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Subcutaneous granuloma annulare is an uncommon, benign self-limiting cutaneous disease, almost exclusively seen in young children. We report a case of 31-year-old male patient, presented with asymptomatic firm plaques over the left lateral malleoli and dorsum of the feet. Histopathological examination was done to confirm the diagnosis and the lesions responded well to monthly doses of the combination of rifampicin, ofloxacin, minocycline (ROM) therapy and intralesional steroid therapy. This case is reported for its unusual presentation of very large plaque in an adult male and its resolution after combined ROM and intralesional steroid therapy.

Background: Confluent and reticulate papillomatosis (CRP) is an uncommon benign, acquired keratinization disorder. Studies on this disorder are lacking except for a few case reports and there is a paucity of Indian literature on the condition. Objectives/Methods: To study and describe the various morphological patterns and histopathological findings, as well as assess the response to treatment of 30 patients diagnosed with CRP. Results: Thirtypatients with a diagnosis of confluent and reticulate papillomatosis were included in the study. The male to female ratio was 1:1.5. Mean age at onset of skin eruptions was 27.3 years and mean duration of skin eruptions was 8.2 months. Most of the patients (60%) were asymptomatic. The majority (66.7%) had lesions distributed over upper trunk. Two-thirds of patients had typical brown macules in confluent and reticulate pattern. KOH mount was done in 24 cases and was positive in three cases (12.5%) for yeast-like hyphae. Biopsy demonstrated variable degrees of hyperkeratosis, papillomatosis, and moderate acanthosis. Thirteen out of eighteenpatients on minocycline showed complete clearance within 3 weeks andthreepatients had more than 50% improvement at the end of 3 weeks. Doxycycline showed satisfactory response but results were less satisfactory with azithromycin. Conclusion: CRP is an uncommon condition. There is a paucity of large studies in Indian literature. The present study highlightssuch a large cohort of cases. Prevalence of CRP was more in female in contrast to western studies. Association of CRP with hyperthyroidism was described in many studies but the present study highlights the association with hypothyroidism. Morphological variants like shiny atrophic lesions, verrucous lesions, and involvement of atypical sites like forearm have been described. Role of minocycline in the management of chronic and recurrent cases has been reinforced.

Aim: The objective of the present clinical study was to compare the effectiveness of radiofrequency de-epithelialization and conventional (slicing) method in reducing gingival pigmentation on long term basis by split mouth design. Materials and Methods: A total of 28 maxillary gingival units from 4 subjects aged between 15-30 years were considered for this clincal study and the selected gingival units were made plaque free and clinically healthy before subjectiing these sites to one of the procedures. The selected sites were abraded by either the conventional (slicing) method (14 gingival units of 21, 22, 23, 24) or by radiofrequency (14 gingival units of 11, 12, 13, 14). After the procedure periodontal dressing was applied to protect the operated area. After 1 week periodontal dressing was removed and the area was irrigated with saline. Follow up examination was done on 30th, 60th and 90 th days to evaluate the recurrence of pigmentation, if any. Results: It was obsereved that, sites operated with conventional (slicing) method, showed higher mean pigmentation than the sites treated with the radioablation during the follow up period of 90 days. Conclusion: When used judiciously, radiofrequency can be clinically valuable, safe and effective method to reduce pigmentation of gingiva.

Background: Geriatric health care has been considered as an emerging issue due to the increase in life expectancy. Cutaneous lesions are more common among the elderly due to aging, which causes decline in the function of skin. Additional factors such as medical conditions, drugs, and environmental irritants also lead to the compromised skin. Objective: To determine the spectrum of cutaneous manifestations among the elderly. Materials and Methods: A total of 300 patients aged 60 years and above reporting to the private clinic in Mandya between July 2013 and June 2014 were evaluated. Skin changes in all the patients were recorded and were classified into physiological and pathological changes. Data were entered in an Excel sheet and analyzed using descriptive statistics. Results: Among 300 patients studied, 68% were men and 32% were women. Eczema (40%) was the most common pathological condition followed by pruritus (32%), and xerosis was common among the physiological changes. Conclusion: Elderly people are one of the more vulnerable sections of our society. Majority of the elderly in this study had xerosis and eczema. Increased prevalence of psychodermatosis in this study emphasizes the need of psychological support in addition to the medical care.