Cutaneous manifestations of leprosy are variable. It is a known fact that, in addition to the skin lesions related to the disease, multidrug therapy can also have an impact on patient’s skin. In this report, we discuss a young girl with leprosy, who developed acute generalized exanthematous pustulosis to minocycline, which was given as an anti-leprosy drug.

BACKGROUNDWhite lesions in the oral cavity may be benign, pre-malignant or malignant. In India, oral cancer ranks first among all cancers in males and third among females. The five-year survival in oral cancer is directly related to the stage at diagnosis.The aim of this study was to investigate the various clinical and histological patterns of keratotic white lesions of oral mucosa and early detection of malignant changes to avert life threatening complications.

BACKGROUND Tzanck smear serves as a primary diagnostic method in diseases like immunobullous disorders, viral blisters, candidiasis, Hailey-Hailey disease, Darier disease, toxic epidermal necrolysis and cutaneous neoplasms. The aim of the study was to investigate the correlation between cytoclinical, histopathology and immunofluorescence findings in chronic immunobullous diseases and to study the sensitivity of Tzanck smear findings in chronic immunobullous diseases, viral vesicular lesions, and spongiotic dermatitis. METHODS 181 patients with chronic immunobullous diseases, spongiotic and viral vesicular skin lesions who attended the department of Dermatology and Venereology between April 2013 to October 2014 in our tertiary care centre were studied. RESULTS Out of 181 patients studied, 66 cases were chronic immunobullous diseases, 65 cases were viral vesicular lesions and 50 cases were eczema. Tzanck smear showing acantholytic cells in pemphigus vulgaris has a sensitivity of 93.75%. For pemphigus foliaceus and pemphigus vegetans sensitivity was 100%. Direct immunofluorescence (DIF) was 100% sensitive for pemphigus vulgaris and histopathology and DIF correlated in 100%. Tzanck smear with eosinophils correlated with clinical diagnosis of bullous pemphigoid in 70% cases, while histopathology correlated in 100% and DIF positivity was in 95% cases. Tzanck smear has a sensitivity of 70.77% in herpetic infections, 75% in allergic contact dermatitis and 72.72 in irritant contact dermatitis. CONCLUSIONS In chronic immunobullous diseases, Tzanck smear helps the dermatologist to make a primary diagnosis with ease and rapidity without much discomfort to the patient. Though the sensitivity of Tzanck smear in viral infections is low, it can be performed which can narrow down the list of differential diagnosis.

BACKGROUND Lupus Erythematosus (LE) is a group of heterogenous autoimmune diseases with an array of manifestations ranging from cutaneous lesions to life-threatening systemic manifestations. Cutaneous manifestations are the second most common feature and it serves as an important diagnostic aid. The nonspecific skin lesions are associated with more active disease. The aim of the study is to study the pattern and prevalence of cutaneous manifestations in LE and to study the correlation between cutaneous manifestations and systemic involvement. MATERIALS AND METHODS Study comprised of 48 patients of lupus erythematosus who attended the Department of Dermatology and Venereology in a tertiary referral centre from a period of November 2010 to November 2012. Patients were subjected to detailed clinical examination, routine investigations, ANA, anti-dsDNA, ANA profile, non-lesional skin biopsy for lupus band test. RESULTS 48 patients were taken for the study. The peak incidence was in the age group of 30-40 (33.33%) yrs. There was female predominance, the ratio being 5.86:1. Discoid Lupus Erythematosus (DLE) constitutes 37.5% and Systemic Lupus Erythematosus (SLE) 62.5%. Majority of DLE patients (38.89%) presented late in 5-9 yrs., whereas SLE patients presented early within 1-6 months (50%). Most frequent presenting features were arthralgia (54.17%), oral ulcers (45.83%). Renal system was the most common system affected (16.67%). Most common haematological abnormality was anaemia and raised ESR (40%). Most common immunological abnormality was raised ANA in 66.7% and raised anti-dsDNA (60%). Most frequent biochemical abnormality was albuminuria and raised 24-hours urine protein. Lupus band was positive in 58.33% and all had renal involvement. Mortality was 6.67%. CONCLUSION In this study, we got comparable results in epidemiological parameters like age and distribution with other studies. The incidence of ANA negative SLE was higher (33.33%) in our study. Though majority of patients with renal involvement had a positive lupus band test, a statistical significance could not be sought in this regard on account of low sample size.

No abstract