More than anything else Lisch Nodules have influenced the way we think about neurofibromatoses. This review concentrates on these tiny iris lesions.

HIV seropositivity rate of 14 percent was observed amongst STD cases. Heterosexual contact with prostitutes was the main risk factor. Fever, anorexia, weight loss, lymphadenopathy and tuberculosis were useful clinical leads. Genital ulcers, especially chancroid, were common in seropositivies. Alopecia of unknown cause, atypical pyoderma, seborrhea, zoster, eruptive mollusca and sulfa-induced erythema multiforme were viewed with suspicion in high risk groups. Purpura fulminans, fulminant chancroid, vegetating pyoderma and angioedema with purpura were unique features noted in this study.

To determine the pathogenesis of drug induced acneform eruption (DAE), 44 patients were evaluated clinically and representative samples histologically. INAH and corticosteroids were the main offenders in 38.6 percent and 36.4 percent patients respectively. Chloroquin precipitated lesions in 9.1 percent of the patients. There were significant differences in the duration of drug-intake before onset, morphology and severity of lesions. Histological differences with different drugs were also noted. Based on clinical and histological findings, pathogenesis of lesions caused by different drugs could be suggested. Keratinization of follicular epithelium was the main effect with corticosteroids and INAH. Suppuration of follicular epithelium was an additional early event with corticosteroids. Type III allergic reaction was responsible for iodine lesions and delayed hypersensitivity for chlorpromazine and chloroquine induced lesions.

Digital vascular flow in paucibacillary leprosy was assessed photoplethysmography (PPG). In PPG, infra-red light emitting diode and an adjacent photosensor detect the blood flow in cutaneous capillaries, as represented graphically on a strip-chart. In 29 (6F, 23 M) untreated paucibacillary leprosy patients (7TT, 16 BT and 6 purely neural type) having ailment on limb/limbs, suffering for 5 months to 12 years, PPG recording were done by applying the device to the distal phalanges of all the digits of four limbs serially with Velcro-strap at an ambient temperature of 28 °C - 30 °C and humidity of 60-70 percent. Diminished digital vascular flow of the affected limb/limbs was seen in long-standing cases suffering for > 2 years irrespective of the type, site, morphology or phase (reactional) of the disease. This may be mostly due to specific vascular changes rather than reactional or functional changes. Specific vascular changes are terminal arteritis, vasculitis of vasa nervorum or truncular arteritis, i.e.. tuberculoid lesions of the major arteries. Two patients, suffering for 1.5 years, paradoxically showed increased digital blood flow which is probably due to reactive hyperaemia or paralytic vasodilatation as a result of autosympathectomy.

Digital vascular status in 10 untreated patients suffering from systemic sclerosis for 1 to 4 years was evaluated by a method called photoplethysmography (PPG). The PPG probe was attached serially to the distal phalanges of all the digits of four limbs with Velcro-strap at an ambient temperature of 28° C - 32° C and humidity of 60-65 percent to record PPG tracings. Six patients (Group A) had clinical symptoms and signs of vascular impairment whereas 4 patients (Group B) did not have. Diminished vascular flow was seen in all the patients of both the groups. On an average, 9 digits (45%) in Group A and 7 digits (35%) in Group B had reduced blood circulation. The difference between the two groups was not statistically significant (p>0.5). Degree of vascular impairment had no bearing upon the duration of the disease (rxy=+0.41). Impairment of digital blood flow may be due to organic narrowing of digital artery, functional vasomotor changes, endothelial proliferation and damage, blood hyperviscocity and less deformable red blood cells.

Skin biopsies from 25 diabetics and an equal number of nondiabetic controls were stained with H and E, PAS, alcian blue and iron hemotoxyline. Thirteen (52 percent) diabetics showed evidence of microangiopathy as compared to 1 (4 percent control). PAS positive thickening of capillary basement membrane and endothelial proliferation each were seen in 44 percent of cases. There was evidence of microangiopathy in 88.8 percent of cases with biopsy from dermopathy lesions as compared to 31.2 percent of other diabetics. Iron deposits were seen in 33.3 percent of cases with dermopathy lesions. No correlations could be established between age and sex of patient, family history, type, severity and duration of diabetes, diabetic retinopathy and neuropathy, skin infection and cutaneous microangiopathy. Higher percentage (69.3 percent) of patients with microangiopathy had poor control of their diabetes as compared to those without it (41.7 percent). All the 3 patients with CVA and hypertension showed microangiopathy.

One hundred and eighty patients of psoriasis and 100 controls were analysed to find out the genetic nature of psoriasis and if so, then to determine the possible mode of inheritance. The prevalence of psoriasis in relatives, percentage of positive family history and percentage of total affected relatives in the patient group was significantly higher than the controls, and clustering of affected relatives in patient group suggested genetic involvement. Ratio of affected and unaffected in the sibships with unaffected parents and one parent affected and ratio in the children of patients suggested polygenic mode of inheritance.

One hundred and twenty children selected at random and diagnosed as having Primary Pyoderma lesions were studied for clinical patterns and bacteriological profile. Sixty percent of the cases were girls. The commonest clinical type was impetigo contagiosa (45%) followed by folliculities of the scalp (44.2%). Staphylococcus aureus was the etiological agent in 47.5% while 26.7% of the cases were due to mixed infection along with Streptococcus pyogenes. Almost all strains were sensitive to Erythromycin and Gentamycin. The highest resistance was to Penicillin (79.3%) followed by Ampicillin (73.9%) and Tetracycline (42.3%).

A report of 3 women with painful and tender papules and plaques on the breast is presented here. In addition to the involvement of the skin over the breast, 2 patients also had skin lesions on the thigh and back. The histopathology was consistent with Leiomyoma cutis. Two patients responded well to Nifedipine.

A case of subcutaneous phycomycosis occurring in a 2 ½ year old child is reported for its rarity, clinical interest and paucity of literature. The condition failed to resolve with conventional antimycotics but improved with the administration of concomitant pyrexial therapy.

This study includes 5 members with dyskeratosis congenita and 8 other affected members in the family who were not available for study. Three successive generations were involved suggesting an autosomal dominant pattern of inheritance. Two had bluish discolouration of the nails in addition to the other features. To our knowledge this has not been reported so far.

A 12-year-old boy had pemphigus vulgaris. When he did not improve on systemic steroid in 15 days, injection gold sodium thiomalate was added. Gold helped in reducing the dose of steroid and the child achieved complete remission after 14 doses of gold. Gold therapy is a useful adjuvant to systemic steroids in the management of pemphigus.

A 50-year-old diabetic female patient had recurrent episodes of reticulate papular rash that resolved leaving a reticulate hyperpigmentation. Histopathology revealed spongiosis, mononuclear exocytosis, liquefactive degeneration of basal cells, pigmentary incontinence, and lichenoid and perivascular dermal infiltrate. Improvement was seen with dapsone. Prurigo pigmentosa is a rare disease reported mainly from Japan and this is the first report from India.

This is a report of oral haemangiopericytoma with urticaria in an infant indicating a previously unrecognized association. The urticarial eruptions cleared after the initiation of chemotherapy for the primary oral lesion and reappeared extensively with cutaneous metastasis after the malignant growth became resistant to treatment.

An eight year old girl presented with an atrophic lesion in the left inguinal region from the age of 3 years which was gradually spreading centrifugally. Biopsy showed absence of subcutaneous fat with normal appendages and dermal collagen.

A case of pyoderma gangrenosum resistant to the usual modes of treatment was successfully treated with minocycline. The drug was well tolerated without any side effects.