Cutaneous reactions were monitored by spontaneous adverse reaction monitoring system among inpatients in Nehru Hospital, over a period of 3 1/2 years. A total of 379 adverse drug reactions were reported during this period, of which 144 (40%) were cutaneous reactions. Maculopapular rashes (50% of cutaneous reactions), and urticaria (21.5%) were the most common eruption. Stevens-Johnson syndrome (13.9%) and toxic epidermal necrolysis (TEN 4.9%) were the serious cutaneous reactions. There were 4 fatal cutaneous reactions (all due to TEN). Antimicrobials (caused 56.9% reactions), radiocontrast dyes (14.6% reactions) and antiepileptics (15.3% reactions) were the most prominent drugs responsible for these eruptions.

Cryotherapy has proved to be an effective tool in the management of various dermatoses. We report 6 patients with histopathologically proven basal cell carcinoma of variable sizes treated with liquid nitrogen cryotherapy by the open spray technique. Lesions tended to heal with depigmentation and scar formation. However depigmented areas often repigmented over a period of time.

In a double blind randomised study to assess the efficacy of single dose fluconazole therapy, 30 patients of tinea versicolor (TV) were enrolled and were assigned into 2 groups. Group A (n=18) received fluconazole 400 mg single dose orally and Group B (n=12) received placebo. At the end of 2 weeks, 8 out of 18 (44.4%) of Group A patients and 1 out of 12 (8.3%) of Group B showed mycological cure (P=0.08). Ten patients of Group A who had KOH positivity after 2 weeks were given 2nd dose of 400 mg fluconazole 2 weeks after the 1st dose. Nine of these (90%) showed mycological cure at the end of subsequent 2 weeks. The difference between the efficacy of single dose fluconazole after 2 weeks and 2 doses of fluconazole after 4 weeks was statistically significant (P<0.01). None of the patients had any significant side effects. Therefore single dose therapy of fluconazole 400 mg is not satisfactory in TV. Instead, 2 doses of flluconazole (400 mg) given at 2 weeks intervals is safe and very effective.

Screening for skin and sexually transmitted diseases was undertaken in 170 pregnant women in all the trimesters of pregnancy. Pruritus was the commonest presenting symptom (58.82%). Candidiasis (21.78%) was the commonest cause of white discharge per vagina, Condylomata acwninata (4.70%) was the commonest sexually transmitted disease. Three patients (1.76%) were seropositive for HIV infection. The commonest dermatological disorder observed was scabies (17.64%) while 48 other diseases accounted for less than 10% each.

Fissuring of feet is a common but neglected problem in India. In this paper an attempt has been made to determine the prevalence of fissuring of feet in a rural village in Tamilnadu. In addition the relationship of fissuring to age, sex, occupation, non-use of footwear and weight is determined Over all prevalence is found to be 48% for age's 15 years and above. The prevalence is found to be higher in females (58.4%) than in males (33.3%) and it is seen more among the housewives (63.7%) and among the farmers (41.9%). Low weight and non-use of footwear are significantly associated with fissuring. 40% of the affected group felt that this is more acute during winter. We conclude that fissuring of feet is a significant problem.

Bleomycin therapy causes multiple side effects. Linear or flagellate pigmentation of the skin is a pattern of pigmentation unique to bleomycin therapy. We report 3 cases of testicular tumors on bleomycin therapy, all of whom manifested with flagellate pigmentation on the neck, trunk and upper limbs and one of whom developed sclerodermoid changes on the arm. Bleomycin, though used in different drug combinations, has consistently resulted in the manifestation of flagellate streaks of pigmentation.

The knowledge about the localisation of skin lesion can be a key to diagnose and to understand the underlying mechanism of many skin diseases. Two phenomena "isomorphic response of Koebner" and "isotopic response" have been described in this regard. Here we report a case of varicella showing a phenomenon partially akin to both isomorpic and isotopic responses but with certain distinct variations.

A 3 year old boy presenting with scleredema of Buschke confirmed histopathologically is being reported for its unusual association with reversible non-cicatricial alopecia of the scalp.

A 5-month old female child with seizures, motor defect, and EEG abnormalities with a hypopigmented skin lesion suggestive of nevus depigmentosus is presented.

Two cases of Cowden syndrome with typical features are presented. In addition to the cutaneous lesions like facial trichilemmomas, oral mucosal fibromas, acrokeratosis verruciformis and palmo plantar hyperkeratosis, the first patient had follicular carcinoma of thyroid, fibrocystic disease of the breasts and ovarian teratoma and second patient had a cerebellar hamartoma (Lhermitte Duclos syndrome) which is a rare entity.

A 37-year old male patient with Hansen's disease midborderline spectrum, presented with bilateral pedal edema. X-ray examination of the feet showed disorganisation and disintegration of the tarsal bones. Bilateral tarsal disorganisation which can develop in Hansen's disease is usually not recognised by the clinician.