Two cases of Cornelia de Lange syndrome with similar phenotypic features are reported.

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Background: Intralesional triamcinolone is an established therapy for cysts of acne. However, intralesional antibacterials have not been used earlier. Aim: To compare the efficacy of intralesional triamcinolone with that of a combination of intralesional lincomycin and intralesional triamcinolone in nodulocystic acne. Material and Methods: Ten patients of nodulocystic were injected with intralesional triamcinolone acetonide (2.5 mg/ml), while nine patients were given lincomycin hydrochloride (75 mg/ml) in addition to the intralesional triamcinolone. They were followed up 48 hrs, one week and one month later. Results: At one week, 7 patients (70%) treated with injection triamcinolone showed 66% improvement, whereas all 9 (100%) patients treated with lincomycin and triamcinolone showed 100% improvement which was stable at one month. Conclusion: A combination of intralesional triamcinolone and lincomycin is superior to intralesional triamcinolone alone in the treatment of nodulocystic lesions of acne.

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Intralesional steroids are commonly used in dermatology. Besides their strong anti-inflammatory effects, the long acting steroids and other preservative agents may induce interesting histopatholoical changes, which may simulate focal mucinosis or a granulomatous pathology. A variety of histopathological changes induced by Intralesional injection of steroid in a lesion of keloid are being described.

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Background: The treatment of chilblains remains unsatisfactory. Nifedipine in higher doses remains the mainstay of treatment. Aims: To compare the efficacy of diltiazem with that of nifedipine, and to determine the efficacy of nifedipine in lower doses, 36 chilblains cases were studied. Material and Methods: Group A (12 patients) was treated with diltiazem 60 mg thrice daily, and Group B (24 patients) with 10 mg nifedipine thrice daily till complete relief and then maintained on a sustained release preparation of nifedipine 20 mg twice daily. Results: Two patients in Group A showed complete relief in 7 days, and 3 patients in about 21 days, but in 7 cases there was little or no response. In group B, 21 cases showed 80-90% relief by the fourteenth day. Conclusions: We conclude that nifedipine remains the drug of choice in chilblains but can be used in a smaller dosage in the Indian population. Diltiazem is less effective in the conventional dose, which may be optimized.

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Acquired ichthyosis in adults may reflect internal disease, viz. internal malignancy, especially Hodgkin’s lymphoma or sarcoidosis. We report a patient who developed ichthyosiform sarcoidosis over a year after completion of 6 cycles of combination chemotherapy for Hodgkin’s disease. To our knowledge, the development of ichthyosiform sarcoidosis after chemotherapy for Hodgkin’s disease has not been described earlier.

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Background: Differentiation of cutaneous tuberculosis from other infective granulomas of the skin is difficult due to paucity of the organisms in tissue biopsies. Polymerase chain reaction (PCR) is a newer technique to identify the DNA of Mycobacterium tuberculosis in the tissues. Aim: We examined the utility of PCR as a tool for rapid diagnosis of cutaneous tuberculosis especially in cases negative by ZN staining and culture. Material and Methods: Twenty five random skin biopsies from patients with various types of cutaneous tuberculosis were subjected to PCR. Results: An overall positivity of 64% was observed, which is comparable to other series. Seventy five percent of lupus vulgaris cases, 62.2% of tuberculosis verrucosa cutis and 50% of scrofuloderma cases showed PCR positivity. Conclusion: Though useful, the cost and the technique involved limit the use of PCR in developing countries like ours.

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Urticarial vasculitis is an uncommon manifestation of cutaneous vasculitis closely resembling chronic urticaria. It is an immune complex deposition disorder, which is not commonly observed in children. We report an 9-month-old infant with urticarial vasculitis and discuss its clinical course and differentiation from common urticaria.

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Acrogeria is one of the premature aging syndromes with an unknown mode of inheritance. Familial cases are quite rare. A report of the disease in a brother and sister demonstrating a possible autosomal recessive inheritance is described. An unusual finding was bilateral corneal opacities in both the patients.

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Koebner phenomenon has been described in relation to many immunological, inflammatory and infectious dermatoses since the time of its first description. We report a man with pityriasis lichenoides et varioliformis acuta showing Koebner phenomenon.

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Severe cutaneous adverse drug reactions pose diagnostic and therapeutic challenges to the medical community. Understanding the pathomechanisms can prevent their onset and improve their management, while timely and judicious intervention can reduce their mortality.

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Background: PUVA therapy is reported to be effective in lichen planus. However, PUVASOL therapy is more easily available in India. Aim: To carry out a three way open comparison of oral PUVASOL therapy with oral metronidazole and with the conventional oral antihistamine plus topical steroid therapy. Material and Methods: Seventy-five cases of lichen planus were studied for 12 weeks with three different modalities: 1. Oral metronidazole and topical emollient cream, 2. Oral PUVASOL and topical emollient cream, and 3. Oral cetirizine and topical betamethasone dipropionate cream. Lesions were assessed before starting the treatment and after every 4 weeks. Results: Seventy patients completed the trial. Statistical analysis showed that therapy 1 was less effective than 2 and 3, which were found to be equally effective. Conclusion: It is concluded that PUVASOL therapy is a useful alternative to conventional therapy in lichen planus in our country where sunlight is available in plenty.

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Toxic epidermal necrolysis (TEN) is a life-threatening cutaneous adverse drug reaction. TEN is known to occur with the fluoroquinolone class of antibiotics, but only four cases of sparfloxacin induced TEN have been reported to the WHO database. This is another case report of sparfloxacin induced TEN.

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A case of localized cutaneous sporotrichosis lasting for 10 years is being reported. The fixed cutaneous variety creates diagnostic difficulty by mimicking other conditions, chiefly lupus vulgaris.

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Fever is rarely caused by levamisole. We report a 26-year-old woman who repeatedly developed fever 4-12 hrs after taking levamisole. The association was confirmed by repeated provocation tests.

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