Response of vitiligo patients to five different regimes was evaluated taking only those patients who had either static or progressively increasing lesions. Selection of the regimen depended upon the clinical characteristics of the disease. Each regime was tried for at least 4 months and if a patient didnot improve with one regime, he was shifted to another regime. A patient was considered to have improved, if the lesions started regimenting or the previously progressive lesions stopped increasing further. Regime I consisted of 150 mg levamisol orally on two consecutive days per week, given to 13 cases, it resulted in improvement in 7 (53.80/o). Regime II consisted of levamisole in the same dose combined with once a day topical massage with 0.1% fluocinolone acetonide acetate cream; it led to improvement in 27 (81.8%) of the 33 cases. Regime III consisted of 3 mg betamethasone orally on alternate days combined with levamisole and topical fluocinolone; given to 32 cases, it was successful in 28 (87.50/o). A combination of 2 mg betamethasone orally alternating with 20 mg 8-methoxypsoralen and sun exposure (regime IV) caused improvement in 17 (85%) of the 20 cases. An oral mini pulse consisting of 5 mg betamethasone orally twice a week combined with 50 mg cyclophosphimide daily orally (regime V) was successful in 20 (90.9%) of the 22 cases, the remaining two cases showed unprovement when the dose ofbetamethasonc .was increased from 5 mg to 7.5 mg twice a week. Thus ultimately each one of the 91 patients responded to one or the other regime. The side effects were minimal and insignificant.The degree of improvement at the time of analysis was 100% in 23.3% cases, 50-100% in 44.2'Yo cases and less than 50% in 32.5%, after 4-14 months of treatment. It is felt that the results may be better after a longer follow-up although all patients are not expected to get complete repigmentation.

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Ten patients having hyperkeratosis with moderate to severe fissures on palms and soles were treated with iontophoresis using 5-10% aqueous solution of sodium salicylate. The results were excellent within a period of 3-4 weeks (6-8 sittings each for a period of 10-15 minutes). The treatment was free from the problems of salicylism. Follow-up in some of the reclcitrant cases for 4 months after stop the treatment and with no local application, showed neither any relapse nor deterioration. Sodium salicylate iontophoresis in hyperkeratosis seems to be safe well tolerated and far more effective than the usual local applications of salicylic acid.

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Fifteen subjects having psoriasis on the hand, comprising both sexes, between 22 and 56 years in age and suffering for durations varying from 10 months to 20 years each with a sex and age niatched control were studied. A thermistor thermometer measured the skin temperature in ambient condition at the finger tip and at selected sites on the dorsa of hands and fingers, both at lesion site and lesion-free adjacent ones. In all cases except one, the thermistor readings were significantly lower (p ) in the psoriatic lesions than in the uninvolved adjacent skin. The hands were next subjected to thermal stresses: first by immersion in an ice-water bath at O'C (cold challenge) and later in a hot water bath at 450C (heat challenge) each for a period of 60 seconds. Immediately after each stress period,ithe fingertip temperatures were recorded, in psoriatic subjects, the finger-tip temperature dropped on cold challenge and the amount of drop expressed as percentage of the basal temperature was significantly less (p ) than the corresponding value for the control. There was no significant difference (p 0.05) in the respo se to the heat challenge between psoriat c and normal subjects. It appears that there is some fault in the local vasomotor tone in subjects with hand psoriasis.

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A quantitative assessment of cutaneous thermal sensation was undertaken in 12 psoriasis, 7 morphoea and 12 vitiligo patients. The thermal sensory threshold (TST) was determined both at the lesion site and the lesion-Eree contralateral site (control) by an electronic device fitted with a probe and a temperature sensor. As the differences in T-ST between the contralateral regions hardly exc I eed I'C in normal individuals a difference in TSC was considered significant. It was observed that about 83% of psoriasis and 71% of morphoca cases showed a significant differencrin TST (3C), but no such difference existed among the vitiugo patients.

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The present paper deals with clinico-pathological analysis of 22 cases of hair follicle neoplasm, representing 23.4% of skin appendage tumours. The mean age was 32 years, M : F ratio was 1:1. Histopathologically, there were 15 cases of pilomatrixoma, 5 cases of trichoepithelioma and 2 cases of trichelemmoma.

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The present paper deals with a clinico-pathological analysis of 172 cases of basal cell epithelioma representing 28% of the total skin cancer case. 1.44% of the total malignant tumours, 1% of the total tumours and 0.24% of the hospital admissions. M:F ratio was 1.26:1. The mean age was 54.06 years with the maximum number of cases in the fifth decade., Most (94%) of the lesions were seen on the head and neck region. Histopathologically it showed solid (60.5%), adenoid cystic (15,7%), keratotic (9.3%), pigmented (6.4%), basi-squamous (3.5%) and morphoea patterns (2.3%). Perineural lymphatic invasion was seen in 52% of the adenoid cystic basal call epithelioma. Amyloid (12.8%) and amyloid like deposits (29.65%) were seen in 42% of the case. Amyloid deposits were seen as lichen amyloidosis in 10.46% cases and in or around the tumour cell masses in 16.8% cases. It appeared as structureless homogeneous eosinophilic material and showed congophilia with apple green birefringence on polarising microscopy. It was found to be KMN04 sensitive (AA type protein- secondary amyloidosis). Amyloid like deposits appeared as less homogeneous,, basophilic, fractured material which showed non-specific congophilia with apple- green birefringence and stained with acid orcein stain indicating degenerated collagen (elastoid-degeneration).

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Scanning electron microscopy of the terminal part of hair taken from Indian girls who complained of terminal splitting of their hair, shortening of the hair lengths and loss of small fragments of hair, revealed longitudinal splitting of the terminal part of the hair into two fragments characteristic of trichoptilosis. In addition these hair had a localized spot a few millimeters proximal to the distal end of the hair which revealed splintering of the hair shaft into multiple fragments which joined again at a lower level. These changes are characteristic of trichorrhexis nodosa and this is considered to be responsible for the breakage and loss of small fragments of hair.

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A 24 years old lady had extensive telangiectases in the skin of both the upper and lower limbs, trunk and face for the last 14 years. There was no associated change in the skin or other organs. haeinorrhage from the skin or mucous membranes never occurred. Family history was negative.

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In a circumcised, 62 year old male, multiple cutaneous horns developed over the lesions of lichen planus on the penis. Biopsy revealed precancerous changes.

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Confluent and reticulated papillomatosis (CRP) is a rarely reported dermatosis. A twelve year old girl who developed CRP was sucessfully treated with selenium sulfide application.

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A 53-year-old female undergoing dialysis for chronic renal failure was seen with multiple discrete hyperpigmented papules of variable size each with a keratotic plug over the buttocks, back of things and knees of 2 months duration. The lesions were mildly itchy. A diagnosis of Kyrle's disease was confirmed on histopathology. The lesions showed improvement with topical tretinoin.

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A 54 year old male had Kyrle's disease manifestion as multiple, discrete papules with cone-shaped keratotic plugs. The lesions were severly pruritic and located symmetrically on the extensor aspects of the limbs and the trunk. Histopatholggical examination confirmed the diagnosis. The patient was known to be diabetic for 18 years and developed chronic renal failure 4 months prior to the onset of the skin lesions. Treatment with 6% salicylic acid topically did not produce any improvement of the lesions.

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A 5 1/2 month old male had vesiculopustular cutaneous lesions along with erythema, erosions, scaling and crusting particularly prominent in the peri - orificial areas for the last 1 month. He was the first child of his mother who had no sign of zinc deficiency. Serum zin level was normal in the mother, but low in the baby. Oral zinc therapy cured the baby. After weaning the baby was disease free even without oral zinc.

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A 40 year old male developed porokeratosis of Mibelli with an unusual warty encrustation on the left foot and hand. The diagnosis was confirmed histopathologically. The warty type of porokeratosts is a rare distinct clinical variant.

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Four middle aged males had multiple, tender nodules on the face, scalp, back, shoulder, arm and thigh, confirmed to be piloleimyomas, milial occurrence was noted in one patient. n Two patients, surgical removal was carried out and there has been no recurrence at the, end of one year.

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