Dexamethasone-cyclophosphamide pulse therapy in systemic lupus erythematosus.

BACKGROUND AND AIMS: Therapy systemic lupus erythematosus (SLE) has been generally discouraging. Methyl-prednisolone pulse therapy has been used for various connective tissue disorders. We used intravenous dexamethasone cyclophosphamide pulse therapy to treat SLE. METHODS: Fourteen patients (10 females and 4 males) between the age of 15-48 years with definite or classical clinical criteria laid by American Rheumatism Association criteria were treated by Dexamethasone-Cyclophosphamide pulse (DCP) therapy at our center. RESULTS: It was possible to induce a complete clinical remission with DCP therapy in most of the patients thereby offering them life free from disease and drugs. The side effects commonly observed with conventional daily dose regimen of corticosteroids were not present or were mild. CONCLUSIONS: Almost all patients had good response after 3-4 pulses to allow them a normal life style. Fever, malar rash and oral ulceration responded early but photosensitivity, discoid rash, alopecia and joint pains took some more time.

Juvenile hyaline fibromatosis in siblings.

Juvenile hyaline fibromatosis (JHF) is a rare, autosomal recessively inherited disorder. We report two siblings with multiple large tumors on the scalp, translucent papules on the nape of the neck, hypertrophic gingiva, and severe flexural contractures of large joints. The histopathology from the skin lesions showed features characteristic of juvenile hyaline fibromatosis. The cases are being reported on account of the extreme rarity of the condition.

Florid cutaneous papillomatosis with adenocarcinoma of stomach in a 35 year old male.

Various paraneoplastic dermatoses may be seen in association with underlying visceral, especially gastrointestinal, malignancy. Florid cutaneous papillomatosis describes the sudden appearance of multiple acuminate keratotic papules that morphologically resemble viral warts. It may be seen in association with acanthosis nigricans and/or the sign of Leser Triotalat. We report a 35-year-old male with extensive seborrhoeic keratoses and florid cutaneous papillomatosis. Unusually marked verrucous changes caused disfigurement of the hands and feet. The patient also reported dyspepsia, abdominal distention and weight loss 6 months prior to the development of cutaneous lesions. Gastroscopy revealed a large growth in the stomach. Histopathology of the tumor showed features of adenocarcinoma.

Occupational contact dermatitis among the traditional 'tie and dye' cottage industry in Western Rajasthan.

BACKGROUND: Dyeing is an age-old process and forms an integral part of textile industries. Tying is a process by which a particular part of cloth is prevented from the process of dyeing. The skin diseases in workers engaged in the 'tie and dye' industry have not been extensively studied. AIMS: To study the prevalence of contact dermatitis among workers engaged in the 'tie and dye' industries in and around Jodhpur (Western Rajasthan). METHODS: One thousand three hundred workers engaged in 'tie and dye' work were evaluated for occupation-related dermatitis. Those with skin lesions were subjected to patch tests using 2% aqueous solution of the dyes and chemicals commonly used by them. These included direct dyes, VAT dyes, sulfur dyes and azo dyes. Fifty workers without skin lesions served as controls. RESULTS: One hundred patients (7.69%) had dermatitis involving the exposed sites, mainly the hands and forearms. Eighty-one patients showed positive reactions to one or more dyes, most commonly Red RC base (azo dye), followed by naphthol. CONCLUSION: Red RC base and naphthol were the commonest allergens in the 'tie and dye' industry.

Comparison of oral azithromycin pulse with daily doxycycline in the treatment of acne vulgaris.

INTRODUCTION: Oral azithromycin has been advocated by some in the treatment of acne. However, its efficacy has not been established. MATERIAL AND METHODS: This non-randomized controlled trial was conducted on 70 outpatients with acne vulgaris to compare the efficacy and safety of azithromycin and doxycycline in the treatment of inflammatory acne. In the first group, azithromycin was administered 500 mg daily before meals for 3 consecutive days in a 10-day cycle, with the remaining seven days in each cycle being drug-free days. The second group was given doxycycline 100 mg daily after meals. Topical erythromycin was prescribed to all patients. Clinical assessment was done at 10-day intervals for both the groups up to three months. We followed the severity index described by Michaelsson for assessment of outcome measures. RESULTS: There was 77.26% improvement in azithromycin treated group in comparison to 63.74% in the doxycycline treated group. There was a statistically significant reduction in severity in the azithromycin treated group. CONCLUSION: The study showed that a combination of azithromycin with topical erythromycin was significantly better than doxycycline with topical erythromycin in the treatment of acne vulgaris. The incidence and severity of side effects were also lower with azithromycin.

Disseminated primary cutaneous histoplasmosis successfully treated with itraconazole.

A 60-year-old immunocompetent lady with disseminated primary cutaneous histoplasmosis is reported. Histology showed a granulomatous skin infiltrate with numerous intracellular PAS positive rounded yeast cells within macrophages. Culture on Sabouraud's dextrose agar yielded a typical cottony white colony characteristic of Histoplasma capsulatum. Treatment with itraconazole showed an excellent response.

A retrospective study of clinico-histopathological correlation in leprosy.

Leprosy is a chronic infectious disease caused by Mycobacterium Leprae and is characterized by well-recognized pathological changes. But there are various disagreement in clinical type and histological finding of leprosy. We observed highest parity in LL and TT group followed by histoid, BT, BL, BB, & indeterminate respectively. There was 10% minor disagreement (difference of one group) and 5% major disagreement (difference of two or more group). Non-specific histological finding was present in 20% cases.

Vegetable and fruit contact dermatitis among housewives-study of 25 cases.

Almost all women have to handle vegetables and fruits, so vegetable and fruit contact dermatitis in females has surfaced as a dermatological problem. This study was therefore undertaken to evaluate the contact sensitization pattern of various vegetables and fruits in housewives in north-west Rajasthan. Thirty-eight commonly used vegetables and fruits extracted/crushed allergen's patch tests were applied as such over back of 25 women having eczema of thumhs, index and middle fingers, 1st and 2nd web spaces, palmar and dorsal aspect of hands. Patch tests were read after 48 and 72 hours and graded as ICDRG. Out of them we obtained positive results in 20(80%), with single allergen positivity in 6 (24%) an11 multiple allergen positivity in 14 (56%).

A clinico - histopathological outcome of 4 weeks methotrexate pluse therapy in psoriasis.

A clinico-histopathological study was carried out In 50 patients of psoriasis to see clinical and histological outcome and/or correlation of weekly methotrexate pulse therapy. Clinically, results of therapy were evalutated by estimating the percentage of total body coverage with psoriasis. Prior to therapy, average involvement was 47.5% which after 4 weeks methotrexate therapy reduced to 8. 3%. A complete clearing of psoriasis occurred in 40% of patients after methotrexate therapy. The clinical response started as early as I week in most of patients. Only 2 patients failed to respond even after 4 weeks of therapy. Histopathologically in pretreatmenl biopsy, 34 showed classical psoriatic pathology while in 16 biopsy was suggestive of psoriasis but not confirmative. Histopathological examination after 4 weeks treatment showed that 41 still showed one or more histological evidence of psoriasis, although only two patients had classical, psoriatic pathology, in rest 9 patients there were complete regression. Thus, with methotrexate, clinical clearance was much faster than histopathological clearance.

Prolong continuous versus weekly oral acyclovir in recurrent herpes genitalis.

Patients with frequent recurrences of genital herpes were treated with oral acyclovir tablet, 800 mg once daily or once a week for 2 years. Confirmed recurrences for all patients were treated with acyclovir, 200 mg orally 5 times per day, for five days. Of 58 patients enrolled, 12 of 26 daily acyclovir recipients and 22 of 32 weekly acyclovir recipients completed two years of study. Patients receiving daily acyclovir experienced a mean of 0.0991 recurrences / month compared with mean of 0.113 recurrences / month for patients receiving weekly acyclovir. A total of 33% of daily acyclovir recipients and 27% weekly acyclovir recipients were free of recurrences for two years.

Topical mometasone furoate for the treatment of childhood vltiligo.

Forty-five children with vitiligo were treated with topical applications of mometasone furoate for 2 to 6 months. The best results occurred in the facial vitiligo. Repigmentation of 90-100% was achieved in more than 80% of patients with vitiligo of the face and more than 60% of patients with vitiligo on other part of the body. Interestingly there was no single side effect noted even after six months application in children.

Cutaneous leishmaniasis in Jodhpur district.

Cutaneous leishmaniasis is a disease with a wide geographical distribution in a range of climate and with different epidemiological patterns. In Rajasthan a new endemic zone of the disease has been found at Jodhpur district. The clincial features of 21 smear positive cases of oriental sore from Jodhpur district studied during a period of 1 year have been described. Also the importance of intralesional berberine sulphate in the treatment of oriental sore has been highlighted.