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Background: Topical therapies are the first line of treatment for patients with stable plaque psoriasis affecting a limited body surface area. Though in use for more than a decade, we could not find any reports of studies directly comparing calcipotriol and tazarotene. Aim: To evaluate the comparative efficacy and tolerability of calcipotriol and tazarotene in the treatment of stable plaque psoriasis. Methods: This was a prospective, right-left side intra-individual parallel 8-week study using calcipotriol 0.005% ointment applied twice daily (right side) versus tazarotene (left side) randomized to either 0.05% (group I) or 0.1% gel (group II) once daily in two groups, each of 10 patients. Efficacy was determined by the assessment of target psoriatic lesions under evaluation by using the severity scale (0-3) of erythema, scaling, and infiltration (ESI score). Evaluation was done at baseline (0 week), 4 weeks, and 8 weeks of treatment. At the end of 8 weeks, patients with more than 75% reduction in ESI score were considered to have marked improvement; 51% to 75%, moderate improvement; 26% to 50%, minimal improvement; and less than 25%, non-responders. Results: Seventeen patients (9 in group I, 8 in group II) completed the study. In group I, reduction in ESI score was significantly more at both 4 and 8 weeks on sides treated with calcipotriol, producing moderate-to-marked improvement (P < 0.05). In group II, improvement was comparable in lesions treated with either calcipotriol or tazarotene (0.1%) at the end of 4 and 8 weeks. Adverse effects noted were mild - in the form of burning, pruritus, and irritation - and were observed more often in the lesions treated with tazarotene as compared to those in the lesions treated with calcipotriol, but the difference was not statistically significant. However, none of the patients discontinued the therapy because of adverse events. Conclusion: Topical calcipotriol 0.005% ointment is more effective than tazarotene 0.05% gel; however, its efficacy is comparable to tazarotene 0.1% gel in the treatment of stable plaque psoriasis.

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

A young male patient of SLE developed bullous lesions. Histopathology and DIF were consistent with the diagnosis of bullous SLE.

One hundred patients with warts (Verruca vulgaris of hands-33; feet-16, hands and feet 10; palmar warts-17 and plantar warts-24) were treated with salicylic acid (16.5%) and lactic acid (16.5%) in flexible collodion wart (SAL) paint. The wart paint was applied twice a week for 3 months. Good response was seen in 82.1% of warts on hands. 46.7% of palmar warts, 54.5% of warts on feet, 84.2% of plantar warts and 57.1% of warts on hands and feet. Overall success rate was 70%. Eighty percent patients completed the study. No adverse effects were observed. During 6 months post treatment follow up recurrence of warts occurred in 11.7% of patients.

Dyschromatosis universalis hereditaria is a common disorder in Japan. We report a case in an Indian woman with no family history of the disorder.

Patch test was evaluated for the identification of causative agent in cutaneous eruptions due to antiepileptics. Patch tests were carried out in twenty patients and ten controls with carbamazepine, phenytoin sodium, phenobarbitone and sodium valproate. Sodium valproate was found tobe irritant in 1 and 5% concentration and further dilution is recommended for patch testing. Patch test was positive in 14 (70%) patients and in 7 with suspected drug alone, and remaining 7 were positive with more than one antiepileptic drug. We recommended patch test for identification of causative drug in rashes due to antiepileptics.

Autologous transplantation of melanocyte/melanocytes bearing epidermis for vitiligo can be done by mini-punch grafting (MPG), suction blister epidermal grafting (SBEG), thin split -thickness skin grafting (TSTG), transplantation of basal cell layer enriched suspension and cultured epithelial/melanocyte transplantation. To date no comparative study of these transplantation procedures has been published. Comparison of different studies carried out at different centers may be difficult in the absence of uniform evaluation criteria. In most of the published studies, the results were evaluated in terms of extent of pigmentation. Complictions and color match were evaluated separately. This approach, however, may not give a fair idea about the results. We have developed a scoring system with holistic approach considering the extent of pigmentation, color match and the complications of both the donor and the recipient areas, all taken together. In the scoring system, the score for individual criteria was multiplied with a factor, the value of which was decided on the basis of relative importance of each criteria. The use of this scoring system is exemplified in twelve patients who underwent TSTG, SBEG and MPG. In the scoring system the results were judged as excellent and fair in 3 patients each, as good in 4 patients and as poor in 2 patients.

Three women with large, mutilating genital ulcers of long duration, destroying almost the lower half of the external genitalia, are reported. They had a history of recurrent oral ulcers as well. All patients had been diagnosed as having ′genital ulcer syndrome′ in the past and had been treated with antimicrobials. Histopathology of the biopsy from the margin of the ulcer revealed features of leukocytoclastic vasculitis. Considering the history, clinical features and histology, a diagnosis of bipolar aphthosis was made in all patients. All patients responded well to immunosuppressive therapy. The cases are reported because of the presence of genital ulcers of an unusually large size, mutilating character and their close similarity to genital ulcers due to sexually transmitted diseases, especially genital herpes and donovanosis.

Forty patients of chronic, stable, plaque psoriasis were treated with different concentrations of crude coal tar (CCT) with varied times of application but constant sun exposure. All concentrations with 8-10 hours of application were found to be equally effective. However, shorter period of application (2 hour) resulted in decreased efficacy. An application of white petrolatum was as effective as crude coal tar when combined with sun exposure.

Bowenâ€s disease is desired as persistent, progressive, non- elevated, red scarry or crusted plaque, which is due to an intraepidermal carcinoma and is potentially malignant. Sunlight is considered as an important aetiological factor. In the past; arsenic exposure was also said to be important 1. The curaneous lesion of Bowenâ€s disease can sometimes be hyperkeratotic or fissured 2. Morphology can vary depending on site of involvement.

A 48 year old male developed erythema on the face and neck with infiltrated papulo-plaque lesions on the neck region. A diagnosis of reticular erythematous mucinosis (REM) was made clinically and with the help of histopathology. Treatment which chloroquine and physical sunscreen gave a good therapeutic response within 8 weeks.

Wells syndrome is a rare inflammatory dermatosis clinically characterised by recurrent itchy erythematous oedematous plaques with features resembling both urticaria and cellulites and histologically characterised by tissue eosinophilia, oedema and flame figures. Erythema elevatum diutinum(EED) is a chronic localized form of cutaneous vasculitis clinically consisting of symmetrical papules and nodules most often of the back of the hands. We present a case of wells syndrome mimicking EED clinically.

A 91/2 year old female born of a nonconsanguineous marriage presented with macrodactyly, hypertrophy of the limb, lymphangioma circumscriptum and varicosities. Lymphangioma circumscriptum was confirmed by histopathology. X-ray of the right foot revealed hypertrophy of both subcutaneous tissue and the underlying bone. This is the second case report from India with the characteristic macrodactyly.

Sporotrichosis is reported to be rare in India. Fixed cutaneous variety is the most pleomorphic type of sporotrichosis and it may mimick several other dermatoses resulting in difficulty in making a correct diagnosis. Here we are reporting a case of fixed cutaneous sporotrichosis which resembled lupus vulgaris both clinically and histopathologically.

Fifty men with recurrent genital herpes were treated with either acyclovir 5% cream or tromantidine 1 % ointment applied topically. Acyclovir cream was applied 5 times and tromantidine cream 4 times daily for 5 days. At least one pre-treatment episode was observed by one of the authors. Self assessment charts were provided to the patients to record prodromal symptoms and healing time. For comparison at least 3 post treatment episodes were observed and com-pared with mean healing time of 3 pre-treatment episodes. Both acyclovir cream and tromantidine ointment significantly reduced the duration of prodrome, hastened healing and so reduced mean healing time.

Twenty rive adult male patients with uncomplicated acute gonococcal urethritis were treated with a single dose of 2 gm of spectinomycin hydrochloride given intramuscularly. All the patients were cured as proved by negative smears and cultures. No side effects were observed with the drug.