twice a week combined with 50 mg cyclophosphimide daily orally (regime V) was successful in 20 (90.9%) of the 22 cases, the remaining two cases showed unprovement when the dose ofbetamethasonc .was increased from 5 mg to 7.5 mg twice a week. Thus ultimately each one of the 91 patients responded to one or the other regime. The side effects were minimal and insignificant.The degree of improvement at the time of analysis was 100% in 23.3% cases, 50-100% in 44.2'Yo cases and less than 50% in 32.5%, after 4-14 months of treatment. It is felt that the results may be better after a longer follow-up although all patients are not expected to get complete repigmentation.

Mycosis Fungoides with Unusual Features.

A case of mycosis fungoides had unusual features such as non- pruritic nodule-ulcerative lesions following a febrile, episode, appearance of many lesions in subsequent episodes in the margins of scars of previous lesions, along with a cyclic course. Higtopathology of the skin and lymph node showed a typical picture, of mycosis fungoides.

Evaluation Of-astemizole- A New H-1 Blocking Antihistamine in Urticaria.

An open trial of astemizole a new anthistamine on 30 patients, having urticaria revealed complete relief in 28 patients. The controlling daily dose was 10 mg in 17 patients, 20 mg in 7 and 30 mg in 4. Two patients did not improve even with 40 mg a day given for 7 days. The side effects included mild sedation in 7, dryness of mouth in 3 and constipation in 2 on a dose of 20 or 30 mg a day. Laboratory parameters remained almost normal.

Nail Patella Syndrome.

A 14-year-old male having nail-patella syndrome, manifested as deficient nails on the ubw aspect of thumbs, V-shaped half- moons, rudimentry patella on right side and absence on left side. X-ray of pelvis showed iliac horns.. Family history was suggestive of autosomal dominant of inheritance.

Captopril Induced Pemphigus Vulgaris.

A 51 Year old man, was taking captopril 200 mg daily' for the management of essential hypertension. Twenty two days after starting captopril, he developed flaccid vescicles and bullae over his scalp, face, trunk and mucous membranes of the mouth. Clinical and histopathological features were consistent with the diagnosis of pemphigus vulgaris' Complete disappearance of the skin lesions within. 15 days of withdrawing the drug and absence of any recurrences in one year follow-up suggest that captopril was the probable offending drug.

A Clinico-epidemiologic Profile of Herpeszoster in Norht India.

A clinico-epidemiological study of 230 cases of herpes zoster revealed an overallincidence of 0.6 percent. Out of 230 patients 160 were males and 70 females (male and female ratio being 2.2:1). The maximum incidence was noted in the second and third decades. A higher incidence was observed in the months of March, April, May and then in August, September and October. A confirmative history of chicken poxin the past was available in 34 (14.7%) patients only. There was no appreciable difference between right and left side involvement, except for the cranial segments, where the right side was predominantly involved. Thoracic segments were most commonly (55.2%) involved followed by cervical (19.5%), lumbo-sacral (13.9%) , and cranial (11.3%) segments. Prodromal symptoms were recorded in 20% patients. Among the cranial nerves, ophthalmic branch of trigeminal nerve was most commonly (57.7%) affected. Post herpetic neuralgia was noticed in 14.3% patients.

Thevenard Syndrome.

Six cases of Thevenard syndrome presented as trophic ulcers on the toes with shortening and loss of pain and temperature sensations. Four cases had spina-bifida out of which two cases had associated faun-tail and one case had hypertrophy of the lower extremity of one side.