Objective:Treatment of chronic urticaria (CU) can be difficult in many patients. Achieving long-term remission and reducing the requirement of antihistamines are vital in CU. The objective of this study was to assess the effectiveness of injection histaglobulin, a complex of histamine and human immunoglobulin, in producing relief in patients with CU.Materials and Methods:Fifty-one patients with CU were enrolled into this prospective clinical study. Patients were administered 1 ml of injection histaglobulin subcutaneous for 8 consecutive weeks. They were also prescribed tablet levocetirizine 5 mg to be taken when required (but not more than the permitted dosage). Efficacy was assessed using urticaria activity score (UAS) which has a maximum score of 33/day, during each weekly visit. Final assessment was done after 24 weeks.Results:Twenty-nine patients had completed the entire 8-week drug regimen. Mean basal UAS was 18.9 ± 6.3 and it reduced to 80.4% by 8 weeks. The angioedema sub-score reduced by 89.8%. Anti-histamine pill burden also reduced significantly. By 24 weeks of starting the therapy, 23 patients (45%) had attained complete remission. No adverse effects to the drug were observed.Conclusions:Histaglobulin was found to be effective in producing long-term remission and it reduced the antihistamine requirement as well. Thus, it can serve as an effective alternative to existing treatment modalities.

Dermatological problems in the geriatric population are common and often underestimated.A few studies are available on the dermatologic diseases in this population. Hence, this study is undertaken to evaluate the spectrum of skin changes in the elderly population. This study was conducted in the Department of Dermatology, Sri Devaraj Urs Medical College, attached to RL Jalappa Hospital, Kolar, Karnataka, India. A total of 300 patients were recruited for this study, among them 185 (61.6 %) were males and 115 (38.4%) were females. All the patients aged more than 60 years with skin disorders attending the dermatology OPD were included in the study. A detailed physical and clinical examination was performed for all the study subjects. Patients with genodermatoses, albinism, premature aging and inherited disorders of DNA which may interfere with chronological aging skin were excluded from the study. Out of 300 patients, 185 cases (61.6%) were males and 115 cases (38.4%) were females. Pruritus was the commonest complaint in 186 patients (62%). Among the chronological changes of aged skin, wrinkling was the commonest manifestation observed in 282 (94%) cases. The most commonly observed diseases were eczematous dermatitis in 133 (44.3%) cases, followed by infections and infestations in 122 (40.6%) and papulo-squamous diseases in 33 (11%). A total of 46 (15.3%) patients were found to have papulo-squamous disorders. Psoriasis vulgaris was observed in 21 (7%) cases. Among premalignant and malignant disorders, 4 (1.3%) cases had actinic chelitis, 2 (0.6%) cases of basal cell carcinoma and 1 (0.3%) case of squamous cell carcinoma. A total of 5 patients had connective tissue disorders. The comorbid conditions included hypertension in 49 (16.3%) cases, followed by diabetes mellitus in 31 (10.3%) and 5 (1.6%) patients had hypothyroidism. Dermatological findings in geriatric population are universal and cause considerable morbidity. This would necessitate the need for conducting an exclusive evaluation for these patients.

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Bowen's disease is a form of intraepidermal squamous cell carcinoma (SCC). It usually presents as a well-demarcated, slow growing erythematous patch, or plaque with a scaly or crusted surface. The size of the tumor varies from a few millimeters to several centimeters. The risk of progression into an invasive carcinoma is 3-5% in extragenital lesions and about 10% in genital lesions. We present two cases of Bowen's disease where the pattern, size, and perception of the disease between the patients varied. The two cases demonstrated two varying spectrum of the disease, one being a giant lesion and other a dwarf. One patient was more concerned about the lesion, whereas the other patient neglected the lesions, though widespread. High index of suspicion is required to diagnose such atypical presentations of Bowen's disease. As Bowen's disease has tendency to progress to SCC, it should be diagnosed and treated as early as possible.

Herpes zoster is a common dermatoses occurring in a dermatomal fashion. Rarely it occurs in a multi-dermatomal distribution. Disseminated cutaneous zoster in otherwise healthy persons who are not on immunosuppressive therapy and have no underlying cancer is rare. we report a case of Disseminated cutaneous zoster in a healthy male