Systemic sclerosis (SS) and dermatomyositis (DM) are both multisystem disorders and share some common clinical features. We report here an 11 year-old girl whose disease showed a changing clinical pattern from juvenile systemic sclerosis (JSS) to slowly progressing juvenile dermatomyositis (JDM) and had associated generalized morphea. Serological studies revealed antinuclear antibodies (ANA) with a speckled pattern. Topoisomerase-I (Scl-70), U1 RNP (ribonucleoprotein), anti-Ro, anti-La and anti Jo-1 antibody tests were negative. Electromyography (EMG) was suggestive of primary muscle disease and histopathological findings indicated scleroderma. The patient fulfilled the American College Rheumatology (ACR) diagnostic criteria for JSS as well as Bohan and Peter criteria for JDM separately and hence, was diagnosed to have sclerodermatomyositis (SDM). Mixed connective tissue disease (MCTD) and antisynthetase antibody syndrome (ASS) which share same clinical features with SS and DM were excluded by immunological studies.

Background: The oral mucosa and tongue constitute a barometer, a mirror reflecting the state of health of patient. Similar to skin, lesions in mouth speak for itself. They often provide unique opportunity to understand systemic disease process. With careful and judicious practice many systemic diseases can be identified through the manifestations present in oral cavity. It is in light of this that it was thought proper to carry out a prevalence study of some of commonly occurring oral lesions in a skin, STD/HIV and leprosy OPD. Aims and Objectives : This study was undertaken to find the prevalence of oral lesions related to dermatoses, sexually transmitted diseases (STD) and Human Immunodeficiency Virus (HIV) infection in outdoor patient department (OPD) with reference to number of cases, age and sex distribution.To determine percentage of symptomatic and asymptomatic patients among those with oral lesions.To analyze into various groups the oral pathologic conditions.To determine the local co-factors for oral lesions, if any. Methodology: The study was carried out in a cohort of 300 new patients attending the Skin, STD and HIV OPD of a teaching hospital in Department of Skin and V.D. in a Tertiary care centre. All new patients attending the OPD, irrespective of age, sex and presenting complaints were entered in the study. Results: Out of 300 patients studied 183 (61%) were male and 117 (39%) were females. Majority of patients belonged to age group 20 to 40 years. Out of 116 patients found to be having oral lesions only 15 (13%) had oral symptoms. 116 (38%) were having oral lesions of which 82 (27%) were males and 34 (11%) were females. Pigmentary disorders, carries and white deposits like candidiasis were much more common in males whereas lichen planus was more common in females.

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