Patients with severe psoriasis were divided into 2 groups. In group A, consisting of 30 patients, remissions were induced by short term use of combination therapy consisting of methotrexate (5 mg every 12 hours x 3 doses per week) + psoralen (30 mg on alternate days) and sun exposure (PUVASOL). Thereafter, remission was maintained by use of minimal possible PUVASOL treatment alone. However, flare-ups during maintenance-phase were controlled by short term addition of methotrexate. Remission was induced in all these cases after a mean of 5.1 weeks (range, 3 - 9 weeks) of treatment using a mean total dose of 74.6 mg of methotrexate along with PUVASOL. During maintenance phase, recurrence was observed in 19 of these patients after a mean of 4.6 months. These recurrences were again controlled by clearance courses of methotrexate. On an average 1 - 6 (mean, 4) clearance courses were required during a period of 2 years. In group B, consisting of 10 patients, remission was induced by use of methotrexate alone and after achievement of remission methotrexate was withdrawn. Comparatively I did not find any significant advantage of adding PUVASOL for clearance of the lesions. However, during follow-up all patients in group b reported with recurrence much earlier. I recommend the use of methotrexate alone for clearance of lesions in severe psoriasis and PUVASOL alone in maintenance phase to prevent relapse.

Twenty cases of pemphigus with oral ulcers who were being treated with dexamethasone-cyclophosphamide pulse therapy were evaluated for the cause of ulcers. The lesions were first classified into pemphigus ulcers, aphthous ulcers, pyogenic infection and candidiasis on the basis of clinical characteristics. Smears from these ulcers were then stained with Giemsa stain to look for acantholytic cells and bacteria. Another smear was mounted in 10% KOH to look for candida. Seven patients were clinically diagnosed to have pemphigus ulcers, but acantholytic cells were seen in only 2 cases. Both these patients had superadded infection with candida and gram positive bacteria respectively. Of the 9 cases clinically diagnosed to have candidiasis, only 6 revealed candida in 10% KOH smears, while 1 patient revealed acantholytic cells. All the 3 cases clinically considered to have aphthous ulcers, revealed only normal looking epithelial cells. One patient clinically diagnosed to have pyogenic infection revealed pus cells and bacteria on gram stain. It is obvious that oral ulcers in a pemphigus patient may not always be pemphigus ulcers, and some of these may be super-infected with candida, pyogenic or other organisms. A proper evaluation is therefore necessary for appropriate treatment.

It is important to have reliable bioassay models for topical steroids and assess their comparative efficacy. In the present study, seven commonly prescribed commercial corticosteroid creams have been evaluated for their efficacy using histamine bioassay method. The results indicated that clobetasol propionate (Excel®) and betamethasone valerate (Betnovate®), fluocinolone acetonide (Supricort®), beclomethasone dipropionate (Beclate®), betamethasone benzoate (Topicasone ®), and dexamethasone trimethyl acetate (Millicortenol ®) in that order of priority.

Of the 705 patients patch tested between March 88 to March 91, 317 were tested for sensitivity to preservatives with antigens obtained from Chemo technique AB, Sweden. Paraben was the commonest sensitizer (22.4%) followed by Groton B K (8.1%) and Triclosan (6.5%). We stress the need to consider these allergens as source of dermatitis and advocate complete labelling of topical preparations marketed.

Two cases of naevus lipomatosus cutaneous superficialis (NLCS) are reported. One of them was a case of multiple form of NLCS while other was having cutaneous lesions resembling solitary form of NLCS.

Three Indian children developed lesions of hypomelanosis of ITO since the age of 1 year, 9 months and 5 years respectively. Cases 1 and 3 had borderline intellectual functioning and case 1 showed diminished sweat response. There were no other associated abnormalities. Several recent reports have suggested that hypomelanosis of Ito is a nonspecific marker of chromosomal mosaicism.

A female prostitute, seropositive for HIV by ELISA and Western blot, presenting with mucous lesions of tongue and lower lip and also with unilateral loss of vision of the right eye is discussed. The tongue and lip lesions were confirmed by histopathological examination to be hairy leukoplakia, and the loss of vision was found to be due to retinitis-probably due to cytomegalovirus infection. The patient also had candidiasis, both oral and genital and lymphopaenia.

Molluscum contagiosum in a 15-month old child was seen over the scalp alongwith other sites. Younger age and rare site involved are interesting features of this case.

A 60-year old female who developed herpes zoster in the distribution of C 6 - 7 on the left upper arm, is reported because of some unusual features. With onset of herpes zoster, she developed ipsilateral painful limb oedema. After healing of cutaneous lesions of herpes zoster the limb oedema was associated with marked restriction of joint movements in the same limb for about 4 months. Roentgenogram of the involved part showed soft tissue swelling with arthritic changes.

A 10-week old female child of Incontinentia pigmenti with linear and bizarre slaty brown hyperpigmented and verrucous lesions on both lower extremities is reported.

A case of relapse occuring in a patient of P B leprosy 1 year after regular MDT (WHO regimen) is reported. This suggests that 6 months of MDT may be too short.

A 55-year old male presented with innumerable lesions of colloid millium unilaterally over eyelids of left eye. This case is reported because of unilateral distribution of lesions on sun protected area.

Sporotrichosis is a rare disease in the southern part of India. A typical, culture proved case of fixed cutaneous sporotrichosis is reported from North Karnataka.