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| CONTINUING MEDICAL EDUCATION |
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Podophyllin and its use in the treatment of condylomata acuminata  |
p. 10 |
| JA Sundharam |
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| ORIGINAL CONTRIBUTION |
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State of hydration and electrical conductance of ichthyotic skin |
p. 15 |
| AB Gupta, Manisha Bhattacharya, B Haldar Dry skin of twelve subjects suffering from ichthyosis vulgaris and the efficacy of a moisturiser-Cotaryl were quantitatively assessed by measuring the skin surface hydration and high frequency (3.5 MHz) electrical conductance of skin. The state of hydration and conductance of ichthyotic skin were 86.9 + 24.6 and 11.0 + 5.7 micro-mho respectively, being much less-compared to 132. 0 + 5.3 and 72.5 + 54.0 micro-mho ofnormal subjects. The moisturiser increased the state of hydration and also the electrical conductance of the stratum corneuni to near-normal values and maintained them as long as the application continued. However, both the hydration and the conductance fell sharply within a week of withrawal of the moisturiser. A moisturiser was thus undoubtedly efficacious in ichthyotic skin, but the effect was only temporary. The state of hydration was found, at all stages, to bear a strong positive correlation (r = 0.69 to 0.80) with the skin conductance. |
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Clinical study of diabetic dermoangiopathy |
p. 18 |
| MPS Sawhney, MA Tutakne, SD Rajpathak, VD Tiwari One hundred and twenty three diabetic patients and 100 non- diabetic controls were examined for lesions of diabetic dermoangiopathy. Twenty two (17.9%) lesions, while simildr lesions were found in only 2 (2%) controls. Age of the patients with opathy was sipifirandy higher than those derm without dermopathy, and it was more common in the fifth to the seventh decade. No statistically siicant relationship could be established with the sex, type, serverity control or duration of diabetes, diatetic neuropathy, larize vessel disease like CAD, PVD or CVA or with metabolic complications of diabetes. However, a higher percentage (59.1%) of patients with dermopathy were found to have a poor control of their diabetes as compared to those without microangiopathy (50.7%). Dermopathy was also more common (23%) 9 the duration of diabetes was more than 5 years, than if it was less than 5 years (14.1%). The percentage (33.3% of patients with retinopathy having dermopathy. Rubeosis was seen in 4 (3.2%) patients. |
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Comparison of podophyllin and trichloroacetic acid for the treatment of genital warts |
p. 22 |
| D Nath, B Kumar, K Vinod Sharma, I Kaur, R Gupta, Sarla Malhotra One hundred patients with genital warts of different morphological types were randomly allocated to a therapeutic trial with 25o/, podophyllin in the tincture of benzoin or 50 trichloroacetic acid (TCA). Ninety five patients were followed up for three months. The warts cleared in 78% and 81% patients after treatment with podophyllin and TCA respectively within 3 months. There was no significant difference in the number of applications needed with each type of treatment. Patients with hyperplastic lesions required lesser number of applications (average 3.5) compared to those with flat or verruca vulgaris type of lesions (average 4.5). Young condylomata (less than 6 months duration) responded better than older lesions. Moist lesions on the glans penis and labia responded better than the dry and keratotic lesions. Local soreness was experienced in 8.5y. cases as a side effect of therapy. Recurrence after initial clearance was seen more commonly with podophyllin application (30% than with trichloroacetic acid (13%). |
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The incidence of congenital syphilis and hepatitis-B virus surface antigen carrier state among deaf mute children |
p. 25 |
| Gururaj A Kumar, N Lakshmi, Sudhakar V Babu Three hundred deaf mute children of both the sexes, aged between 5-16 years were examined for the presence of syphilitic stigmata. All these children were having bilateral total sensory-neural deafness. None showed Hutchinson's triad. VDRL and micro TPHA tests for syphilis and RPHA test for HbsAg tested Blood samples. VDRL test was positive in 15 (5%) TPHA test in 34 (1133%) cases and HBsAg in 36 (12%) cases. VDRL and TPHA tests were both Positive in 15 (5%) cases, but VDRL negativity was observed in 19,(6.3%) TPHA positive cases, while VDRL, TPHA and HBsAg were positive in6 (2%) cases. |
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Contact dermatitis from compositae plants |
p. 27 |
| SC Sharma, S Kaur Eighty patients (58 males and 22 females) suspected of compositae contact dermatitis and 22 controls were investigated using ethanolic plants extracts., Fifty four (68%) patients and none of the controls had positive patch tests. Forty five (56%) of these patients showed positive reactions with, extracts of only a single Compositae plant. Parthenium hysterophorus produced positive reactions in 51%, Chrysanthemum morifolium in 23%, Dahlia pinnata in 9% and Tagetes indica in 4% patients. The highest number (84%) of patients with positive patch tests were exposed to these plants during their occupation. |
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Short contact therapy in psoriasis using derobin oinment |
p. 31 |
| Prasanta Basak, Surrinder Kaur, Inderjeet Kaur Derobin ointment was used for a short contact period of 30 minutes a day for the treatment of 12 patients with chronic plaque psoriasis. Full strength Derobin ointment (containing 1.15% dithranol)was used on the lesions situated on the left side, while the right side lesions were treated with Derobin oitnment diluted with yellow soft:paraffin to a concentration of 0.5% dithranol. At the end of 6 weeks, 75% patients completely cleared using either strength of Derobin. Pigmentation of the peri-lesional skin and irritation were minimal with the diluted formulation. |
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Treatment of acne vulgaris with anti androgens |
p. 34 |
| Neena Vaswani, RK Pandhi This study was conducted to compare the relative efficacy of spironolactone and cimetidine in moderately severe acne vulgaris. Fifteen women were treated with spironolactone (100 mg daily) given cyclically, while 14 women were given cimetidine (1400 mg daily) cyclically. The response was evaluated at 12 weeks. Spironolactone produced a good to excellent response in 11 (73. 3%) acne patients while with cimetidine 6 (42.8%) patients showed a good to excellent response. The mean reduction of the non-inflammatory and inflammatory lesion count was 29. 3 + 3. 6 and 9. 7 + 1. 3 respectively with spironolactone and 18.6 + 5.8 and 6.4 + 2.1 respectively with cimetidine. The response of acne vulgaris to spironolactone was superior to that of cimetidine and this difference was statistically significant (p<.05). The side effects were minimal and did not necessitate withdrawal of treatment. |
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Atypical manifestations of early syphilis |
p. 37 |
| RV Koranne, PJ Raju A study of 36 untreated patients with early syphilis revealed atypical variations namely; long incubation period of 101 days in I patient, more than 3 chancres in 1, undermined margin of the chancre along with tenderness in 1 and moderate to severe tenderness of the ulcers in 2 cases. In 3 patients there was no indurations of the ulcers. Three patients with primary syphilis had unilateral lymphadenitis, and in I case the lymph nodes were not only tender but showed tendency towardsmatingawell. Insecondarysyphilis, 11 out of 16 patients having condylomata lata had no other muco-cutaneous lesions. Concomitant presence of other venereal disease to account for the atypical manifestations was discounted- by appropriate laboratory tests, response to therapeutic agents and follow up. |
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| CASE REPORTS |
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Reversal of systemic sclerosis with dexamethasone pulses |
p. 40 |
| JS Pasricha, M Ramam, Sanjay Shah A 22 year old female had for the last 8 years,, progressive tightness of the skin along with hyperpigmentation, Raynaud's phenomenon, calcinosis cutis over bony prominences, dysphagia and pulmonary involvement. Treatment with 100 mg dexamethasone given intravenously in 5% dextrose on 3 consecutive days every month led to a significant reversal of all the clinical manifestations over a period of 18 months. |
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T-cell deficiency with recurrent mucocutaneous candidiasis |
p. 43 |
| AC Karnik, R Vijayvargiya A case had recurrent and chronic mucocutaneous candidiasis . The main immunological feature were gross T cell deficiency, anergy to common recall antigens but normal serum immunoglobulins, complement and phagocytosis. Ultimately, the multiple candida infections led to a fatal outcome. |
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Pseudoepitheliomatous, keratotic and micaceous balanitis |
p. 45 |
| B Mohan Gharpuray, PB Joshi, H Anil Patki, Ashok Lohalikar Two patient aged 56 and 18 years respopectively, developed pseudoepitheliomatous, keratotic, and micaceous balanitis on their glans. One of them developed a malignancy 6 years later. |
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Confluent and reticulate papillomatosis |
p. 48 |
| MP Binitha, V Laxmi Nair, M Lilly, T Gopinath A 40 year old man developed brown, flat-topped warty papules on the upper trunk with confluence of the lesions in some sites. The lesions showed involution with topical applications of 1% clotrima zole cream. |
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Erythema nodosum in psittacosis |
p. 50 |
| S Tharakaram, RS Chapman A 23-year-old woman developed erythema nodosum on her lower legs, two weeks after a respiratory infection manifesting with generalised bodyache, rhinorrhoea, sore throat, cough and sputum. Her pet budgerigar had been unwell two weeks previously. CFT for psittacosis showed a high titre. Oral tetracycline 4 gm a day for 3 weeks was effective. |
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Klippel trenaunay syndrome associated with unusual eye changes |
p. 52 |
| L Mohan, RD Mukhija, AroraSSK, VN Prasad, RK Jain, S Grover A young female had Klippel-Trenaunay syndrome with involvement from the head the toe on the left ide. The radiological, ophthalmological and histopathological findings were consistent with Klippel-Trenaunay syndrome. The unique feature was negalocornea which has not been reported earlier. |
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Exfoliative dermatitis and non-fatal hepatitis induced by phenytoin |
p. 54 |
| SD Choudhary, VY Jain, VB Dixit, Rajeev Sen A 15 year old boy having epilepsy developed exfoliative dermatitis hepatitis accompanied by fever, lymphadenopathy, facial edema and eosinophilia, three weeks after the regular 'intake of phenytoin. He was treated with systemic corticosteroids which prevented the fatal termination. |
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White piedera in Delhi |
p. 56 |
| JS Pasricha, PK Nigam, Uma Banerjee A 19 year old girl developed asymptomatic, hard, yellowish, 1-2 mm nodules adhering to the shafts of her scalp hairs. Microscopic examination of a nodule in 10% KOH re a greenish-tinged mycelium, with arthrovo and blastopores. Culture of the hair on Sabouraud's deidrose agar medium r Trichosporon beigelii.Treatment with 1% clotrimazale aidplied oA the h.aris once a day led to disappearance of the nodules in 4 weeks. is our second case of piedra from a non-endemic area. |
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Blastomycosis-like pyoderma |
p. 58 |
| Vijay Kumar, BR Garg, MC Baruah Seven cases of blastomycosis like pyo4erma without, any systemic were treated with a combination of antibiotics and corticosteroids, with good results. The number of lesions from one to ten and were present on the extremities. All the patients were having eosinophilia with an increased ESR, Staphylococcus aureus was the commonest micro-organism isolated there was no underlying medical problem in any patient. |
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Primary cutaneous rhinosporidiosis |
p. 61 |
| NS Hadke, MC Baruah Primary cutaneous rhinosporidiosis is very rare and only 10 cases have been reported in India. A 51 year old man had a painless, progressive ulcer for 6 months on the right leg. The ulcer was 2 cm x 2 cm and, had raised, irregular, nodular and partly, undermined margins. Biopsy of the ulcer margin revealed rhinosporidiosis. Excision led to uneventful healing. |
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| SHORT COMMUNICATION |
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Squamous cell carcinoma on a patch of mucosal vitiligo |
p. 64 |
| S Ravi, V Ramesh, RS Misra |
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