Periorbital mass with cellulitis caused by dirofilaria.

Dirofilariasis is a zoonotic disease caused by Dirofilaria, a parasite of domestic and wild animals. The disease is transmitted by inoculation of mosquitoes infected with the microfilariae during their blood meal. Accidental infection of man results in lung nodule, subcutaneous mass anywhere in the body or ocular lesion that may be subconjunctival or periorbital. The incidence of ocular dirofilariasis is on the rise in several parts of India particularly in Kerala. Here we report a case of ocular dirofilariasis with cellulitis presenting as a periorbital mass.

Kasabach merritt syndrome: management with interferon.

Kasabach Merritt Syndrome (KMS) is a rare, locally aggressive, vascular tumor. The objectives of treatment of KMS are to prevent bleeding from consumptive coagulopathy and induce vascular tumor regression. A 14-month old female child was brought with a reddish lesion on the left scapular area noticed at birth, which suddenly increased in size since 3 days. Hemogram revealed anemia severe thrombocytopenia, prolongation of bleeding, clotting time and increased fibrin degradable products, suggestive of KMS. Coagulopathy was managed by transfusing fresh frozen plasma and platelets. Oral prednisolone up to 5mg/kg/day for four weeks yielded no effect on thrombocytopenia or regression of tumor size. Embolization of feeding artery was attempted but not feasible. We used Interferon -alpha- 2b (IFN α 2b), in a dosage of 3million IU/m(2) /day subcutaneously. Within a month the platelet count increased and the vascular tumor started regressing. This case signifies the importance of step wise management of KMS.

Subcutaneous panniculitis-like T-cell lymphoma.

This case report describes a 38 year-old lady with the clinical, histopathological, and immunohistochemical (IHC) changes of subcutaneous panniculitis-like T-cell lymphoma (SPTCL). The IHC findings revealed CD8 + and CD56 - cells, which are indicative of tumors which have an indolent course. Our patient is being managed with tapering doses of corticosteroids for the last nine months with good improvement.

Carbamazepine--the commonest cause of toxic epidermal necrolysis and Stevens-Johnson syndrome: a study of 7 years.

BACKGROUND: Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are a group of severe life threatening drug reactions. The drugs commonly implicated as the cause of these drug reactions vary depending on host factors and the prescription pattern of drugs in that particular area. AIM: The aim of the study was to find the drugs implicated as the cause of SJS/TEN in the patients admitted in the dermatology ward at the Medical College, Thrissur and to find the clinical outcome. METHODS: It was a retrospective study of 7 years from 1997 to 2004. The case records of all patients with a clinical diagnosis of TEN or SJS were studied in detail regarding the drugs implicated as the cause, the management and the clinical outcome. RESULTS: During the study period, 41 patients in the age group ranging from 12 to 72 years were treated as inpatients, of which 20 were males and 21 were females. The commonest drug implicated as the cause of SJS/TEN was carbamazepine (44%). The indication for carbamazepine was control of pain in more than 50% of the cases. Presence of a major systemic disease before the onset of SJS/TEN was associated with a bad prognosis. CONCLUSION: The increased use of carbamazepine, especially for control of pain, may be the reason for the increased incidence of SJS/TEN due to the same drug. Awareness about the drugs implicated in life threatening drug reactions will help physicians in preventing them by judicious use of the drugs.

Acute generalised exanthematous pustulosis.

Acute generalised exanthernatous pustulosis (AGEP) is a condition characterised by sudden onset of non-follicular aseptic pustules all over the body. It is distinct from pustular psoriasis with characteristic morphology, histopathology and evolution.

Bowenoid papulosis turning to squamous cell carcinoma.

Bowenoid papulosis is clinically a benign appearing genital lesion that shows histologic features of squamous cell carcinoma-in-situ. Bowenoid papulosis of the scrotum turning to invasive squamous cell carcinoma is reported in an elderly male.

Metastatic Crohn's disease.

Crohn's disease is a granulomatous inflammatory disease of the gastrointestinal tract. It can involve other sites of the body also. When such lesion are separated from Crohn's lesion of the intestine by normal skin, they are referred to as metastatic Crohn's disease. Two such cases are reported.

Toxic epidermal necrolysis--a retrospective study.

BACKGROUND: Toxic epidermal necrolysis (TEN) is a severe, idiosyncratic, exfoliative disease of the skin and mucous membranes. The treatment of this condition is controversial. High-dose corticosteroid therapy has been the most commonly advocated treatment, but, more recently, this has changed to a no-steroid protocol. These conflicting treatments prompted us to evaluate retrospectively our protocol. METHODS: The patients admitted to the hospital from 1989 to 1995 with a clinical diagnosis of TEN were included in the study. These patients were given systemic steroids, prophylactic antibiotic, and supportive measures. RESULTS: The patients belonged to both sexes with an average age of 34 years. The average area of involvement was 85.62%. All the patients made an uneventful recovery without any evidence of sepsis. CONCLUSIONS: Treatment with systemic steroids is useful in the management of TEN, and there is no need for a burn care center.

Zosteriform network of spiradenoma.

Spiradenoma is a solitary, deep seated nodule occurring on the ventral surface of the body, especially over the upper half. We are describing a case of spiradenoma with zosteriform arrangement.

Necrobiotic xanthogranuloma with paraproteinaemia.

Necrobiotic xanthogranuloma is a subset of inflammatory form of normolipaemic xanthomas. Because of its characteristic clinical and histopathological findings necrobiotic xanthogranuloma may be regarded as a specific marker of paraproteinaemia.

Dermatological manifestations of human immunodeficiency virus infected / acquired immunodeficiency syndrome patients in a referral hospital of Central Kerala.

A number of skin diseases are described in association with HIV infection/AIDS. In the present study the frequency of various skin manifestations among HIV infected / AIDS patients are noted. Generalised pruritus and dry skin were the common manifestations encountered. There was a significant absence of Kaposi's sarcoma, multi-dermatomal herpes zoster and oral hairy leukoplakia. A prominent hyperpigmented band on finger nails was seen.

Proteus syndrome.

Proteus syndrome is a hamartomatous disorder characterised by focal overgrowths that can involve any structure of the body. An eleven-year-old girl with Proteus syndrome has been described with clitoromegaly.

Lip leishmaniasis.

A case of leishmaniasis of lip without any involvement of other parts of the body in a 36 year-old-male is described.

Keratitis, ichthyosis and deafness (KID) syndrome.

Keratitis, ichthyosis, deafness (KID) syndrome is a genetically determined disorder. The present case is having marked photophobia, bilateral corneal ulceration with vascularisation, neurosensory deafness and skin changes.