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INTRODUCTIONPyodermas defined as purulent infection of the skin constitutes one of the common clinical conditions encountered by dermatologists in regular practice. Most of the studies in India state that pyodermas constitute 17% of cases in regular practice. Multiple factors like overcrowding, illiteracy, poor socio economic status, lack of hygienic practices account for personal factors in occurrence of pyodermas. Additional environmental ABSTRACT Background: Most of the studies in India state that pyodermas constitute 17% of cases in regular practice. Pyodermas are classified as primary and secondary. Primary pyodermas account for infection on normal skin whereas secondary on preexisting skin disease. The spectrum of pathogens, are however changing constantly as such their resistance to antibiotics. Indiscriminate usage of antibiotics, topical or systemic has lead to the development of resistance among the pathogens, which is a big problem to the physicians. The present study was conducted to assess the magnitude of different types of pyodermas, clinical types, the causative agents and their antibiotic susceptibility pattern. The study also determines the prevalence of MRSA among pyodermas. Methods: 375 newly diagnosed cases of pyodermas attending the OPD of department of Dermatology were enrolled in the study. A thorough clinical examination, demographic data, and relevant laboratory investigations were performed including culture and sensitivity. Results: The incidence of pyoderma in our study was 1.55% with male preponderance and common in 21-30 years age group. Primary pyodermas (225 cases) outnumbered secondary pyodermas (150 cases). Lower limbs were the most common site of pyodermas. Furuncle followed by folliculitis was most common primary pyodermas. Infectious eczematoid dermatitis was the most common entity in secondary pyodermas. Staphylococcus was the most common isolate in the study followed by Coagulase negative staphylococcus. Escherichia coli were most common gram negative isolate. Among diabetics, furuncle was commonest with history of 100% recurrence. Incidence of MRSA in the study was 47%. Gram negative isolates were susceptible to Carbapenems, fluroquinolones and higher generation cephalosporins. Conclusions: To conclude, our study highlighted the clinico epidemiological features of pyodermas attending our hospital. The common clinical types of primary and secondary pyodermas and associated risk factors were stated in the study. Etiological agents were identified in the study with antibiotic susceptibility, which especially assist the clinicians in selection of antibiotics in absence of culture and sensitivity.

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<p class="abstract"><strong><span lang="EN-US">Background:</span></strong>Mucocutaneous infections have played an important role in initial diagnosis of HIV infection and in clinical staging of the disease. Mucocutaneous manifestations in HIV infected individuals are myriad and can serve as a main indicator of other problems. Health care personnel involved in HIV health care must therefore have a clear idea of type, pattern, and prevalence of skin diseases in their locality. <span lang="EN-US">The objective of the study was </span>to determine the various mucocutaneous manifestations in newly diagnosed cases of HIV and to correlate them with CD4 cell counts. The manifestations and CD4 cell counts are correlated with WHO staging of the disease.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong>Data was collected from all the newly diagnosed cases of HIV presenting to the Department of Dermatology. Thorough clinical examination was done and findings were noted. CD4 cell counts were performed by FACS counter and supportive laboratory tests were done for diagnosis of other skin manifestations<span lang="EN-US">.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>250 cases were enrolled with males 148 and 102 females. Most common age group was middle age group and hetero sexual route was the most common route of transmission. Bacterial skin infections were more common and candidiasis was most common among fungal infections. Herpes zoster was most common in viral infections. Significant correlation was observed between CD4 cell counts and WHO clinical staging of disease. Majority of infections were more common at advanced stage of HIV.</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>To conclude, HIV-related mucocutaneous manifestations are a good clinical clue in diagnosis of advanced stages of HIV. Most of these manifestations can serve as diagnostic and prognostic markers in HIV infection. Management of HIV related mucocutaneous manifestations should always be precluded with a screening of CD4 cell counts. A lowered CD4 cell counts will prolong the duration of treatment and may significantly alter the outcome of the disease.</p>