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Pyoderma gangrenosum (PG) is a rare neutrophilic disorder with an incidence rate of 3–10 cases per million per year, characterized by classically painful and aseptic ulcers, which may be associated with underlying systemic diseases. The pathergy reaction is seen in one-fourth of patients with PG. Accurate and timely diagnosis is crucial, as PG is known for its rapid progression. The management of PG is challenging and depends on its severity and rate of progression. An underlying systemic involvement should be sought even in spite of no symptoms. Herein, we report a case of giant pyoderma gangrenosum involving almost the entire left buttock with exceptionally raised c-ANCA levels, but no underlying systemic abnormality. The patient reported intense pain, rapid progression of the ulcers, an inability to perform daily activities, was significantly morbid and pathergy-positive. Aggressive and early management is required in cases such as this. A dramatic response was achieved with a combination of cyclosporine, dapsone, and methylprednisolone pulses.

Background: Non venereological diseases of genitalia can be a diagnostic dilemma to a dermatologist and also a cause of considerable concern to the patient because they tend to get misdiagnosed with venereal diseases. Aims: To study the pattern and clinico-epidemiological profile of non-venereal dermatoses of male genitalia in Hadoti region of Rajasthan. Materials and Methods: We conducted this prospective, descriptive study in 250 male patients with non venereal dermatoses in Rajasthan from January 2015 to July 2016. The demographic profile and clinical findings of the patients were recorded and appropriate investigations and histopathological examination were done as and when required. Cases having venereal diseases were excluded from the study by clinical examination, serological and microbiological tests for venereal diseases. Results: The age of the patients ranged between one to 70 years, with mean age being 27.1 years. The most common dermatosis was nodular scabies 54 (21.6%) followed by sebocystoma multiplex 24 (9.6%), fixed drug eruption 19 (7.6%), tinea genitalis 17 (6.8%) and genital psoriasis 14 (5.6%) cases. Conclusion: This study highlights the importance of diagnosing non-venereal dermatoses for both correct treatment of the patient as well as to alleviate the anxiety associated with venereophobia and cancer phobia.

Porokeratosis (PK) are a group of keratinizing disorders clinically characterized by atrophic plaques with peripheral hyperkeratotic ridge which gradually spread in a centrifugal manner. The sites of predilection are trunk or extremities and facial lesions are rarely reported. We report a sporadic adult-onset case of porokeratosis of a 20 year old female with a solitary, asymptomatic, persistent classical plaque confined to the ala of nose. On reviewing the literature, nasal and perinasal area has been found to be exclusively involved in many cases of facial porokeratosis. Such cases have unique yet common epidemiological and clinical profile thereby deserving a separate category while being classified.

Darier’s disease (DD) is a rare acantholytic dyskeratotic autosomal dominant genodermatosis characterized by the presence of warty, brown papules and plaques affecting the seborrhoeic areas. Frequent bacterial, fungal and viral particularly herpes simplex virus (HSV) infections complicate DD. Bell’s palsy is an acute onset, idiopathic facial paralysis resulting from a dysfunction anywhere along the peripheral part of the facial nerve. Reactivation of HSV is considered to be the main cause of Bell’s palsy. This case represents, to the best of our knowledge, the first case of DD presenting with Bell’s palsy. This case underlines the importance of recognizing HSV infection in DD.

Introduction: Previous studies from India concluded that the incidence of cutaneous tuberculosis has fallen from 2% to 0.15%, whereas more recent reports suggest that cutaneous tuberculosis is again becoming more prevalent. Aims: To study the patterns of clinical presentation of cutaneous tuberculosis, to correlate them with histopathology, Mantoux reactivity and BCG vaccination status in the north-west region of Punjab. Methods: Analysis of the records of patients with cutaneous tuberculosis who attended the hospital between Jan 2009 to Dec 2012. Results: A total of 36 (0.02%) of dermatology patients had cutaneous tuberculosis. The type of cutaneous tuberculosis in decreasing order of incidence was lupus vulgaris 16 (44.44%) followed by tuberculosis verrucosa cutis 10 (27.77%), scrofuloderma 7 (19.44%) and tuberculids 3 (8.33%). There were no cases of erythema nodosum or miliary tuberculosis. Multiple sites were involved in 17 (47.22%) patients. Face and neck were the most common sites affectedMost of the patients (52.77%) presented with single lesion. Active tuberculosis in other organs were observed in 8 (22.22%) patients. Mantoux test was positive in 23 (63.88%). BCG scar was present in 23 (63.8%) patients. 29 cases (80.55%) showed characteristic histopathological changes of cutaneous tuberculosis. Conclusions: The incidence of cutaneous tuberculosis in the present study was found to be 0.02% which is far lower as compared to previous reports. Reason for this observation could be the effective implementation of the National Program for tuberculosis at primary and secondary level leading to early diagnosis and treatment, hence lesser number of cases reaching to a tertiary center. This study also depicts the histopathological correlation evident in 80.55% of the histopathological specimens which is highly significant.

Herpes zoster is a neuroectodermal viral infection which afflicts one or more closely grouped, spinal or cranial nerves, resulting in unilateral radicular pain and vesicular eruption limited to a dermatome innervated by that nerve [1]. Bilateral involvement is rare, bilaterally symmetrical involvement is extremely rare. We hereby report a case of bilaterally symmetrical herpes zoster in an old immunocompetent female.