Chronic folliculitis (CF) is a chronic infection of hair follicles leading to atrophy and loss of the affected hairs. This study was done on 51 patients with CF presenting at the Dermatology Clinic at General Hospital Matara, Sri Lanka, to identify specific clinical features and aetlological factors, and to study histopathology. Pus cultures were done on 25 cases. Biopsies were done on 6 patients. CF was commoner in males (59%); 76% were under 34 years, and 39% had occupational exposure to possible irritants. Thirty five precent admitted of scrubbing legs with rough objects. Ichthyosisvulgaris was evident in 47%. All pus cultures revealed Staphylococcus aureus. Clinical features and histopathological features were similar to those described by Harman (1968). Rough scrubbing, ichthyosis and occupational exposure to irritants may be aetiologically relevant.

2221 consecutive live births taking place between March 1994 and February 1995 were evaluated for a minimum period of 5 days to note for the occurrence of various normal anatomical variants specially those of skin. Birth weight, gestational age, maternal age, socio-economic status and consanguinity were carefully recorded in all the cases. Mongolian spots (72%), Epstein pearls (43.8%), Milia (26.2%), and Erythema toxicum (25.2%),were the common dermatological variants noted. Maturity of the babies and possibly genetic factors (consanguinity) are important factors in their causation as observed in our study.

A 5-lipoxygenase inhibitor-sulfasalazine was compared to a known effective drug-methotrexate in psoriasis. Fifteen patients each were put on sulfasalazine (1500 mg/day) and methotrexate (7.5 mg/week). Assessment was made on the basis of EST (Erythema, Scaling and Thickness) scale, initially and then weekly upto 4 weeks followed by 4 weekly upto 12 weeks. Efficacy was comparable for the 2 drugs: decrease in mean EST in patients on methotrexate and sulfasalazine therapy was 86.55% and 83.64% at 4 weeks; and 92.86% and 92.13% at 12 weeks respectively. Nine patients on sulfasalazine therapy and 10 patients on methotrexate therapy had complete clearance at the end of 12 weeks.

HBsAg was studied in 50 patients of STD’s and promiscuous persons. In 10.52% cases it was positive. Vaccination against Hepatitis-B was recommended in promiscuous individuals.

The efficacy and safety of amoxicillin plus clavulanic acid was compared with that of amoxicillin, erythromycin and co-trimoxazole in an open label, randomized trial in 50 children in each group (total 200) with mild to severe pyodermas. Majority (47%) had impetigo. Fifty (25%) children had mild pyoderma, 56 (28%) had moderate and 94 (47%) children had severe pyoderma. Pure growth of S aureus was isolated in 13(65%) children, S pyogenes in 42 (21%) and both organisms in 28 (14%) children. In mild to moderate pyoderma either of the drug tried was equally effective. In severe pyoderma, 24 of twenty five (96%) children receiving amoxicillin plus clavulanic acid, 18 of twenty (90%)children in amoxicillin group, 20 of twenty four (83.3%) children in erythromycin group and 13 of twenty five (52%) children in co-trimoxazole group showed clinical cure on therapy. Amoxicillin combined with clavulanic acid was well tolerated in children and there was no significant side effect except mild diarrhoea in two cases (4%) which was well controlled by taking the drug with meals.

Thirty cases of female genital tract infection were investigated for the presence of Chlamydia trachomatis antigen. Endocervical swabs obtained were subjected to antigen detection by enzyme immunoassay. Rabbit antiserum to chlamydial lipopolysaccharide was used in a card test.Anti rabbit immunoglobulin G conjugated to alkaline phosphatase with a chromogenic substrate 5 bromo-4 chloro-3-indolyl phosphate and nitro blue tetrazolium were used for the enzymatic reaction. Chlamydial antigen could be detected in four out of thirty samples (13.3%). In contrast direct immunofluorescence detected 5 cases (16.6%). Although less sensitive, enzyme immunoassay can be used as a rapid diagnostic tool in detecting Chlamydia trachomatis antigen in genital infections.

A study of 58 paitents of tinea faciei was conducted. Twenty five (43.1%) patients had history of photosensitivity. Twenty eight (48.2%) patients were applying topical steroids, 2 (3.4%) patients were on 10 mg of prednisolone daily. Associated tinea of other sites were observed in 14 (24.13%). 23 (39.6%) patients had typical circinate, arcuate, annular plaques with raised margin showing vesiculo-pustules. Atypical manifestations were in the form of arcuate plaques on the pinna in 4 patients, erythematous plaques full of vesiculo-pustules without central clearing in 3. Thirty two (55.17%) patients had plaques with broad edges and indistinct central clearing. In 2 patients lesions resembled discoid lupus erythematosus. Skin scrapings for fungus was positive in 36 (62.06%) cases. All patients responded to systemic griseofulvin 10 mg/kg with 1% clotrimazole topicaly in 4-8 weeks.

A young child with clinical presentation and histology like chronic bullous dermatosis of childhood and immunopathology of bullous pemphigoid is being reported to make the readers aware of its existence in Indian population and to stress the importance of immunopathology in bullous disorders of childhood.

A 65-year-old female had psoriasiform, depigmented, angiolupoid, lupus pernio, papular and verrucous plague type of cutaneous sarcoidosis. Systemic involvement (hepatomegaly, bilateral persistent swelling of the parotid glands, pain in the hands, weakness and atrophic rhinitis of the left nasal cavity) was also present. The histopathological features of a non-caseating epithelioid cell granuloma with giant cells confirmed the diagnosis. The patient is responding favourably to prednisolone 10 mg daily.

An 8-year-old girl having alopecia areata which progressed to alopecia totalis in 1 1/2 years showed an incomplete regrowth of the hair when treated with our standard regime of 1 mg betamethasone per day orally In spite of the treatment having been continued for 8 months. She had also increasedher body weight by 4 kg during this period. On instituting the OMP regime consisting of 5 mg betamethasone as a single oral dose with breakfast on two consecutive days per week, she showed complete regrowth of the hair over the entire scalp during the next 3 months, and there were no side effects. We recommend OMP as another choice for patients having alopecia areata especially in recalcitrant cases where the treatment has to be given for prolonged periods.

A 45-year-old woman with livid plaques showing central atrophy and erythematous vesicular borders over both dorsa of feet and buttocks, and follicular and papular lesions over buttocks and lumbar area, was difficult to diagnose as either lichen planus (LP) or lupus erythematosus (LE). The histological studies from two places showed features of both LE and LP. Laboratory findings were with in normal limits first, but follow up studies for two years showed persistent albuminurea, leucopenia, arthritis and erythema over the exposed areas with same histology suggesting that eruption may be an unusual variant of LE.

An 18-year-old girl presented with a persistent skin eruption of 6 years duration. She had skin-coloured follicular papules involving the trunk, proximal extremities, neck and face. Histopathology revealed spongiosis of the follicular infundibulum and infiltration with lymphocytes and neutrophils. Treatment with oral vitamin A and topical retinole acid was ineffective.

Two cases of continual skin peeling syndrome (CSPS) are presented

A case report of a 2-year-old child with trichotillomania is described.

A 5 1/2-years-old boy presented with multiple skin coloured subcutaneous nodules on scrotum and penoscrotal regions. Oldest lesion started 8 months back and new lesion was one month old. Biopsy report revealed the tumour to be granular cell tumour.

A case of atypical cutaneous blastomycosis is reported. Patient responded to oral fluconazole 200 mg per day given for 9 months.

A case of tuberous sclerosis with intracranial calcification, retinal phakoma and premature canities is reported for its interesting features,