Unilateral linear pansclerotic morphea affecting face and limbs.

Disabling pansclerotic morphea is a rare atrophying and sclerosing disorder of the subcutaneous tissue, muscle and bone. It is characterized by atrophy of the skin, subcutaneous fat, muscle and bone involving half of the face. In some patients the atrophic lesions extend to involve the ipsilateral or contralateral upper and lower limbs with radiological evidence of hemiatrophy. The patients may present with arthralgia, convulsions or cramps. We report a case of a woman with deformity of face, and left upper and lower limbs that had started as an indurated plaque on the left half of forehead at the age of 5 years and had gradually enlarged, followed by the development of atrophic changes in left eye. The case is being reported in view of its rare occurrence.

Utility of polymerase chain reaction as a diagnostic tool in cutaneous tuberculosis.

BACKGROUND: Differentiation of cutaneous tuberculosis from other infective granulomas of the skin is difficult due to paucity of the organisms in tissue biopsies. Polymerase chain reaction (PCR) is a newer technique to identify the DNA of Mycobacterium tuberculosis in the tissues. AIM: We examined the utility of PCR as a tool for rapid diagnosis of cutaneous tuberculosis especially in cases negative by ZN staining and culture. MATERIAL AND METHODS: Twenty five random skin biopsies from patients with various types of cutaneous tuberculosis were subjected to PCR. RESULTS: An overall positivity of 64% was observed, which is comparable to other series. Seventy five percent of lupus vulgaris cases, 62.2% of tuberculosis verrucosa cutis and 50% of scrofuloderma cases showed PCR positivity. CONCLUSION: Though useful, the cost and the technique involved limit the use of PCR in developing countries like ours.

Disseminated cutaneous rhinosporidiosis in a HIV sero--positive patient.

Rhinosporidiosis is a chronic disease, classically involving the nose and nasopharynx, clinically presenting as polypii. However,disseminated rhinosporidiosis, involving various other sites including lips, conjunctiva, uvula, vagina, larynx. trachea. scalp and skin is also known to occur. A case of rhinosporidiosis, with nasal, oropharyngeal and multiple cutaneous lesions, in a patient who is sero--positive for HIV is reported.

Generalised morphoea with lichen sclerosus et atrophicus and unusual bone changes.

A 26-year-old male patient presented with multiple plaques on the limbs and trunk suggestive of morphoea. He also exhibited multiple, small, atrophic, hypopigmented macules on the left side of the trunk, the histopathology of which was consistent with lichen sclerosus et atrophicus (LSA). The patient developed large ulcers on the left leg and foot, and contractures with flexion deformity of the left ring and little fingers. This combination of generalised morphoea with LSA and unusual osteolytic bone changes is uncommon.

Kyrle's Disease with Diabetes Meuxfus and Chronic Renal Failure.

A 54 year old male had Kyrle's disease manifestion as multiple, discrete papules with cone-shaped keratotic plugs. The lesions were severly pruritic and located symmetrically on the extensor aspects of the limbs and the trunk. Histopatholggical examination confirmed the diagnosis. The patient was known to be diabetic for 18 years and developed chronic renal failure 4 months prior to the onset of the skin lesions. Treatment with 6% salicylic acid topically did not produce any improvement of the lesions.

Dapsone Induced Methaemoglobinemia.

A 33 old I female developed methaemoglobinemia manifesting as cyanosis fatigue, malaise and headache 3 weeks after being put on l00 mg of dapsone daily for borderline - tuberculoid leprosy. Similar manifestations develope4 in a 15 year old boy 9 days after he, was put on 50 mg of dapsone daily for suspected indeterminate leprosy. withdrawal of dapsone resulted in reversal of methaemoglobinemia.

Xeroderma Pigmentosum with Mailgnant Melanoma and Squamous Cell Carcinoma.

A 25 year old female with xeroderma pigmentosum since 3 ye4ws of age, developed a nodular growth on the left ala of the nose since 4 months. Histopathology revealed m ant melanoma of the nodular variety. A squamous cell carcinoma was also detected at the fimbus in the right eye. There were no metastases.