With changing times various newer topical agents are introduced in the field of dermatology. Tacrolimus and pimecrolimus are immunisuppressants, which are effective topically and are tried in the management of atopic dermatitis as well as other disorders including allergic contact dermatitis, atrophic lichen planus, pyoderma gangrenosum. Imiquimod, an immune response modifier, is presently in use for genital warts but has potentials as anti- tumour agent and in various other dermatological conditions when used topically. Tazarotene is a newer addition to the list of topical reginoids, which is effective in psoriasis and has better effect in combination with calcipotriene, phototherapy and topical costicosteroids. Tazarotene and adapelene are also effective in inflammatory acne. Calcipotriol, a vitamin D analogue has been introduced as a topical agent in the treatment of psoriasis. Steroid components are also developed recently which will be devoid of the side effects but having adequate anti-inflammatory effect. Topical photodynamic therapy has also a wide range of use in dermatology. Newer topical agents including cidofovir, capsaicin, topical sensitizers, topical antifungal agents for onychomycosis are also of use in clinical practice. Other promising developments include skin substitutes and growth factors for wound care.

A survey of 200 students aged 18 to 23 years attending GGS Medical College and Hospital, Faridkot, assessed their sexual risk practices, AIDS- specific attitudes and beliefs, sexual relationship pattern and preferences and social characteristics. Overall, 39% of students were sexually experienced and these young people had on average, one sexual partner. Only 10% of sexually experienced students said they consistently used condom and 29% said they never did. Unprotected vaginal intercourse was the predominant and preferred sexual practice; it was also the practice that most often occurred with their last sexual partner. In all, 28% of students defined “safer sex� as condom use. Many young people believe that AIDS is a threat only to members of particular “risk groups�; relatively few believed that they could get AIDS (17%) or said that AIDS information had influenced their sexual behaviour (29% of those who were sexually experienced). Females were more likely than males to prefer having an exclusive partner and males were more likely to prefer having casual partners.

Records of new STD patients attending the Base Hospital, Barrackpore, near Kolkata between 1991 and 2000 were analysed to examine the pattern of STDs among them. Among 567 new STD patients examined, syphilis predominated, followed by gonorrhoea, chancroid, genital warts, lymphogramuloma venereum and herpes genitalis. Non- gonococcal urethritis constituted 4.2% of study population. The overall HIV seropositivity showed a rising treads in the recent past.

The present retrospective study comprised 71 patients of pemphigus enrolled for dexamethasone- cyclophosphamide or plain dexamethasone pulse therapy between January 1997 to December 2001. Ten patients were lost to follow up, 2. expired and treatement was withheld in 2 patients due to side effects. Fifty-seven patients are on regular follow up. The type of pemphigus was P. vulgaris in 48, P. foliaceous in 6, P. erythematosus in I and P. herpetiformis in 2. Of 57 patients, 2 were in phase –1,3 in phase II, 9 phase – III and 43 phase – IV treatment. The type of pemphigus and the duration of the disease were found to influence the response to treatment. Main side effects encountered included candidiasis, diarrhoea, pyodermas, facial flushing, dermatophytosis and hiccups. Pulse therapy had to be stopped in 2 patients, because of cataract and psychosis in one patient each. Serious side effects seen were pancytopenia in one patient and septicaemia in another, both of whom died. Relapse was seen in 2 patients.

Despite the development of newer patient- friendly agents and regimens, treatment of scalp psoriasis is difficult and relapse are common. The adverse effects and drawbacks of topical corticosteroids and calcipotriol led us to compare the effects of three relatively bland therapeutic agents in a prospective randomized trial in scalp psoriasis. A literature search was also done on the treatment of scalp psoriasis. Forty patients with scalp psoriasis were randomized to receive any of the following topical therapies under overnight occlusion:5% coal tar solution mixed 1:1 in coconut oil; a preparation containing 10% urea, 10% lactic acid, 10% propylene glycol and 10% liquid paraffin in a washable cream base and only coconut oil. The 3 groups showed significant improvement in 57%, 64.4% and 58.3% patients respectively (p<0.1). Clearance rates were also comparable between the groups. There were no adverse effects reported in patients using tar or coconut oil. The literature search revealed that only topical corticosteroids had substantially higher response and clearance rates that those achieved by us. The risk/ benefit ratios of topical corticosteroids and calcipotriol vs bland emollients and their place in the treatment of scalp psoriasis are discussed.

Sixty newly diagnosed cases of paucibacillary leprosy were studied for the efficacy of ofloxacin combined with rifampicin in the treatment of paucibacillary leprosy and to compare the combination with the standard WHO multidrug therapy (MDT). All patients were evaluated clinically and bacteriologically at the beginning and then monthly for six months. Histopathological correlation was present in 70% of the cases while divergence was seen in 30% cases. Clinically, at the end of one month there was significant improvement in the group which was treated with ofloxacin and rifampicin combination as compared to standard WHO multidrug therapy. However no significant difference among groups treated with ofloxacin, rifampicin combination or standard MDT was seen after 3 months or 6 months of treatment. There was also no significant difference whether ofloxacin and rifampicin were given for one month or three months

A retrospective analysis of all cases of dapsone syndrome, which presented to us between January 1997 to June 2002, was done using the patients case records. An attempt was made to characterize the clinical profile, therapeutic and prognostic aspects of each case. Overall, sixteen cases of dapsone syndrome were seen. The male to female ratio was 1.3:1 (males-9, females-7). The mean age of these cases was 34.8 years(range 11 to 57 years). All patients had taken dapsone for periods ranging form 2 to 300 days, average being 60.2 days. Of the sixteen cases, 7 had confirmed Hansen’s disease (borderline tuberculoid leprosy-5, borderline lepromatous leprosy-1, indeterminate leprosy-1), 8 cases had been suspected of having leprosy while one case had lichen planus. Mucocutaneous manifestations were present in all cases. Systemic manifestations included fever, pallor, icterus, lumphadenopathy, hepatomegaly splenomegaly and ascites. Of the sixteen cases with dapsone syndrome, 14 had a favourable outcome. Of the two patients who expired, one developed septicaemia with nephrotic syndrome while the other progressed to toxic epidermal necrolysis and succumbed to complications thereof (septicaemia)

In the present study, skin biopsies in suspected cases of deep fungal infections were subjected to H &E and special stainings. In 2 of the 5 cases of sporotrichosis and in both cases of chromomycosis and of histoplasmosis, PAS positive fungal elements could be demonstrated. In both the cases of histoplasmosis, the fungi were also demonstrated by GMS staining. In 3 cases of sporotrichosis, 2 cases of mycetoma and 3 cases of subcutaneous phycomycosis, fungus could not be demonstrated by PAS staining. However, the histopathological features were corroborative.

Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory dermatosis that results in white plaques with epidermal atrophy usually affecting the genital area in both adults and children. The causes of LSA are not clear but possible predisponsing factors include trauma, infection (borrelia, human papilloma virus), autoimmune diseases and local irritation. This study is a retrospective case review of children and adults with LSA attending the department of Dermatology at the Royal Infirmary in Edinburgh, clinical notes for 22 patients were reviewed for age, sex, personal and familial history, symptoms associated diseases and clinical course and treatment. The mean ages at diagnosis of LSA in 9 children (8F: 1M) and 13 adults (13 F) were 7 and 57.5 years respectively. The mean duration of illness was 1.5 year in children and 5.5 year in adults. Itching was the most common symptom in both children and adults. Children also suffered with difficulties in defaecation and in micturation , dribbling, incontinence, constipation and bleeding. Atopy and hypothyroidism were common associated conditions in both the groups. Squamous cell carcinoma of the vulva was confirmed in two adult patients. This study showed the variable symptoms in children, which seemed more severe than in the adult population.

Bullous ichthyosiform erythroderma is a rare autosomal dominant disorder of keratinization resulting in increased epidermal cell transit time. We describe a teenager who had five members of his family similarly affected with sparing of face, neck and upper part of chest.

Cockayne syndrome is a rare autosomal recessive disease of complex clinical phenotype that usually presents in early childhood. Characteristically the child presents with delayed milestones, growth and mental retardation associated with typical facies, photosensitivity, retinitis pigmentosa, deafness and ataxia. The various features are attributed to abnormal transcription rather than abnormal repair of photodamaged DNA. Based on clinical criteria a classical case of Cockayne syndrome in a 7 year old girl is described.

A 32 year old female presented to us with herpes zoster involving the T 8 to T 10 dermatomes. She had a scar involving the same dermatomes on the other half of the body. Investigations revealed that both the patient and her husband were HIV positive with CD4 cell count less than 200.

Tinea nigra is a rare superficial fungal infection of the skin affecting mainly the palms. So far, mostly isolated case reports have appeared in the Indian literature. Five cases in a single family are being reported here. The response to treatment is also highlighted.

Actinomycosis is an indolent, chronic infection caused by microaerophilic, gram positive, non- sporing, slender bacilli of the Actinomyces genus. Ore-facial, abdominal and thoracic locations of infection make up majority of clinical cases. Gluteal or locations of actinomycosis on extremities are rarities. We present here a typical case of actinomycosis of the right gluteal region, without disease in other parts of the body in a nineteen year old female who presented with a three year history of a slowly growing, film lump in the right gluteal region. This case is of interest as it presents the typical history of indolent disease, the characteristic clinical and histopathological findings, and repeated misdiagnosis as a case of tuberculoses.

A case pf lichenoid type of cutaneous sarcoidosis with grade I pulmonary involvement treated with hydroxychloroquine and intralesional steroid is reported.

Microcystic adnexal carcinomas are rare but highly malignant and locally aggressive type of tumour that arises most commonly on the face, mostly over the upper lip and perioral area. Originally described as a tumour of middle aged women, the tumour was subsequently shown to occur equally in both the sexes. Here, we present such a case in a 54 year old female who had a 3 year long history of a swelling with a draining sinus, along with operative manoeuver and histological differentiation, with review of literature.