Hereditary punctate palmoplantar keratoderma--a clinical study.

28 patients of hereditary punctate palmoplantar keratoderma (HPPK) were selected from DermatoVenereology out patients of Rajindra Hospital, Patiala. Cases were divided into group A with PPK as major feature and group 6 with PPK as minor feature. 11/28 belonged to group A and 17/28 to group B. Group A patients revealed scattered pundate PPK in 6 and scattered pundate plus focal plaques in 5, while in group B patterns seen were KPPC (6), KPPC with focal (6), focal plus scattered punctate (3) and diffuse with superimposed KPPC (2).

Comparative immunological and histopathological study in fifty cases of mucosal/nonmucosal lichen planus.

Lichen planus is a common disorder and 40-50% of LP patients also reveal mucosal lesions. It is well known that mucosal LP lesions take very long to heal in comparison to cutaneous lesions. Rarely erosive mucosal LP can turn malignant. Both CMI and humoral immunity may play role in aetiopathogenesis of LP. Present study was conducted to study and compare CMI, Humoral Immunity, histopathology in mucosal and nonmucosal LP.

Chilblain lupus erythematosus mimicking acrofacial vitiligo.

Chilblain lupus erythematosus with depigmentation is a rare presentation of lupus erythematosus that may simulate vitiligo. A 52-year-old lady with such a manifestation is being reported.

Accessory auricles with ectopic digit a new association.

A 25-year-old male had accessory auricles at birth and developed ectopic digit since 1 year. As this association could not be traced in literature, it is being reported. Ectopic digit in the present case was differentiated from supernumerary digit because of late onset at the age of 24 years, recurrence after surgery, unilateral appearance, had origin from central depression of a well defined, round plaque on the distal inter-phalangeal joint of left thumb and had curvature simulating cutaneous horn. X-ray thumb did not reveal any bone formation in this ectopic digit.

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.

Palmoplantar keratoderma in myxedema.

A 45-years-old woman came with diffuse yellowwaxy thickening, dryness and scaly skin of palms and soles and thickening of knuckles on dorsa of hands since 2 years. In addition, she had hoarseness of voice, weight gain, slow response, intolerance to cold, loss of pubic and axillary hair, generalised dryness and coarseness of skin, and mask like fades. Diagnosis of palmoplantar keratoderma and myxedema was confirmed by investigations.

Peripheral T-lymphocyte counts in seborrhoeic keratosis.

One hundred and forty-eight cases of clinically diagnosed seborrhoeic keratoses and 12 of stuccokeratoses were selected from Dermato Venereology department of Rajendra Hospital, Patiala, during a period of 15 months. Histopathology confirmed that 123 out of 148 cases were of seborrhoeic keratosis and 8 out of 12 were of stuccokeratosis. T-lymphocyte counts in histopathologically confirmed cases were done by Thomson's E-rosette method (1977). Peripheral T-lymphocyte counts were statistically significantly increased in both seborrhoeic keratosis and stucco keratosis, thus revealing important role of cell mediated immunity in seborrhoeic keralosis.

Blue rubber bleb nevus syndrome.

Two cases of blue rubber bleb nevus syndrome are being reported because of their rarity. Case one was classical with multiple, soft, painful, tender, bleb- like, bluish nodules and gastro- intestinal tract bleeding. In case 2 typical zosteriform, soft bluish, compressible, tender, painful nodules simulating that of blue rubber bleb nevus syndrome were present on the right thigh since the age of 14 years. He refused biopsy and therefore it was not possible to exclude other segmental vascular naevi.

The sign of Leser-Trelat.

Four cases of Leser-Trelat sign were studied in detail clinically and were investigated to establish their association with internal malignancy. One of them had papillary carcinoma of thyroid and the second had carcinoma of the body of pancreas. USG revealed mass in the gall bladder in the third case. He was lost before completion of other investigations. The fourth case was normal. So patients with Leser-Trclat sign must be carefully investigated in detail.

Clinico-histopathological study of subacute cutaneous lupus erythematous.

Fourteen cases of sub acute cutaneous lupus erythematosus (SCLE) were selected from Dermato-Venereology outpatients during the last 2(1/2) years. Clinically all patients revealed photosensitivity and annular plaques either covered with peripheral collarette of scale or EM--like or DLE--like lesions. Systemic associations were arthralgia in 4, hypertension in I. rheumatoid arthritis in I and pulmonary tuberculosis in L Histopathologically epidermal atrophy, interface dermatitis, basal cell degeneration, colloid bodies and mononuclear infiltrate of dermis were salient features. Good response to 15 mg prednisolonc, medium potency topical steroids and sunscreens was seen in all cases.

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.

Azathioprine as a therapeutic modality for the treatment of severe adult atopic dermatitis.

Atopic dermatitis is a difficult disease to treat. A few reports suggest that azathioprine may be effective in the treatment of atopic dermatitis. We therefore, evaluated the role of azathioprine in adult atopic dermatitis not adequately controlled with conventional therapy. Four patients of adult atopic dermatitis were treated with azathioprine 50 mg twice daily orally for 3-4 months. All the patients had complete remission after therapy. There were no significant side effects. Therefore, azathioprine can be considered a better and safer alternative drug in recalcitrant adult atopic dermatitis.

Multiple lichen striatus--an unusual presentation.

A 2-year-old mare child presented with multiple hypopigmented, flat topped papules with a bilateral distribution along the lines of Blaschko. A 7-year-old girl presented with multiple hypopigmented macules arranged linearly along the left upper and lower limb and also on the back along the lines of Blaschko. Three discrete lines in three distinct anatomical areas in a case of lichen striatus do not appear to have been described.

Trachyonychia treated with oral mini pulse therapy.

A 12-year-old girl presented with dull, opalescent, nails with a roughened surface. She was successfully treated with oral mini-pulse therapy, which consisted of 4 mg betamethasone as a single oral dose with breakfast on two consecutive clays every week.

Lichen planus treated with betamethasone oral mini-pulse therapy.

Ten Patients, 6 males and 4 females between 7-60 years of age having lichen planus for I month to 2 years were treated with betamethasone 5mg orally on two consecutive days in a week for 3 months. There was excellent (75-100%) response in 6 (60%) patients and good (50-75%) in 4 (40%) patients. None of the patients had significant side effects of the therapy and there were no treat-ment failures. Betamethasone on two consecutive days in a week as oral mini pulse therapy may be a safe, effective and a better therapeutic alternative for the treatment of lichen planus.

Chronic leg ulcers in drug abusers.

Four young males with chronic non pitting swelling of lower legs associated with multiple ulcers, scars and pigmentation after parenteral drug abuse were observed in the Dermatovenereology department during last one year. Three of them had active ulcers which healed with withdrawal of offending drug, use of systemic and topical antibiotics and B-complex. All cases were referred to the deaddiction centre. The characteristic clinical features helped in the diagnosis even before history of drug abuse was obtained.