Twenty two cases of sporotrichosis recorded in 15 years span are discussed. Geographic distribution of the disease in various regions of the country are identified. The clinico-investigative profile of the patients is discussed. An uncommon extracutaneous form having osteomyelitic changes of phalangeal bones in a 14 year old boy is also described.

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Two young females developed late onset solitary mastocytomas at the ages of 20 and 18 years respectively. Both, patients complained of mild to moderate constant itching with bouts of intense pruritus associated with increase in the redness and inflammation of the, nodules and flushing of the face. Nodules in both patients were intracutaneous, multilobulated, pinkish-red, likely mobile, slightly tender with ositive Darier's sign. Histopathology confirmed the diagnosis m both cases. Itching was suppressed with antihistaminic tablets and topical steroids, intralesional steroids in case 1 relieved pruritus for few months.

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An unusual but serious side effect of methaemoglobinemia following topical application of decomposed Castellani's paint is described .

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A 50-year-old mining engineer at Dhanbad was having air bome contact Dermatitis suspected to be caused by Xanthium strumarium. Patch tests with a 15% aqueous extract of air dried leaves showed a severe positive reaction, but the patient also had positive patch tests with Parthenium hysterphorus and a few other weeds and trees known to cause air-borne contact dermatitis. The titre of contact hypersensitivity with the extract of Xanthium struma'rium was more than 1:100,000 and for Parthenium hysterophrous it was 1:10 indicating a high degree of hypersensitivity to Xanthium strumarium. Further tests in 14 other patients revealed a high prevalence of cross sensitivity between these two plants both of which belong to the compositae family.

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A Total of 11 patients of pyoderma gangrenosum (PG); 5 males and 6 females were observed over 8 years. The ages ranged between 35-72 years. Nine patients were associated with ulcerative colitis, one with chronic renal failure, and one was labelled idiopathic. Three of the 9 patients of PG, who had ulcerative colitis presented first with skin lesions and had clinically silent, but acute, ulcerative colitis, diagnosed only after colonoscopy and rectal biopsy. This highlights the need for investigation including colonoscopy and biopsy even in asymptomatic patients of PG. Most of the cases benefitted from medical treatment (Corticosteroids + Salazopyrin).

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School surveys followed by contact surveys were done in an urban area to studv the epidemiology of childhood leprosy. In a survey of 10, 112 school children in the urban leprosy zone under the Trivandrum Medical College Hospital. leprosy was detected in 55 (a prevalence of 5 per 1000 school children) of these 5 (9%) had multibacillary leprosy. Prevalence rate was more in boys than in girls (M:F ratio 1.6:1). More cases were seen in children above 10 years and this preponderance was more in boys. The prevalence of leprosy was more in Government schools than that in private schools. The majority of children had only single lesions which were on exposed parts of the body. Examination of intrafamilial contacts of cases and matched controls revealed leprosy in 20 houses (47%) among cases, and in 3 families (5%) among controls. Majority of younger children (81%) below 10 years of age had source case in the family itself. The father was the most common (58%) primary source of infection. Majority of index cases (73%) were multibacillary. This study reaffirms the value of school surveys and contact tracing in the detection of leprosy in urban areas.

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An 18 year old female had developed bilateral tops , like keloidal swelling on both ear lobes following piercing. These were treated with shave excision and cryosurgery with an indigenously developed instrument utilizing nitrous oxide as refrigernant. There has not in any recurrence of kenloid till 6 months of flow up.

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A 45 year old female, presented with generalised pruritus, erythematous papular eruptions, vomiting, at times haernatemesis and constipation alongwith generalised of skin and loss of body hair. Generalised pruritus and thickening of whole body skin are very uncommon in hypereosinophilic syndrome (HES). Haematemesis and loss of body hair are hitherto unreported to our knowledge in HES.

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Bone changes in morphoea are well recognised. However bone cyst in morphoea has been reported only once in the past. We describe a second case of bone syst associated with generalised linear morphoea.

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A 26 year old male with epidermolysis bullosa acquisita presenting as severe erosive lesions in the mouth, anterior nares and vesico-bullous lesions over the body arising spontaneously or following trauma is reported. There was no underlying systemic disease and he responded to oral administration of vitamin E.

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Serum immunoglobulin levels and oral glucose tolerance tests were studied in 56 histologically confirmed idiopathic cases of lichen planus. The results were compared with twenty-five normal healthy controls and twenty-nine freshly diagnosed Type II diabetes mellitus patients 17 patients with lichen planus had glucose tolerance abnormalities-of the nature of type II diabetes. The serum IgA and IgM levels were significantly lower in the patients with lichen planus irrespective of the presence of carbohydrate-intolerance in them. The patients having type II diabetes mellitus and lichen planus had significantly lower serum lgA and IgM, as comapred to those having diabetes alone.

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Vitiligo and thyroid disease are well known to be associated. Sera from 22 patients of vitiligo without any clinical evidence for thyroid dysfunction were assayed for triiodothyronine, thyroxine and thyrotropin levels. Six cases showed increased levels for triiodothyronine. This appears to be an adaptive change.

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A clinico-mycological study of 75 suspected cases of superficial mycoses occurring at Balaghat (MP) was done. Out of these 51 cases were both KOH as well as culture positive. Among these 51 cases, 33 were of onychomycosis and in the rest of the cases either skin and/ or both nails were infected. Among the isolates recovered, 27 were of dermatophytes, 22 non- dermatophytes and 4 yeasts. Trichophyton rubrum was the only species recovered among dermatophytes. The most prevalent among non dermatophytes were Hendersonula toruloidea. Microascus cinereus, Fusarium solani. Trichosporon sp. Canadida Curvularia lunate, Chaetophoma dermo-unquis, Geosmithia putterilli. Eupenicillum pervum, Phialophora bubakii and Phoma multirostrata. The use of cycloheximide free medium is recommended in the isolation of non-dermatophyte aetiologic agent causing superficial mycoses.

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The iatex exuding from the freshly sliced stems/leaves of 11 Indian plants was tested on 10 volunteers each by the open patch test and in 5 volunteers each by the 48 hour occluded patch test technique. In the open patch test, there was no reaction with (1) calotropis procera, (2) Alstonia scholaris,(3) Euphorbia splendens, (4) Euphorbia clarkina (5) Nerium indicum, and (6) Padilanthus tithymaloides (Green and white leaf variety), while mild reactions were observed with Euphorbia pulcherrima in 3 volunteers, Ficus elastida in 2 volunteers, and Pedilanthus tithymaloidas (Green leaf variety ) and Plumeria indica in one volunteer each Sapium sebiferum on the other hand produced severe itching, burning and erythema in all the 10 volunteers. The 48 hour occluded patch test produced definite reactions with Pedilanthus tithymaloides (Green leaf variety)in 2 cases and calotropis procera and Euphorbia clarkina in 1 case each. Sapium sebiferum on the other hand produced cauterization type of reactions in all the cases.

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Thirty two patients having alopecia areata of less than two months duration were inducted into the study. This included 20 males and 12 females. Of the 28 cases who completed the study, 20 (71.42%) showed complete hair regrowth in 14 weeks, out of which 16 (57.14%) had it in 10 weeks and 4 (14.28%) in 14 weeks, 8 methoxy - psoralen (0.75% solution) was applied half an hour prior to the exposure to sunlight, for 30 seconds which was gradually increased to 2 minutes. The procedure was repeated daily. No side effects were observed during the trial.

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