RESUMEN
Erythema multiforme (EM) is a rare immune-mediated condition that can manifest as cutaneous, mucosal, or both types of lesions. The target lesion, with concentric zones of color change, is a cutaneous feature that is typical of this illness. Despite the fact that a number of factors can lead to EM, the most common being Herpes simplex virus (HSV) infection, drug-induced EM is a rare entity. As disease severity and mucosal involvement vary across individuals, treatment should be optimized for each patient, considering the risk versus benefit ratio. To distinguish EM from other clinical imitators and to confirm the diagnosis, histopathologic tests and other laboratory procedures may be utilized. Our patient presented with symptoms suggestive of a viral infection, such as fever and rash, but the RTPCR report for various viral infections came out to be negative, hence indicative of the diagnosis of drug-induced erythema multiforme.
RESUMEN
The "Malaria Evolution in South Asia" (MESA) program project is an International Center of Excellence for Malaria Research (ICEMR) sponsored by the US National Institutes of Health. This US-India collaborative program will study the origin of genetic diversity of malaria parasites and their selection on the Indian subcontinent. This knowledge should contribute to a better understanding of unexpected disease outbreaks and unpredictable disease presentations from Plasmodium falciparum and Plasmodium vivax infections. In this first of two reviews, we highlight malaria prevalence in India. In particular, we draw attention to variations in distribution of different human-parasites and different vectors, variation in drug resistance traits, and multiple forms of clinical presentations. Uneven malaria severity in India is often attributed to large discrepancies in health care accessibility as well as human migrations within the country and across neighboring borders. Poor access to health care goes hand in hand with poor reporting from some of the same areas, combining to possibly distort disease prevalence and death from malaria in some parts of India. Corrections are underway in the form of increased resources for disease control, greater engagement of village-level health workers for early diagnosis and treatment, and possibly new public-private partnerships activities accompanying traditional national malaria control programs in the most severely affected areas. A second accompanying review raises the possibility that, beyond uneven health care, evolutionary pressures may alter malaria parasites in ways that contribute to severe disease in India, particularly in the NE corridor of India bordering Myanmar Narayanasamy et al., 2012.