Allergic contact dermatitis (ACD) to Parthenium hysterophorus is the most common cause of plant dermatitis in India. Parthenium dermatitis is caused by dry powder of leaves and flowers and hair-like structures (trichomes). Sesquiterpene lactones (SQLs) are the most important allergens responsible for ACD to parthenium. The different patterns include classical airborne contact dermatitis, chronic actinic dermatitis (CAD), exfoliative and widespread dermatitis. There is a definite trend towards a change from an airborne pattern to a CAD pattern in the natural history of parthenium dermatitis. In CAD, there is a reported increased sensitivity to UVB, UVA and even visible light. However, SQLs including parthenin, the major allergen in the Parthenium hysterophorus, has neither documented photoallergic nor phototoxic properties. Recently, the high photoreactivity of α-methylene-γ-butyrolactone ring toward thymidine and resulting photoadducts has been proposed as an explanation of the progressive evolution of allergic contact dermatitis toward chronic actinic dermatitis. However, more data is required to reach a conclusion on the mechanism of photosensitivity in parthenium dermatitis. Sunlight, especially UV radiation, may have a role in increasing the germination capacity and the amount of allergens in the Compositae family, especially in parthenium plants under appropriate conditions like summer and spring, which may contribute to high prevalence of parthenium dermatitis especially in northern India.

No abstract

Epidermodysplasia verruciformis (EV)is a rare genodermatosis characterized by an unique susceptibility to cutaneous infection by human papilloma viruses (HPVs). Pityriasisversicolor like lesions persists from childhood.

Severe Combined Immunodeficiency (SCID) is a genetic disorder characterised by the disturbed development of functional T cells and B cells caused by numerous genetic mutations. (1) These patients are extremely vulnerable to infectious diseases and early death.(1) A 1-year-old child, known case of SCID since 8 months of age, presented with septic shock. He had a swelling on the left hand for 1 month and over left hand, which was a prior site of IV cannulation and swelling over axilla since 6 months. The child received multiple blood transfusions, though no bone marrow transplant was done. We entertained a differential diagnosis of cutaneous tuberculosis, atypical mycobacterial infection, deep fungal infection and foreign body granuloma for the left hand nodule. We thought of scrofuloderma with lymphadenopathy as a diagnosis for the axillary lesion. Biopsy of the hand lesion-multiple broad aseptate hyphae with granulomatous infiltrates suggesting mucormycosis. FNAC of axillary lymph node-necrotising lymphadenitis with AFB positive. Chest X-ray HRCT-PCP Pneumonia. He was started on IV Amphotericin-B. KEYWORDSSCID Septic Shock, Hand swelling, Axilla swelling, Trauma site. HOW TO CITE THIS ARTICLE: INTRODUCTION CASE REPORTA 1-year-old child known case of SCID (Diagnosed outside by peripheral blood cytometry) since 8 months of age presented to our hospital with septic shock. He was treated earlier with Inj. vancomycin and fluconazole. On admission he was continued on IV antibiotics. He was referred to the Dermatology Department for a swelling on the left hand and left axilla. The child's mother gave history of swelling, appearing 1 month ago over left hand which was a prior site of IV cannulation and swelling over axilla since 6 months. The child had received multiple blood transfusions, though no bone marrow transplant was done. On examination-A single hyperpigmented nodule 3×2cm was present over dorsum of left hand. Another nodule of size 5×2cm was present over his left anterior axillary fold with axillary lymphadenopathy. We entertained a differential diagnosis of cutaneous tuberculosis, atypical mycobacteria infection, deep fungal infection and foreign body granuloma for the left hand nodule. We thought of scrofuloderma with lymphadenopathy as a diagnosis for the axillary lesion.

Considerable clinico-histological overlap was observed in inflammatory nodules over extremities. Histopathology alone was not helpful in differentiating one entity from another at all times since variable histo-pathological patterns were seen.