Sixty-one patients with psoriasis were studied for concomitant diseases and compared with 61 age and sex-matched controls. Concomitant cutaneous diseases most often seen with psoriasis were lichen simplex chronicus (16.3%), verruca vulgaris (9.8%) and me Iasina (4.9%). Of the systemic disorders, diabetes showed the highest frequency (13.1%) followed by hypertension (8.1%). Two patients had HIV infection (3.2%). Both the patients had severe and atypical lesions.

Dapsone syndrome or sulphone syndrome was noticed within four to six weeks of starting treatment in 10 out of 604 patients (1.6%) on MDT for leprosy treated at Rajah Muthiah Medical College Hospital,South Arcot District, Tamil Nadu State during the period 1995-1998.Patients developed either maculo papular rash or exfoliation along with fever and lymphadenopathy.Abonormal liver function tests were noticed in 50%.The patients with dapsone syndrome were treated with corticosteriods after withdrawing dapsone.There was complete resolution of skin lesions and other symptoms.

Pruritic papular eruptions are a common manifestation in patients infected with HIV. The significance of these lesions is not known. We have many apparently normal individuals presenting with exaggerated insect bite reaction on the exposed parts of the body as the only manifestation of HIV disease. A pilot study was done to see whether the appearance of exaggerated insect bite reactions is an indicator of impending immune suppression in HIV infected individuals. CD4 count was done in 10 serial patients presenting to our clinic with exaggerated insect bite response of recent onset and HIV infection. Out of the 10 cases, 8 showed low CD4 counts (less than 400/cmm). Further studies may prove that exaggerated insect bite reaction can be a marker of impending immunosuppression.

Forty-six patients, 35 males and 11 females between 30 and 75 years age having patch test confirmed air-borne contact dermatitis for 6 months to 20 years were treated with azathioprine for varying periods of 3 months to 3 years. Twenty-two patients (Group 1) received azathioprine 50 mg twice daily orally for 6 months to 3 years, 12 patients (Group 2) were given the drug in a dose of 50 mg once daily and 300 mg once in four weeks orally for 3 months to 2.5 years, and the remaining 12 patients (Group 3) were treated with azathioprine 50 mg twice daily and 300 mg once in 4 weeks orally for 4°months to 2.3 years. All the patients were evaluated clinically as well as biochemically every month to determine the side-effects ofazathioprine. Out ofthese 46 patients, only 2 (4.3%) patients had severe drug-induced side-effects of gastrointestinal and hepatic origin. Three patients had transient rise in SGPT. Eighteen patients had other milder side effects which included mainly cutaneous infections.

The study was conducted from the patients attending mainly the Medical OPD revealed some fascinating facets. 56.66 % of patients were migrants settled in Delhi from endemic zones, rest of the patients were indigenous. Influx of migrants seemed likely to be risk factors to infection in a densely populated city like Delhi.43.33 % of patients harboured the disease for more then 2 years before intiation of treatment. It denotes the pathetic attitude of the patients. Relapse in 6.66 of case within I year of ALT in PB cases requires review as there is no justification in difference of treatment schedule for PB and MB cases. Chaulmoogra oil dressing in trophic ulcers was found to be very useful and may be extensively tried.

Melasma continues to be a therapeutic challenge. 100 patients of melasma not responding to conventional depigmenting agents were divided into 2 groups, one treated with 55 - 75% glycolic acid (68 patients) and the other with 10-15% trichloroacetic acid (32 patients). Applications were made after every 15 days and response assessed clinically along with relapse or hyperpigmentation after 3 month follow up period. More than 75% improvement was seen in 30%, and 50-75% improvement in 24% patients. Response with TCA was more rapid as compared to GA. Chronic pigmentation responded more favourably to TCA. Relapse and hyperpigmentation was more-25% in TCA as compared to 5.9% GA. Sun exposure was the most important precipitating factor followed by pregnancy and drugs.

Two cases of lymphocutaneous sporotrichosis are reported from Imphal. Sporothrix schenekii was isolated from pus from the lesion and identity was confirmed by mycelial to yeast conversion at 37°C and mice pathogenicity test. One patient gave history of injury with bone of fermented fish (Ngari ). Both the patients were treated successfully with oral administration of potassium iodide. These two cases are the first authentic cases of sporotrichosis from Manipur.

Appendageal tumours localized to the head, face and neck region continue to fascinate and confuse the dermatologists. We report a case of multiple apocrine hidrocystomas on the face of a 35 year-old woman. Good cosmetic result was obtained with excision followed by cauterization.

A rare case of ichthyosiforn sarcoidosis is being reported.

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.

A case of xeroderma pigmentosum with multiple cutaneous malignancies is being reported. The case presented with freckles, letigens, and keratosis, a non-tender ulcerated nodular lesion on the nose, a nodular ulcerated lesion on the right outer canthus of the conjunctiva, and a nodular growth which developed on the right cheek which on histopathology was found to be squamous cell cercinoma, basal cell carcinoma and malignant melanoma respectively.

Parapsoriasis is aeon troversial topic. There are many studies regarding the relationship of parapsoriasis to lymphoma\ but no correlation between histology and clinical appearance. Parapsoriasis satisfies histologic criteria for mycosis fungoides and therefore it should be considered as patch stage of mycosis fungoides. A 30-year-old man presented with scaly skin lesions over the trunk since 4 years. Routine blood and urine investigations were normal. Skin biopsy from the lesion revealed atypical lymphocytes within the epidermis without spongiosis.

Dermatology in the new millennium will have to focus on the demands, hopes, and satisfaction of those who look at themselves as having skin liaments. Governments may modify this by declaring some unperceived needs as important and therefore fundable and others as unimportant. Hopefully there should be equity, the women will be equal to men, and poor countries equal to the rich. The importance of skin to the individual will not diminish and hopefully will be better recognized by funding agencies. The costs of treating skin diseases will always be an issue, and the case for treating skin diseases will have to be made in the competitive world of much life threatening disease. Dermatologists may themselves opt out of treating conditions which governance deems important. An example would be all breaks in surface continuity of the skin which other professions might wish to take over as leg ulcers, the diabetic foot ulcer, the pressure sore, or burns.