Limited cutaneous scleroderma is a subtype of scleroderma limited to the skin of the face, hands, feet and forearms. We present a case of a 45-year-old woman affected by limited cutaneous systemic scleroderma involving the orofacial region and causing restricted mouth opening. The patient showed noteworthy improvement of the skin lesion by use of a combination of intralesional corticosteroid with hyaluronidase and various multiantioxidants, resulting in amelioration of her mouth opening problem. The patient gave her full informed written consent to this report being published.

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Primary or secondary nasal tuberculosis is rare and usually, it is considered as an extra pulmonary form of tuberculosis. Nasal tuberculosis infection may spread to maxillary palatal region by contagious or haematogenous route causing palatal perforation. In some instance, it may cause septal perforation with nasal obstruction which may give rise to halitosis. We report a case where, there was bilateral nasal mucosal involvement leading to severe nasal obstruction. This rare manifestation should be considered in areas where the disease is prevalent as delay in diagnosis and treatment could lead to serious and life threatening complications due to local spread from the nose to the para nasal sinuses and brain.

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A 23-year-old male presented to dental clinic with three months history of bifrontal pulsatile headache which was associated with nasal congestion, right facial numbness. Subsequently, he complained of photophobia and pulsatile tinnitus in both the ears for past two weeks. The pain intensity was 4 on the Visual Analogue Scale (VAS) lasting five hours and gradually progressed over the next five days to a score of 6 on VAS.There was no previous history of trauma and no family history of headache, migraines. There was no prior history of thrombosis and thrombophilic predisposition. His past medical history was remarkable for maxillary sinusitis for which he had been on self medication acetaminophen 650 mg (Dolo 650) three times a day as required for past one month. On physical examination he was conscious, oriented, and haemodynamically stable with normal visual acuity but grade III papilloedema on fundus examination. Rests of the cranial examinations were normal and there was no motor or sensory deficit or incoordination. Signs of meningeal irritation were present with positive kernig's sign.Preliminary laboratory investigations including a complete haemogram, routine urine test were normal. The Cerebrospinal