A clinical study of skin changes A clinical study of skin changes in geriatric population in geriatric population Sir, As advances in medical care have prolonged lifespan and expanded the elderly demographics, there is a need to evaluate various cutaneous disorders in the growing geriatric population.Two hundred patients aged 65 years and above, reporting to the Department of Dermatology, Command Hospital, Bangalore, between December 2005 and April 2007 were evaluated. A detailed history was recorded and complete examination carried out. Relevant investigations were performed, whenever indicated, after obtaining informed consent.There were 153 men (76.5%) and 47 women (23.5%). Majority were of 65 to 70 years of age (110, 55%) followed by those 71 to 75 years of age (43, 21.5%). One hundred twenty-nine cases (64.5%) had associated systemic illnesses, the most common being hypertension (80, 40%) and diabetes mellitus (59, 29.5%). and pathological cutaneous disorders presenting in the geriatric population in our study group.

A clinico-mycological study of superficial mycoses was conducted on 121 cases (98 males and 23 females). Direct microscopy by KOH mount and culture was undertaken to isolate the fungal pathogen in each case. The commonest age group involved was 21-30 years (39.6%). Dermatophytosis was the commonest clinical presentation (70.5%), followed by candidiasis (20.5%) and Pityriasis versicolor (9.0%). The commonest dermatophytosis was Tinea pedis (29.2%), followed by T cruris (26.2%). The commonest dermatophyte isolated was Trichophyton tonsurans (20.5%), followed by T rubrum (8.7%). Cultures grew a high proportion of non dermatophyte moulds (34%), of which Cladosporium spp (37.1%) was the commonest mould isolated. Total KOH positivity rate was 53.3% and total culture positivity rate was 79.1%. Our study revealed a variant local dermatophyte flora, a clinical pattern typical to our work environment in the Defence Services and a high isolation of yeasts and NDM. MJAFI 2003; 59 : 114-116Key Word : Superficial mycoses subjected to direct microscopy for fungal elements in 10% KOH with Parker Quink ink. Nail clippings were immersed in 10% KOH overnight and examined next morning. One week after the specimens were adequately dried of the moisture in the envelopes, they were inoculated in plain Sabouraud's Dextrose Agar (SDA) and SDA with chloramphenicol slants and incubated at room temperature. All cultures were examined bi-weekly for growth and incubated for four weeks before declaring them negative. The growths were noted for colony characteristics in the form of texture, surface, colour, colour on the reverse and any diffusible pigment. Tease mount, cellphone tape mount and slide cultures were undertaken for microscopic morphology [3,4]. Germ tube tests were performed on all growths identified as yeasts. As Pityrosporum is a normal skin commensal, scrapings from clinically diagnosed cases of P versicolor were subjected to KOH mount only and not cultured. However, due to non-availability of differentiation test media for yeasts and dermatophytes, no further biochemical tests were performed and the cultures were reported on the basis of the macroscopic and microscopic examination and germ tube tests only. ResultsA total of 121 patients were enrolled in the study, comprising 98 males (81%) and 23 females (19%). None of them had any systemic diseases. The commonest age group involved was 21-30 years in 48 (39.6%), followed by 31-40 years in 36 (29.7%) and 41-50 years in 18 (14.8%) cases (Table 1).A total of 146 samples were collected and 21 cases (17.3%) had multiple site involvement. Dermatophytosis was the commonest superficial fungal infection in 103 cases (70.5%), followed by candidiasis in 30 (20.5%) and P versicolor in 13 (9.0%) cases (Table 2). The commonest dermatophytosis was T pedis in 30 (29.2%), followed by T cruris in 27(26.2%), T corporis in16 (15.5%), T manuum 14

Background:The pattern of skin diseases varies form one country to another and across different parts within the same country. A two-day multispecialty medical camp was held among the local population at the district of Kausambi, Allahabad, UP, in October 2005. A cross section of pattern of skin diseases observed at the camp is reported and compared with similar studies in literature.Materials and Methods:All cases attending the medical camp were included in the study. All those with dermatological complaints were examined in detail, brief relevant history was elicited and clinical diagnosis was made.Results:Skin diseases comprised 7.86% of all those who attended the camp. The 11–20 year age group was the most common age group involved with 164 (31.4%) cases. Infective disorders were found in 59.1% and noninfective disorders in 40.9% of all the skin cases. Among the infective disorders, fungal infections were most common (54.52%), and among the noninfective dermatoses, eczemas were most common (39.2%) cutaneous disorders.Conclusion:Our study brought out a higher prevalence of infective dermatoses and a relatively higher, but statistically insignificant, prevalence of fungal infections, scabies and eczemas, thereby reflecting minor regional variance in our study group.

Aims:Tuberculous infection of the thoracic cage is rare and is difficult to discern clinically or on radiographs. This study aims to describe the common sites and the imaging appearances of chest wall tuberculosis.Materials and Methods:A retrospective review of the clinical and imaging records of 12 confirmed cases of thoracic cage tuberculosis (excluding that of the spine), seen over the last 7 years, was performed. Imaging studies available included radiographs, ultrasonographies (USGs), and computed tomography (CT) scans. Pathological confirmation was obtained in all cases.Results:All patients had clinical signs and symptoms localized to the site of involvement, whether it was the sternum, sternoclavicular joints, or ribs. CT scan revealed sternal destruction in three patients and osteolytic lesions with sclerosis of the articular surfaces of the sternoclavicular joints in two patients. In five patients with rib lesions, USG elegantly demonstrated the bone destruction underlying the cold abscess. All cases were confirmed to be of tuberculous origin by pathology studies of the aspirated/curetted material, obtained by CT / USG guidance.Conclusions:Tuberculous etiology should be considered for patients presenting with atypical sites of skeletal inflammation. CT scan plays an important role in the evaluation of these patients. However, the use of USG for demonstrating rib destruction in a chest wall cold abscess has so far been under-emphasized, as has been the role of CT and USG guided aspiration in confirming the aetiology.