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Background: In India, an increased prevalence of chronic, recurrent, and recalcitrant dermatophytosis is being observed. The present study assesses the clinico-mycological profile, antifungal drug sensitivity and therapeutic efficacy of various systemic antifungal drug regimens, in extensive dermatophytosis patients of coastal Andhra Pradesh. Materials and Methods: One hundred and fifty clinically diagnosed cases of extensive dermatophytosis affecting more than one body region were enrolled. Skin samples were taken for direct microscopy and fungal culture. Antifungal drug sensitivity testing was done with broth microdilution test. Therapeutic efficacy of systemic antifungal drug regimens was determined by randomly dividing the patients into 5 groups of 30 each. Results: The most common clinical patterns observed were tinea corporis et cruris (62.7%) followed by extensive tinea corporis (11.3%). KOH and culture positivity were seen in 132 (88%) and 84 cases (56%) respectively. Trichophyton mentagrophytes was isolated in 78 cases (92.8%) followed by Microsporum gypseum in 6 patients (7.1%). The overall mean minimum inhibitory concentration values for itraconazole (0.04 μg/mL) were low when compared to griseofulvin (4.61 μg/mL) and terbinafine (6.9 μg/mL) ( P < 0.05). Combination of itraconazole and griseofulvin achieved highest clinical and mycological cure rates (93.1%). Among patients receiving single drugs, itraconazole had higher cure rates (71.4%) compared to terbinafine (59.2%) and griseofulvin (53.8%) ( P < 0.05). Conclusion: Trichophyton mentagrophytes has replaced Trichophyton rubrum as the predominant species causing dermatophytosis in Andhra Pradesh, presenting with a severe phenotype. Itraconazole was found to be the most effective drug both in vivo and in vitro . A combination of systemic drugs should be considered in cases of monotherapy failure and in recalcitrant dermatophytosis.

<p class="abstract"><strong>Background:</strong> Comedonal acne commonly seen in adolescents and young patients which is refractory to standard treatments. This study is being undertaken to determine the efficacy and adverse effects of oral isotretinoin, electrodessication and comedone extraction in patients of comedonalacne.</p><p class="abstract"><strong>Methods:</strong> A total of 120 patients of comedonal acne were enrolled and randomly divided into 4 groups of 30 patients each. Group A, B, C and D patients were treated with isotretinoin (20 mg daily), electrodessication, comedone extraction (4 weeks interval) and topical antibiotic daily for 12 weeks. The response in each group was assessed based on decrease in total comedonal count after 12 weeks of treatment. Statistical analysis was done using chi square test.<strong></strong></p><p class="abstract"><strong>Results:</strong> Eighty seven (72%) cases had predominantly closed comedones and 33 (27%) cases showed open comedones. After 12 weeks of treatment, more than 75% decrease in comedonal count was seen in 60% of patients in electrodessication group followed by 30% (isotretinoin), 13.3% (comedone extraction). The decrease in total number of comedone was significantly higher with electrodessication (84.4%) followed by isotretinoin (73%), comedone extraction (43.2%) and topical antibiotic (5.7%). After follow up of 3 months, recurrence of comedones was least with isotretinoin followed by comedone extraction and electrodessication.</p><p class="abstract"><strong>Conclusions:</strong> For comedonal acne, initial electrodessication followed by isotretinoin over 12 weeks gives the best outcome of quick remission and least recurrence. Electrodessication and comedone extraction are the preferred modalities in patients with predominantly closed and open comedones respectively.</p><p class="abstract"> </p>

<p class="abstract"><strong>Background:</strong> Warts are one of the most common benign growths of skin caused by human papilloma virus. No single treatment has proved to be completely effective and most therapies for palmo-plantar and periungual warts remain unsatisfactory. The present study was conducted to evaluate the therapeutic efficacy and safety of intralesional bleomycin injection in palmo-plantar and periungual warts in patients in region of south east India.</p><p class="abstract"><strong>Methods:</strong> Ninety patients of multiple palmo-plantar and periungual warts were included in the study. They were infiltrated with bleomycin (1 mg/ml) till blanching. The treatment was repeated after paring of eschar at 2 weeks interval in cases with partial or no response. The patients were reviewed at monthly interval for 24 weeks to note cure, adverse effects, recurrence and outcome satisfaction levels.  </p><p class="abstract"><strong>Results:</strong> Out of total 305 warts, 103 (34%) were cured after 1st injection and 249 (82%) were cured after 2nd injection. The number of warts requiring more than 2 sittings was 55 (18%). At the end of study, overall cure rate was 94.5% and 10 patients showed recurrence.</p><p class="abstract"><strong>Conclusions:</strong> Intralesional bleomycin injection is an effective and safe treatment option in palmo-plantar and periungual warts.</p>