Dermatitis artefacta.

A 27-year old lady presented to our department with multiple erosive lesions over extremities, which had a very bizarre pattern and was only over accessible parts of body. A thorough history was taken and a diagnosis of dermatitis artefacta was made. We present this interesting case for its rarity and future reference.

Ichthyosis hystrix.

The present report describes the condition in a three day old male child with bilateral ,linear, hyperpigmented and hyperkeratotic verrucous plaques and patchy alopecia over scalpe without any nail and skeletal abnormalities. It was suggestive of ichthyosis hystrix type of epidermal nevus,and is being reported in view of the rarity of this condition.

Mantoux test and its interpretation.

The tuberculin skin test is one of the few investigations dating from the 19(th) century that are still widely used as an important test for diagnosing tuberculosis. Though very commonly used by physicians worldwide its interpretation always remains difficult and controversial. Various factors like age, immunological status coexisting illness etc influence its outcome, so also its interpretation. Utmost care is required while interpreting the result and giving an opinion. This article has been written with the purpose of elucidating the performance and interpretation of the standard tuberculin test.

Lipoid proteinosis in a six-year-old child.

Lipoid proteinosis (LiP) (OMIM 247100) is a rare autosomal recessive disease caused by loss of function mutations in the extracellular matrix protein 1 gene, ECM1, on chromosome 1q21. Clinically characterized by hoarseness in early infancy, followed by waxy papules and plaques on the face and body along with pox-like and acneiform scars. We report here a 6-year-old female child with LiP, who presented to our OPD for recurrent vesicullobullous lesions and beaded lesions over eyelid margins.

VDRL test and its interpretation.

Venereal disease research laboratory (VDRL) test is a nontreponemal test, used for screening of syphilis due to its simplicity, sensitivity and low cost. Prozone phenomenon and biological false positive (BFP) reaction are two shortcomings of this test. Quantitative estimation of VDRL is essential in treatment evaluation. CSF VDRL test is very specific for neurosyphilis though its sensitivity is low. Interpretation of VDRL in HIV infection is incompletely understood.

Deflazacort versus other glucocorticoids: a comparison.

Steroids form an important component of dermatological therapy and are used since very long time for different conditions in different forms. Though very few molecules are used since very long time, the side effect associated with this group of drugs are almost always there. Recently a new molecule deflazacort has been introduced into Indian market, is a glucocorticoid and a derivative of old molecule prednisolone. Though claimed to be having less side effect, very few studies have been done in Indian prospective. This review will highlight the very basics of this drug and its advantages and disadvantages.

Adverse cutaneous drug reaction.

In everyday clinical practice, almost all physicians come across many instances of suspected adverse cutaneous drug reactions (ACDR) in different forms. Although such cutaneous reactions are common, comprehensive information regarding their incidence, severity and ultimate health effects are often not available as many cases go unreported. It is also a fact that in the present world, almost everyday a new drug enters market; therefore, a chance of a new drug reaction manifesting somewhere in some form in any corner of world is unknown or unreported. Although many a times, presentation is too trivial and benign, the early identification of the condition and identifying the culprit drug and omit it at earliest holds the keystone in management and prevention of a more severe drug rash. Therefore, not only the dermatologists, but all practicing physicians should be familiar with these conditions to diagnose them early and to be prepared to handle them adequately. However, we all know it is most challenging and practically difficult when patient is on multiple medicines because of myriad clinical symptoms, poorly understood multiple mechanisms of drug-host interaction, relative paucity of laboratory testing that is available for any definitive and confirmatory drug-specific testing. Therefore, in practice, the diagnosis of ACDR is purely based on clinical judgment. In this discussion, we will be primarily focusing on pathomechanism and approach to reach a diagnosis, which is the vital pillar to manage any case of ACDR.

Disseminated cutaneous rhinosporidiosis.

A 48-year-old male patient presented to Skin and VD outpatient with multiple granulomatous growths of different sizes all over the body, including numerous subcutaneous swellings mimicking lipomas of 2 years duration. Two and half years back he was operated for a polypoidal growth of left nostril with subsequent recurrence. Fine needle aspiration cytology and histopathology of the cutaneous lesion confirmed the diagnosis as rhinosporidiosis. We report this rare case of disseminated cutaneous rhinosporidiosis.

Epidermolytic hyperkeratosis with rickets.

A 6-year-old child presented with generalized hyperkeratosis, most marked over the flexures; windswept deformity of the legs; and limping since 3 years. On the basis of the clinical, histopathologic and biochemical findings, he was diagnosed as a case of epidermolytic hyperkeratosis with rickets. He was treated with parenteral vitamin D3 and calcium supplements orally. Nutritional rickets has been reported in children with various types of ichthyosis like lamellar and X-linked types. We report this case of epidermolytic hyperkeratosis with rickets for its rarity.

Proteus syndrome.

Proteus syndrome is a variable and complex disorder characterized by multifocal overgrowths affecting any tissue or structure of the body. We present a girl aged 3 years and 8 months with an epidermal nevus, port-wine stain, macrodactyly with gigantism of the feet, lymphohemagiomas and multiple lipomas.