Oral isotretinoin showed better and earlier response than topical isotretinoin. Oral isotretinoin should definitely be given a trial particularly in cases of multiple facial warts before trying various destructive procedures.

We have previously demonstrated that urocortin protects cultured cardiac myocytes from ischaemic and reoxygenation injury and decreases the infarct size in the rat heart exposed to regional ischaemia and reperfusion. Urocortin-mediated cardioprotection is via activation of the mitogen-activated protein kinase (MAP kinase, MEK1/2) pathway. In addition, it is well documented that heat shock protein (hsp) 70 and hsp90 are cardioprotective against lethal stress. In this study we show, for the first time, that urocortin induces the expression of hsp90 but not hsp70 in primary cultures of rat neonatal cardiac myocytes. Levels of hsp90 protein increase by 1·5-fold over untreated cells within 10 min of urocortin treatment and are sustained for 24 h with a maximal increase of 2·5-fold at 60 min (P<0·05 at all time points). The increase in hsp90 expression by urocortin was not inhibited by actinomycin D, and urocortin failed to increase hsp90 promoter activity. Urocortin induction of hsp90 was inhibited by the MEK1/2 inhibitor PD98059 (P<0·001) and by cycloheximide, and both inhibitors abrogate urocortin-mediated cardioprotection (P<0·05 for cycloheximide, P<0·001 for PD98059). Hence, MEK1/2 and protein synthesis are involved in the cardioprotective effect of urocortin against hypoxic-mediated cell death, possibly due to an increase in expression of hsp90 protein. This is the first report of heat shock protein induction by urocortin or any other member of the corticotrophin-releasing hormone family.

Objectives: To evaluate and compare the efficacy of MMR vaccine and MIP vaccine for resolution of Cutaneous warts (Cw). Methods: The hospital-based prospective randomized interventional study was done where a total of 60 patients of Cw were divided into two groups of 30 patients each: Group A received 0.1 ml of intralesional injection of MIP vaccine and Group B received 0.5 ml of MMR vaccine. The treatment protocol involved three intralesional injection of vaccines at intervals of 3 weeks (maximum of three injections). The follow-up was done every 4 weeks for at least 24 weeks for the comparison of the two groups. The primary outcomes were the decrease in size of the wart or clearance of primary warts. The secondary outcomes were the improvement in the distant warts and any complications related to the use of vaccines. The data were entered in MS Excel and analyzed using SPSS 17.0 version. A P value of <0.05 was considered statistically significant. Results: The baseline demographic and wart characteristics were comparable between the two groups (P > 0.05). As compared to MMR, MIP showed an early (9.41 vs 11.71 weeks, P = 0.027), and a significantly higher complete response (90% vs 76.67%) with P < 0.05. The less duration of the warts was significantly associated with the higher complete response ( P < 0.05) in both the groups. The common side effects were erythema/inflammation [19 (63.34%)] in Group A and pain during the injection [19 (63.34%)] in Group B with P < 0.0001. Conclusion: In conclusion, MIP intralesional injections have a quicker response and are more efficacious compared to MMR in the treatment of Cw, though each vaccine carries its own sets of side effects.

Scabies is an infestation caused by Sarcoptes scabiei and characterised by polymorphous lesions that may include burrows, papules, nodules, excoriation and crusts. Vesicular and bullous lesions are rather rare. Several diseases may be confused with scabies. We report a case of bullous scabies which, on the basis of the clinical and histopathological picture, mimicked bullous pemphigoid. Direct and indirect immunofluorescence were negative. Bullae recurred and persisted despite systemic corticosteroids. The patient was successfully treated with 5% permethrin and remained disease free for up to 12 months of follow-up.

The mouse neuroblastoma cell line (Neuro 2 A) has been shown to contain the mRNA of a prohormone converting enzyme, PC2. The Chinese hamster ovary cell line (CHO) does not express PC2 mRNA, but is thought to contain the ubiquitous protease, furin. The enzyme(s) responsible for releasing corticotrophin-releasing hormone (CRH) from its precursor (proCRH) have not been identified, therefore to investigate the possible function(s) of PC2 or furin in the processing of proCRH, stable Neuro 2 A and CHO cell lines that express the 21 kDa human (h)proCRH were established. A specific two-site IRMA for CRH demonstrated that the hpreproCRH-expressing Neuro 2 A cell line cleaved the CRH precursor to the CRH peptide, and was able to release the mature peptide into cell medium at levels that were 4-fold higher than produced by the hproCRH-expressing CHO cells. RIA showed that the CHO cells secreted levels of CRH-containing peptides that were 10-fold higher than produced by the Neuro 2 A cells. Medium from the transfected CHO and Neuro 2 A cells was analysed by HPLC; this showed that CHO cells released a single protein corresponding to the unprocessed CRH precursor, whereas Neuro 2 A cells secreted two peptides, which could be identified as the 5 kDa CRH(1-41) and residual 16 kDa CRH peptides. These results suggest that Neuro 2 A cells, which contain PC2, can process proCRH to the mature peptide.