SLE can present with hematological manifestations alone or along with features of other system involvement. With a low index of clinical suspicion or inadequate follow up the diagnosis may be delayed or missed at the time of presentation, in those with hematological abnormalities as the initial manifestation. An observational study was conducted among patients of SLE, in a tertiary referral centre of North Kerala, with the purpose of estimating the proportion of patients with hematological manifestations as the initial presentation of the disease and to study their nature. It was observed that 82% of the patients had hematological manifestations at presentation. It is the most common presenting manifestation of SLE in people of North Kerala. Autoimmune hypothyroidism was one of the common coexisting abnormalities in these patients, which is not included in the American College of Rheumatology (ACR) criteria for diagnosis. Arthritis was uncommon among those who presented with hematological manifestations. A significant number of patients do not satisfy the ACR criteria at the time of diagnosis but do so on follow up. The ACR criteria are weak to diagnose such patients and therefore need revision. We therefore propose an alternative to ACR criteria as “Kozhikode criteria for SLE”.

Objectives: The objectives of the study were (1) to study the cutaneous manifestations in patients with type 2 diabetes mellitus (DM) in comparison to normal subjects and (2) to document the association between cutaneous manifestations and complications of DM. Materials and Methods: In this 1-year comparative cross-sectional study, 100 patients receiving treatment at the diabetic clinic of a tertiary center were evaluated for cutaneous manifestations and complications due to diabetes. The cutaneous features in diabetics were compared with that of normal controls. An attempt was made to find out any association between cutaneous features of DM and internal organ involvement due to diabetes. Results: Cutaneous manifestations were more frequent in patients with type 2 DM than normal controls. The most common manifestation in diabetics was fungal infection followed by bacterial infection. Diabetic dermopathy was found to have statistically significant association with nephropathy, retinopathy, and neuropathy due to type 2 DM. Limitations: Limited sample size and study confined to a tertiary referral center. Conclusions: Dermatology manifestations provide important clues of prognostic significance in type 2 DM.

Thromboembolism is a well-recognized complication of hematological malignancy. The incidence of symptomatic thrombosis at diagnosis is relatively low in AML (acute myeloid leukemia) patients, though its incidence increases on treatment with anthracyclines. We reported a case of 69 year old female with T2DM who presented with DVT and later on acute limb ischemia of the same lower limb. On hematological evaluation, she had leukocytosis and thrombocytopenia. Further evaluation revealed AML. Thromboembolism as a rare presentation of AML in adults with leukemic hyperleukocytosis has seldom been reported. In the absence of clear guidelines, early diagnosis and management are desirable.

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