Forty patients of exfoiliative dermatitis (ED), 35 of which were male and 5 female, constituted the study sample. The mean duration of ED were 10, 15 and 5 days for ED secondary to psoriasis, exzema and others, and drug reactions respectively. Fourteen (35%) patients had reduced serum protein levels of which 12 (30%) had reversal of albumin to globulin ratio. Normal serum protein levels were maintained up to 12.8 g of daily protein loss through scaling. In ED secondary to psoriasis, a mean duration of 15 days and protein loss of the 16 g per day through scaling were found to have significant (p<0.01) lowering of serum protein levels. In ED due to eczema and drug reactions, it was not significant. Total serum protein level was inversely proportional to the amount of protein loss through scaling and duration of the disease.

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Pityriasis rubra pilaris (PRP) is an uncommon idiopathic papulosqamous disorder characterized by circumscribed follicular keratosis, palmoplantar keratoderma and frequently erythroderma. Seven patients of PRP (five females and two males) in the age range of 2 to 50 years seen over a 2-year period are presented with their clinical features, triggering factors, associations and laboratory investigations. The clinical type of PRP was adult onset classical variety in three, juvenile circumscribed variety in two and adult onset atypical variety and juvenile classical variety in one each. The triggering factors were upper respiratory tract infection with nutritional deficiencies in two and folliculitis in one. The histopathology was consistent with PRP in all. Four patients were managed with oral vitamin A while one each was put on methotrexate, etretinate and topical steroids and they showed a good response. More number of cases should be studied over a longer period to substantiate the suggested immunologic mechanism of PRP.

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Serum lipid profile was evaluated in twenty leprosy patients (paucibacillary and multibacillary cases) and twenty age and sex matched healthy controls. The serum lipid profile of the two groups showed no statistically significant difference.

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A comparative study between patients of psoriasis and matched control group was carried out at a municipal hospital. They were administered a semistructured proforma and psychiatric comorbidity was clinically assessed. The scales used were: Hospital Anxiety and Depression Scale, Hindi version of Factor C of the 16PF questionnaire, presumptive Stressful Life Events Scale and Mechanism of Coping Scale. It was found that psoriasis had a significant impact on the patient’s day life in various areas. There was a significant prevalence of anxiety and depression in these patients. As compared to the control group, emotional factor and coping skills rather than stressful events played important role in the development of psychopathology. The significant psychiatric comorbidity in patients of psoriasis greatly affects the quality of life and the course of the disease. The clinical implications of the study are discussed in the paper.

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A retrospective analysis of 166739 freshly diagnosed cases who had attended the Dermatology, STD and Leprosy outpatient department of SMHS Hospital (Associated teaching hospital of Govt. Medical College, Srinagar) during a period 12 years, was undertaken. Scabies, fungal infections and pyodermas were the major groups of skin diseases. Sexually transmitted diseases and leprosy followed by cutaneous tuberculosis were the rarest among the skin disorders.

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A 34 year old Nepalese male presented with 10 year history of recurrent itchy erythematous papules, plaques and vesicles healing with scarring and milia on his shins. He also had dystrophic toenails since childhood. Family and past history were not contributory. Histopathological findings were consistent with the clinical diagnosis of pretibial epidermolysis bullosa (PEB). The patient was treated with oral vitamin E with some relief.

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Pellagra is a nutritional disorder that occurs due to niacin deficiency. In the present day context, in western world, pellagra is confined to individuals who have improper food intake, such as psychiatry patients, alcoholics and recluses. Here with we report a case of pellagra occurring in a 60 year old male who was a chronic alcoholic.

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Earlobe keloid secondary to ear piercing is a recognized complication and may be unsightly and often cause significant distress to the patient. The size of the keloid may very considerably; although usually small, large lesions weighing up to 38 g have been reported. This article describes a case of bilateral recurrent massive keloid of earlobes and review of literature.

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The frequency of occurrence of ARA criteria and other constitutional symptoms in SLE and the effect of various treatment modalities on these criteria were studied. Immunological features and arthritis were the commonest findings. Addition of an immunosuppressant.

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A 17 year old South Indian female born of consanguineous marriage presented with a widespread non-itchy eruption over scalp, face, below breasts and flexural aspects of limbs including axillae, inguinal regions and popliteal fossae since 3 months of age. The eruption consisted of individual small, flat, brownish black hyperkeratotic papules, which at some places, coalesced to from a reticulate pattern. Histopathological examination of biopsies from the axilla and forearm showed typical hyperkeratosis and papillomatosis without acanthosis. The dermis demonstrated a mild perivascular infiltrate. On the basis of the clinical and histopathological findings, a diagnosis of confluent and reticulate papillomatosis of Gourgerot and Carteaud was made. Partial response to doxycline in our case point towards this being a keratinization disorder where microflora may be playing an exacerbating rather than a primary role.

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Two classical cases of congenital eryhropoietic porphria, a rare autosomal dominant disorder, are described.

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Digital vascular status in 10 patients of systemic lupus erythematous (SLE) suffering for 1 to 5 years and 5 control (normal) subjects was assessed by a highly sensitive, non-invasive technique called photoplethysmography (PPG). Six patients (Group A) showed clinical sign. PPG recordings were done by applying the PPG probe serially to the distal phalanges of all the digits of four limbs with Velcro-strap at an ambient temperature of 27 to 31C and humidity 60 to 65% Diminished capillary flow. On average, 12 digits (60%) in Group A and 8 digits (40%) in group B patients showed reduced blood circulation. Degree of vascular impairment had no bearing upon the duration of the disease. The PPG has objectively shown digital vascular impairment in all SLE patients having no correlation with the extent of clinical manifestations and the duration of the disease.

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A case of giant molluscum contagiosum (GMC) with AIDS is described here. Such GMC lesions usually occur in the late stages of HIV disease and are considered to be a marker of AIDS.

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Monilethrix is a rare structural hair defect leading to dry, beaded, brittle hair with characteristic thinning of hair in a rhythmic node internode pattern. We report a case of monilethrix in a healthy four year old child with no family history of similar disorder.

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Systemic lupus erythematous (SLE) is a systemic autoimmune disease that tends to occur in early adult life. The peak age of onset of the first symptom or sign in females is about 38 years and later in men, at about 44 years. Females outnumber men in this illness in a ratio of about 8 : 1. Cutaneous lesions in male have not been properly investigated and some studies in male with SLE have shown that the illness may present with atypical skin lesions. A case of SLE in a 20 year male who developed sudden onset of haemorrhagic vesiculobullous butterfly rash is described.

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Monilethrix is a rare heritable disorder characterized by a structural defect of the hair with increased fragility. We here by report a case of monilethrix in a nine year old male child in view of the rarity of this condition.

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Cutaneous metastasis from head and neck cancers is uncommon. More rarely, it is found as the initial presentation. Herein, we report an old lady with carcinoma tongue, who had cutaneous metastasis at the time of initial presentation.

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