Arcanobacterium pyogenes is an established but often unrecognized human pathogen. A. pyogenes may also be misidentified as Arcanobacterium haemolyticum, which gives remarkably similar results in conventional biochemical tests. In this study, we have reported three cases of wound infections associated with A. pyogenes and also on the bacteriological characteristics which are relevant for identification of these isolates. The negative reverse CAMP test, the ability to produce acid from xylose and to hydrolyse gelatin and the positive b-glucuronidase test clearly differentiated A. pyogenes from other closely related species. All three isolates were uniformly susceptible to penicillin, ampicillin, amoxicillin-clavulanic acid, ceftriaxone and gentamicin, variably susceptible to tetracycline and erythromycin and uniformly resistant to cotrimoxazole. Only a few confirmed cases have been reported throughout the world and therefore the diagnostic evaluation of this organism is emphasized.

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Congenital insensitivity to pain with anhidrosis, also known as hereditary sensory and autonomic neuropathy type IV, is an autosomal recessive disorder characterized by the congenital lack of pain sensation, inability to sweat, episodes of recurrent hyperpyrexia, mental retardation, and self-mutilating behavior. It is an extremely rare disorder with only a handful of reports from India. A five- year- old boy, born to second-degree consanguineous parents after uneventful antenatal period, presented to us with history of recurrent unexplained fever, recurrent ulcers in the lower limbs, insensitivity to painful stimuli (like injections, vaccination) and self-mutilating behavior from early childhood. Cutaneous examination showed multiple ulcers, loss of teeth, loss of tip of the tongue (due to biting), scarring of finger tips, xerosis and lichenification. Sensory examination showed complete loss of pain and temperature sensations, but fine touch and vibration were preserved. Deep tendon reflexes were normal. Evaluation for Hansen's disease was non-contributory. An intradermal injection of histamine did not show any flare response. Based on clinical as well as compatible histological features a diagnosis of congenital insensitivity to pain with anhidrosis was made. The ulcers were treated with appropriate antibiotics and daily dressings. The parents were counseled about appropriate care of the child.

<p class="abstract"><strong>Background:</strong> Skin diseases are a major health problem in the paediatric age group and are associated with significant morbidity. Dermatoses in children are more influenced by socioeconomic status, dietary habits, climatic exposure and external environment as compared to adults. The present study was undertaken to know the prevalence of paediatric dermatoses among patients attending Dermatology outpatient department in a tertiary care hospital in Puducherry.</p><p class="abstract"><strong>Methods:</strong> All newly diagnosed, untreated male and female paediatric patients (from neonates to adolescents ≤19 years of age) attending Dermatology OPD, from October 2015 to September 2017 were evaluated to study the prevalence and patterns of paediatric dermatoses. The skin disorders were classified into groups like infections, infestations, eczemas, acne, hypersensitivity disorders, sweat gland disorders, pigmentary disorders, nevi, keratinisation disorders, hair and scalp disorders, papulosquamous disorders, bullous disorders, nail disorders, drug reactions, other dermatoses.<strong></strong></p><p class="abstract"><strong>Results:</strong> The prevalence of pediatric dermatoses in our OPD is 25.21%. Incidence of pediatric dermatoses was found to be more in males 237 (59.39%) than in females 162 (40.60%) and the majority of the patients were in adolescent age group (217; 54.38%). Present study showed that majority of cases belonged to the lower socioeconomic group 186(46.6 %). In our study, majority (58.98%) of dermatoses belonged to infections and infestations group. Of the infective dermatoses, fungal infections (27.88%) were the most common.</p><p><strong>Conclusions:</strong> Infectious dermatoses were commonly seen in this study that may be due to poverty, overcrowding, poor hygiene. There is an increasing trend of fungal infections which might be related to hygiene and environment. </p>

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