No abstract

Vernal keratoconjunctivitis (VKC) is a recurrent seasonal disease of childhood, characterized by severe bilateral inflammation of the conjunctiva and by giant papillae of the superior tarsal conjunctiva, gelatinous hypertrophy of the limbus, and keratopathy. Clinical and immunohistochemical studies suggest that IgE-dependent (type I allergic) and IgE-independent (type IV allergic) mechanisms are involved in the immunopathogenesis of VKC, in which various inflammatory cells, including different T cell subpopulations play an active role via a cascade of chemical mediators. Endocrine, genetic, neurogenic, environmental and socioeconomic risk factors have been identified. The clinical course of this disease is usually benign and self-limiting, but a minority of patients will face very debilitating and sight threatening complications. The variety of currently available drugs to treat VKC include anti-histamines, mast-cell stabilizers, dual acting agents, corticosteroids and immunomodulators but none is enough to treat all aspects of the multifaceted pathophysiology of VKC. More selective drugs like anti-chemokine receptor antibodies and leukotriene receptor antagonists are under evaluation. Cyclosporine has been shown to be effective in the treatment of VKC but further randomized control trials are required to establish the minimum effective concentration. The purpose of this paper is to describe the clinical expression of VKC, to discuss its pathogenic mechanisms, and to suggest novel therapeutic strategies.

Condyloma acuminata are usually associated with persistent and recurrent infections and early surgical intervention is often required to prevent recurrences. The Buschke–Löwenstein tumor, a locally invasive, slow-growing, cauliflower-like growth, is an example of a giant condyloma acuminatum. Herein, we report a case of sexually-acquired perianal giant condyloma acuminata in a fourteen-year-old male successfully treated by electrofulguration with radiofrequency cautery under general anesthesia in a single session with no evidence of recurrence over a follow-up period of six months.

No abstract

Fungal infection on nails is most underestimated by human beings due to lack of physical inconvenience apart from unconventional appearance of nail surface. Dermatophytes, yeasts and molds are major class of fungal pathogens responsible for nail infections, clinically called onychomycosis. These infections slowly progress into severe form deteriorating nail core by deposition of fungal spores which are unaffected by topical antifungal medicines. The disease takes a long time to heal by conventional procedure of topical treatments. The preset study explains onychomycosis from pathological perspective, reviewing the clinically relevant treatment strategies. Due to limitations in terms of antifungal drug penetration and patients' hesitation towards laser therapies, the study provides an unexplored research horizon and need for developing device based strategies for treatment of onychomycosis.