Pre-sezary To Sezary Erythroderma Syndrome.

A 50-year old woman was admitted with pre-Se'zary syndrome in May, 97 as she had intractable progressive erythroderma with intense pruritus since 15 months. She also had axillary, inguinal, hilar and para-aortic lymphadenopathy, hepatomegaly, alopecia, hypersensitivity to cefadroxyl, and abnormal Sezary cells in peripheral blood film. Histopathology confirmed the diagnosis. Initially she was given 20 mg of prednisolone which was later increased to 40 mg daily but she did not respond. She responded favourably to combination of 20 mg prednisolone and chlorambucil 2.5 mg daily.

Oral submucous fibrosis (OSMF).

Two patients with oral submucous fibrosis, a disease exclusively found in India, are being reported.

Skin changes in acute myelogenous leukemia.

A 65-year old woman developed progressive, firm, mild to moderately itchy, erythematous, papular and nodular lesions, over cheeks, extensors of limbs, scalp and lower back without any accompanying systemic complaints except for severe backache. Initially clinical diagnosis was cutaneous sarcoidosis. However presence of myeloblasts, monoblasts, myelocytes and metamyelocytes in peripheral blood smear and typical histopathology of nodule with mixed cellular infiltrate more around blood vessels, sweat glands and hair follicles with admixture of larger polymorphonuclears (myeloblasts/myelocytes), eosinophils with double nuclei, and larger phagocytic cells confirmed the diagnosis of acute myelogenous leukemia (AML).

Brunsting perry cicatricial pemphigoid.

Two cases of Brunsting Perry cicatricial pemphigoid are being reported for their rarity. Initially as a clearcut clinical diagnosis was not possible, both cases were labelled as a typical vesiculo-bullous disorder. Later only after repeated biopsies, dermoepidermal junction split, fibrosis and perivascular mononuclear infiltrate were seen and a diagnosis of cicatricial pemphigoid was established which was further confirmed by immunoflurescent studies. A favourable response to dapsone was observed in both cases.

Atypical multicentric reticulohistiocytosis.

A 38-year-old male had arthritis since 8 years and erythematous papules, plaques, cutaneous and subcutaneous nodules over face, ears, trunk, and extensors of arms since 2 years, Histopathologically, presence of multiple foreign body giant cells confirmed the clinical diagnosis of multicentric reticulohistiocytosis. Unusual associations were: tapered fingers with depressed scars on their tips, low ESR - (5mm 1st hour). Raynaud's phenomenon and exaggeration of lesions after methotrexate.

Nodular colloid degeneration over herpes zoster scars.

A rare case of nodular colloid degeneration is reported which presented clinically as plaques studded with soft yellow papules simulating adult colloid milia superimposed only on herpes zoster scars of right side of the face.

Nodular malignant melanoma - Secondary to carcinoma rectum.

A 45-year female presented with a sudden eruption of multiple brownish black nodular lesions since 5 months over the face, trunk and extremities which were clinically diagnosed as a case of nodular malignant melanoma. Histopathologically, they revealed the secondaries from carcinoma rectum.

Treatment of high undescended testes by low spermatic vessel ligation: an alternative to the Fowler-Stephens technique.

PURPOSE: We determined whether testis viability after a Fowler-Stephens orchiopexy depends on ligating the spermatic vessels high and far proximal to the undescended testis. MATERIALS AND METHODS: Based on studies of testicular vascular anatomy we developed a technique of low spermatic vessel ligation and performed it on 39 high undescended testes in 33 patients. RESULTS: Testis viability was 97% at 1 month and 93% (25 of 27) at 1 year. CONCLUSIONS: Ligation of the spermatic vessels does not need to be performed high to ensure testis viability. Testicular vascular anatomy supports low spermatic vessel ligation and by decreasing tension on the testis low spermatic vessel ligation may enhance viability. A 2-stage laparoscopic approach to the high undescended testis is difficult to justify on the basis of cost or outcome analysis.

Cellular blue naevus.

A 31-year-old man had asymptomatic, stationary, 1.5X2 cm, shiny, smooth, dark blue nodule on dorsum of right hand since 12-14 years. In addition he had developed extensive eruption of yellow to orange papulonodular lesions on extensors of limbs and buttocks since one and half months. Investigations confirmed that yellow papules were xanthomatosis and he had associated diabetes mellitus and hyperlipidaemia. Biopsy of blue nodule confirmed the clinical diagnosis of cellular blue naevus. Cellular blue naevus is rare and its association with xanthomatosis and diabetes mellitus were interesting features of above patients which is being reported for its rarity.

Dilated pore of Winer.

Two cases of dilated pore of Winer were observed. First case had single defined black papule with well defined margin, central pore and discharge of black powdery material from nose since 3 years. The second case had one 9 mm, black well-defined papule with central pore discharging black powdery material on right forearm since 9 months and 9 similar smaller papules were seen on forearm and lower abdomen. Histopathologically both revealed greatly dilated infundibulum lined by acanthotic epidermis and atrophic subinfundibular hair structures thus confirming diagnosis of dilated pore of Winer.

Preliminary report: detrusor hyperreflexia in schizophrenia.

The object of this study was to demonstrate detrusor hyperreflexia (DH) in schizophrenic patients. Twelve consecutive schizophrenic patients were evaluated by DSM-IIIR diagnostic criteria and other standard psychiatric measures, urological history and examination, and urodynamic study. All were referred for clinical indication, voiding dysfunction, or incontinence. Two patients were excluded for confounding variables, mental retardation and benign prostatic hypertrophy. Of the ten evaluable patients, four had DH. Detrusor hyperreflexia does occur in a subset of schizophrenic patients, even in the absence of other recognized disease to explain the occurrence. This relationship, previously unreported, warrants further investigation.