<p><strong>Background</strong>: Leprosy, in 2016, globally a total of 214,783 new cases were reported over half of them were from India (135,485) alone. However, 16 other countries with pockets of high endemicity were reported. On the other hand, actual numbers of people affected by the disease is likely to be far higher than statistics show as there still prevails lack of awareness about the disease, lack of skills of general health staff in leprosy diagnosis, inadequate active case findings, lack of inclusion of cases from private sector and presence of high stigma in the community. Aims and objectives were to study the number of increasing new cases of Hansen’s disease in post elimination era.</p><p><strong>Methods</strong><strong>:</strong> A prospective observational study of number of new cases of leprosy presented at a department of DVL, BMCH, Chitradurga, Karnataka, from 2017 April-2018 September. A total of 91 cases were detected.</p><p><strong>Results:</strong> Series of 91 cases were detected, and based on WHO classification were classified as multibacillary (MB)-72 cases and paucibacillary (PB)-19 cases. The maximum number of cases were detected between 20-29 years of age. The male to female ratio was 1.2:1. 46 (50.54%) cases were diagnosed to have borderline tuberculoid (BT). Patients mainly belonged to low socioeconomic status (89.1%). Deformities were seen in 21 (23.07%)) cases. 7 patients presented with type-I reaction and 13 patients with type-II reactions.</p><p><strong>Conclusions:</strong> Even with MB-MDT and monitoring, some high endemic pockets of leprosy may continue to persists in India. Every year new cases are increasing and causing morbidity from neglected cases. We should not be complacent at this stage because it may become a serious health problem again.</p>

<p class="abstract"><strong>Background:</strong> Erythroderma is a cutaneous morphological reaction pattern of skin having many underlying causes and finding the etiology helps in the proper management of erythroderma cases.</p><p class="abstract"><strong>Methods:</strong> A cross sectional study was performed at the department of dermatology, Basaveshwara Medical College, Hospital and Research center, Chitradurga. Authors studied 30 consecutive cases of erythroderma from July 2017 to June 2019 with respect to the epidemiological, clinical and histological data. Clinico-histological correlation was analyzed for etiology of erythroderma.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of onset was 35.03 years with a male to female ratio of 3:2. In addition to erythrema and scaling that were present in all patinets, other co-existent features included were pruritus (43.3%), fever (23.3%), and edema (16.7%). Of the pre-existing dermatoses, psoriasis was the most common (36.6%) disease followed by eczema (26.7%), drug-induced erythroderma (16.7%), colloidan baby (3.3%), pityriasisrubrapilaris (3.3%) and in 13.3% of cases, etiology could not be ascertained. Clinico-histopathological correlation could be established in 73.3% of cases.</p><p class="abstract"><strong>Conclusions:</strong> In all erythroderma cases cutaneous features were identical irrespective of etiology. Detailed history, clinico-histopathological examination and other necessary haematological investigations helps to establish the etiology of erythroderma which helps in further management.</p>

Rheumatological illnesses are common differential diagnosis in the evaluation of childhood fever of unknown origin (FUO). We report an 11-year-old female child referred as FUO for eight months, possibly sarcoidosis. Her past records showed treatment for UTI, enteric fever in initial two months of fever. She was referred to tertiary institute due to recurrence of fever, multiple joint pain, right eye pain where she underwent evaluation for FUO. Investigation showed positive anti-nuclear antibody (ANA), elevated ESR. She was diagnosed as a case of juvenile idiopathic arthritis (JIA) with uveitis and treated with steroids, disease-modifying anti-rheumatic drugs (DMARDs). Two months later, she developed fever, multiple joint pain and worsening right eye visual acuity.Ophthalmic reevaluation revealed panuveitis and periphlebitis. CT chest showed mediastinal lymphadenopathy.With the above features, childhood sarcoidosis was suspected and treated with T. Azathioprine. Child was referred to our institute due to return of fever spikes. On examination, she had intermittent fever, plaque like lesion in cheeks? lupus pernio,, but skin biopsy was suggestive of SLE. Investigations showed positive ANA by indirect immunofluorescence (IIF), positive anti dsDNA (IIF), low complement (C3), positive immunoblot for SmD1, U1RNP, SSA/Ro60. Diagnosis was revised as childhood SLE with one clinical and three immunological criteria. She responded to steroids and immunosuppression. We report this case of childhood lupus presenting as FUO, multiple joint pain, uveitis, periphlebitis, without specific skin lesions, renal and hematological manifestations.We emphasize the need for meticulous evaluation and long term follow up for children with FUO diagnosed as rheumatological illness. The slow evolution of disease process and atypical presentation of common illnesses may lead to diagnostic dilemma.

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