A case of tuberous sclerosis (Pringle) demonstrating cutaneous manifestation of adenoma sebaceum, skin tags and shagreen patches along with histological and radiological features is reported in a twenty year old female.

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The purpose of this paper is to point out the problems in making a diagnosis in a case like ours. We made a diagnosis of aplasia cutis congenita at first on our case based on the history of symmetrical defects of skin on all four extremities at birth. The development of blisters made us wonder whether this was a case of aplasia cutis congenita or epidermolysis bullosum with an unusual onset. The histopathological features of the scar and the vesicle favour the latter possibility. The presence of intact basement membrane at the floor of the vesicle makes the simplex variety of epidermolysis bullosum. Like our case, some of the cases reported in the literature as aplasia cutis congenita are probably cases of epidermolysis bullosum.

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Results of a study undertaken to investigate the effects of intradermal injections of trypsin, pepsin, chymotrypsin and epidermal extracts and application of cantharidin ointment to skin of humans and dogs in vivo and in vitro are reported. Dermoepicermal separation with progressive loss of all cellular elements of epidermis and dermis were seen with all the proteases and the epidermal extracts. The effects possibly represented a non-specific proteolytic activity of the enzymes. Epidermal extracts were also seen to produce similar changes. Acantholytic changes seen with pepsin resembled those seen with cantharidin and it is postulated that the action of cantharidin is mediated by a pepsin like cathepsin. Severity of changes in the in vivo studies was much less, possibly due to absorption or inactivation of the enzymes by the circulation. Absence of macroscopic blisters and the paucity of inflammatory reaction in the excised skin were attributed to absence of circulation.

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Part I Basic immunology and Part 11 Clinical immunology have been reviewed to provide a basic and practical knowledge of dermatoimmunology.

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A male child of incontinentia pigmenti is presented, with no other evidence in the family. Besides mental retardation, the other pertinent dermatological finding was a keratoderma of the palms and soles. No hair and nail dystrophies, nor folliculat atrophoderma or patchy alopecia were encountered. Other known manifestations are mental retardation, epilepsy, spastic tetraplegia, defects of the eye balls, delayed dentition, defects of bones and joints, congenital heart defects, umbilical hernia, supernumerary ear lobes and urachal cyts.

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The effect of ultrasonic is reported in 16 cases suffering from various skin conditions e.g. neurodermatitis, psoriasis, warts, keratosis of the palms and dyskeratosis. Possible mechanism of the relief of signs and symptoms is discussed.

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A case of xeroderma pigmentosum in a patient aged 29 years having multiple haemangiomatous tumours and a rare manifestation of melanoma of lower lip.

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Intralesional infiltration with corticosteroids were used in two cases. Ledercort suspension in one and Wycort in the other, were injected intrademally. The results were encouraging suggesting that intralesional infiltration is an effective supplement to systemic corticosteroids in the management of some difficult cases of pemphigus.

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