Autologous split thickness miniature punch skin grafting is one of the surgical modes of treatment of stable vitiligo. Out of 87 different sites, of stable vitiligo, occurring in 62 cases, (32 focal, 22 segmental and 8 generalised) 75 sites showed total repigmentation with excellent cosmetic colour match. Out of the 62 cases, 46 cases who were treated postsurgically with PUVA therapy repigmented within 2 ½ to 3 months, 10 cases, who received no treatment postsurgically repigmented by 3 ½ to 6 months. In addition 6 cases in whom no treatment was given postsurgically had to be given PUVA therapy 3 months after surgery as there was poor repigmentation. The complications seen were graft rejection due to improper immobilization in 6 cases, graft rejection due to secondary infection in 1, contact allergic dermatitis to framycetin in 3, and reactivation of vitiligo in 2. Side effects seen were cobblestoning in 32, sinking pits in 12, variegated appearance in 4, and superficial scarring at donor site in all 62 cases.

Sixty patients having 70 residual lesions of vitiligo not responding to medical treatment for a period of at least 4 months were subjected to punch grafting. The donor skin was taken from the buttock, thigh or leg of the same patients with a 4 mm skin biopsy punch and placed on the recipient area prepared by excising the vitiliginous skin with a 3 mm skin biopsy punch. The recipient areas were placed at a distance of 1 cm from the margin of the lesion and 1-2 cm from each other. Out of total of 280 grafts applied in these lesions, 256 (91.1%) gfafts were successful, while 21 grafts were rejected, 2 grafts became depigmented and 1 graft developed into a keloid. The pigment spread centrifugally around each of the successful grafts and 76% of grafts showed a pigment-spread of more than 6 mm within 6 months. Pigment continued to spread even in the grafts applied 2 years ago and the maximum spread so far has been 22 mm. The pigment-spread was faster in the lesions situated on the trunk, neck, face and proximal parts of the extremities. Lesions on the dorsal aspects of hands, fingers, feet and maleoli were slow to repigment. Treatment of the lesion with topical psoralen followed by sun exposure led to a faster spread of pigmentation.

Clinical and histological skin changes were studied in 30 cases of chronic renal failure. Generalised pruritus and numbness were the commonest symptoms observed in 14 and 11 patients respectively. Ichthyotic skin changes of varying degree were observed in 27 cases and hyperpigmentation of sun-exposed skin was seen in 11 cases. Half and half nails were seen in 4 cases only. Cutaneous changes like pruritus, pallor, scaling and hair loss correlated strongly with the severity of renal failure. Histopathological examination revealed epidermal and dermal changes, latter were seen only in moderate to severe cases of renal failure.

Four groups of 16 patients each, having acne vulgaris, were treated with (1) 5% lactate lotion, applied all over the face twice a day, (2) 5% lactate lotion topically along with 200 mg ketoconazole orally per day, (3) 2% erythromycin lotion topically all over the face twice a day, and (4) 2% topical erythromycin lotion with oral ketoconazole, respectively. The efficacy of these regimes was evaluated by counting the number of comedones, inflammatory lesions, and cysts separately, before starting the treatment and at 4, 8, and 12 weeks of treatment. Percent reduction in the number of inflammatory and comedonic lesions respectively at the end of 3 months of treatment was 61 .1 % and 44.0% with lactate lotion, 62.6% and 32.8% with lactate lotion combined with oral ketoconazole, 66.4% and 62.2% with erythromycin lotion alone, and 78.1% and 48.8% with erythromycin lotion and oral ketoconazole. The overall improvement was graded into 3 categories i.e.,. excellent response, moderate response, and poor response. Lactate lotion produced excellent, moderate, and poor responses in 3,10, and 3 patients respectively; lactate lotion with ketoconazole in 1,12, and 3 patients; erythromycin lotion alone in 4,8, and 4 patients; and erythromycin lotion with ketoconazole in 1, 15, and nil patients respectively with respect to the inflammatory lesions. The results with respect to the comedonic lesions were 3, 7, and 6 patients; 1, 6, and 9 patients; 4, 6, and 6 patients; and 1, 8, and 7 patients in the respective categories. All the agents were well tolerated.

Thirty three patients of 15-35 years age having various types of stable vitilligo from 1-15 years duration were selected for punch grafting. Vitiligo lesions in all these patients were relatively refractory to systemic PUVA therapy tried for a period of 1 to 8 years. The technique of punch grafting was modified from the method described by Falabella and Behl. Complete responses was observed in 10 patients, still under follow up for 1 year and partial response in rest 23 patients who are under observation.

Fifteen cases of vitiligo and 12 cases of contact depigmentation were compared histopathologically. Incontinence of melanin in dermis was seen in 33% cases of contact depigmentation and 6.6% cases of vitiligo. Mononuclear infiltrate was more in contact depigmentation and had lichenoid character at places. Vasculitis with perivascular mononuclear infiltrate was seen in all cases of contact depigmentation. It is proposed that chemicals responsible for contact destruction of melanocytes.

In this study of 476 men, 113 (23.74%) were found to have pearly penile papules. Fourteen (12.38%) cases had been misdiagnosed as genital warts by general physicians.

Atypical lymphocytes were noted in the peripheral blood smear of 19 patients of zoster. Sixty eight percent of them had aberrant lesions. The positive correlation between the atypical lymphocytes and aberrant lesions is described and its usefulness in predicting the possible dissemination is discussed.

A case of congenital vitiligo with its distribution over both lower extremities and trunk is reported.

A case of Vogt Koyanagi Harada syndrome is reported. The depigmented macules appeared initially over eyebrows and around both eyes after an episode of fever and then rapidly involved almost the entire body within 6 months.

A 51-year-old female patient developed vitiligo at the previous sites of treated leprosy immediately after thyroidectomy. A neurological factor in association with thyroid dysfunction is considered as the possible aetiology of vitiligo in this case.