Clinicians and histopathologists sometimes disagree on the classification of a case of leprosy. A detailed histopathological study of 92 fresh uncomplicated cases representing the whole spectrum of leprosy was done for the last one year. There was complete agreement between clinical and histopathological diagnosis in 53 cases (57.61)% and disparity in 39 cases (42.39%). Among the latter, shift towards the lepromatous pole of the spectrum was found in 13 cases (14.13%) and shift towards tuberculoid pole in 26 cases (28.26%). The latter group included 16 cases (17.39%) where histopathological diagnosis was indeterminate leprosy because of the presence of early histopathological changes. It is concluded that in case of discrepancy, the more advanced finding (i.e. towards the lepromatous pole) should be given greater weightage and the case is to be classified and treated accordingly.

One hundred and five patients with active lesions of acne vulgaris were included in the open clinical trial. All the patients were administered tablets containing multiple herbal drugs (purim), at a dose of 2 tablets twice daily for four weeks. Simultaneously, they were instructed to apply A herbal cream (Clarina) twice daily on the affected area of acne lesion twice daily for four weeks. The response to treatment was excellent in mild to moderate acne (Grade I & II) after 4 weeks of treatment. In severe acne with large papules and pustules, the response was also significantly good, in healing the papules and pustules. There were no local or systemic side effects seen in all these patients. Thus, this polyherbal cream (Clarina) along with a polyherbal tablet (Purim) tablets was useful in treating patients with various degrees of acne.

Eighty two soil samples were screened for the prevalence of Chrysosporium and dermatophytes. Out of the 75 positive samples 2 were M. gypseum and 73 were Chrysosporium spp.None of the soil samples yielded both Chrysosporium spp. and M. gypseum. The co- inoculation of Chrysosporium spp. with different species of dermatophytes (T. rubrum. T. Mentagrophytes. E. floccosum and M. gypseum) in sterilized soil revealed that none of the dermatophytes except M. gypseum could be recovered after the 15th day of co- inoculation. Whereas, these organisms when inoculated alone in sterilized soil, could be recovered even upto 25 days. In the light of the above finding, we suggest that Chrysosporium spp. might pose a definite challenge to dermatophytes in their saprophytic existence in soil.

One hundred fifty nine patients with clinically suspected footwear dermatitis were patch tested to determine the frequency of positivity of common footwear antigens. Patch testing was done with 22 allergens of Shoe series (Chemotechnique Diagnostics AB Sweden) extended with neomycin, gentamycin, soframycin, paraben, cresol and lanolin. Forty- two percent of patients was sensitive to footwear allergen(s) whereas the overall positivity was 62%. Potassium dichromate. 2 mercapto- benzothiazole (MBT) and nickel sulphate were the frequent sensitizers followed by gentamycin, neomycin, gluteraldehyde, formaldehyde, diphenyl guanidine, diphenyl thiourea, dibutyl thiourea, para-tertiary butyl phenol and 4 aminoazobenzene. Dorsa of feet was the commonest site. potassium dichromate sensitivity was higher in males and the history was not always helpful in incriminating the antigen.

Tuberous sclerosis is now frequently designated as the tuberous sclerosis complex (TSC) Its inheritance is autosomal dominant, but upto 70% of the cases are new mutations. Its prevalence was found to be 4.50 per 10.000 cases attending our dermatology outpatient department. A total of 9 patients attended the out patient department between August 1998 to June 2000. Five were males and 4 females. Eight cases were having definite TSC, whereas a single had suspect TSC. The age of our patients ranged from 10 months to 50 years. A positive family history was available in 4 cases. Most common cutaneous manifestation of TSC was adenoma sebaceum (8 cases) followed by shagreen patches (7 cases) and Koenen’s tumour (6 cases). Ash leaf macules and forehead plaques were seen in 5 cases each. Other findings were skin tags (3 cases), café-au-lait macules(2 cases), enamel pits (2 cases), portwine stain (1 case) and subconjunctival naevus (1 case). Classical triad of epilepsy, mental retardation and adenoma sebaceum was seen in one case only.

Xerosis is a common complaint in patients attending Dermatology clinics. Twenty patients with xerosis, irrespective of cause were enrolled in the study, treated with urea free lotion Dewderm (R) as the only form of therapy and the response was noted. In 13 (65%) patients good results were obtained, specially in senile xerosis, idiopathic xerosis and asteatotic eczema. It is quite safe and may be advocated as first line of therapy in xerotic skin disorders. Further it can miniize the excessive use of topical steroids specially in wide spread disease

Nodular seleroderma is rare variant of circumscribed scleroderma (morphea). Treatment is often unsatisfactory. This report is on the use of extracorporeal photochemotherapy. A 12 year old girl and a 49 year old woman have been treated once a month on two consecutive days. A complete remission was achieved in one patient after 10 months and an almost complete remission in the young girl after 6 months. The treatment was well-tolerated and no severe side – effects occurred. In contrast to previous attempts in treating nodular scleroderma with different modalities, ECP seems to be an effective therapy.

A case of Mycosis Fungoides showing typical clinical and histopathological features responding to PUVASOL therapy.

A case of embryonal rhabdomyosarcoma of vagina in an infant is being reported here because of its rarity and the changing trend in the treatment.

The most common malignancy of the skin is basal cell carcinoma (BCC), usually occurring in the head and neck. It can occur elsewhere as also in the lower extremity. We describe two patients with BCC in the lower extremities, which were nodular type and without any predisposing factors.

Basal cell carcinoma is one of the most common skin cancers encountered in dermatological practice. The case details of a basal cell epithelioma occurring near the left eye in a 42 years old male and its successful treatment with cryofeeze is reported for its clincial interest and therapeutic considerations.

An interesting episode of fixed drug eruption to two chemically unrelated antifungal agents (griseofulvin and fluconazole) prescribed for onychomycosis in a 66- year – old male is being presented. The lesions developed at different sites. Oral challenge led to recurrence with both the drugs. However patch test with 10% fluconazole in petrolatum was negative.

Cheilitis granulomatosa is characterized by recurrent swelling of labial tissue which may be followed by permanent enlargement. We report a 35 year old man with cheilitis granulomatosa whose lesions regressed with clofazimine.

A 32 year old male patient reported initially with lesions of lichen planus. This was followed years later by a network of generalized small erythematous papules, reticulate pigmentation, atrophy and telangiectasia. The histopathological changes were suggestive of lichen planus and poikiloderma.

A 15 year old girl presented with a rare association of generalized maculopapular rash with exfoliation, hepatic involvement, nephritis, arthralgia and repeated serum sickness type of reaction after taking depsone. The case is reported because of its unusual presentation.

A 62 year old male agricultural labourer presented with itchy pigmented lesions involving mainly upper and lower limbs of 6 months duration. On physical examination he had macular and popular hyperpigmented violaceous lesions associated with Koebner phenomenon. Palms and soles demonstrated diffuse as well as macular type of huperpigmentation. Histopathological examination of forearm lesion showed basal cell liquefactive degeneration with melanin incontinence suggestive of healing lichen planus. The case is reported for the unusual palmoplantar lesion seen in our case.

Three cases of Sturge – Weber syndrome are being reported. All our cases had incomplete form of Sturge- Weber syndrome. They had cutaneous facial angiomas and leptomeningeal agiomas evidenced by central nervous system manifestations (seizures) and /or computerized axial tomography showing typical gyriform calcification. None of our cases had glaucoma. The cases are being reported for its rarity.