A. Kamalam

Cutaneous infection by Cryptococcus laurentii

Crypiococcus laurentil was isolated twice from cutaneous granulomas in the leg and foot of a 40‐yearold man. Histologically the cells of C. laurentii were found in groups in the dermis and also inside giant cells. There was cpithelioid cell infiltration in the dermis and subcutis. An atypical mycobacterium was isolated in addition to C. laurentii. Therapy with anti‐tuberculous drugs after an initial amphotericin B infusion was found to be satisfactory.

Tinea capitis an endemic disease in Madras.

A study ofTinea capitis in Outpatient Clinic, Skin Department, Government General Hospital, Madras during a three year period from November, 1973 to October, 1976, has shown a gradual increase in incidence of 3.56%, 5.09 % and 6.25 % respectively. Findings suggest thatTinea capitis is endemic in South India. Male children were more commonly affected than female children and the age groups chiefly affected were between 5 and 10 years. A considerable number of adults were also affected. The disease showed no correlation to environmental temperature, humidity and rainfall but was correlated to all types of mycoses and total incidence of mycoses.Among 357 isolates,Trichophyton violaceum was the commonest in 264 (73.94%) andT. tonsurans was the next common in 47 (13.16%). The other agents wereT. rubrum in 30 (8.4%),T. mentagrophytes in 11 (3.08%) andT. simii in 5 (1.4%). Noninflammatory lesions were more common than inflammatory lesions and both were produced byT. violaceum andT. tonsurans, suggesting strain differences in pathogenesis. Treatment with oral griseofulvin was satisfactory in all but had to be discontinued in 4 patients due to side effects.

An unusual presentation of Trichophyton violaceum infection

A case with encapsulated Tricophyton violaceum abscesses in the skin is recorded. Defective cell mediated immunity was shown in the patient and in his two cousins. This defect combined with malnutrition, hypoadrenalism and griseofulvin resistance gave unusual lesions and chronicity. A probable genetic factor for the defective cell mediated immunity is postulated.

Scenario of chronic dermatophytosis: An Indian study

Chronic dermatophytosis was observed in 2276 (10.02%) of 22 692 patients with dermatophytosis during a period of 5.5 years. Males were affected at least 3 times more frequently than females. The age group most commonly affected was between 20 and 40 years of age. Females were affected more between the ages of 30 to 40 years. Tinea cruris and tinea corporis were the most common clinical types and tinea pedis was the least common type observed. The most frequent isolate was Trichophyton rubrum followed by T. mentagrophytes and T. violaceum. Ichthyosis vulgaris was the most common cutaneous association whereas atopy and diabetes mellitus were the most common systemic associations.

Paronychia and black discoloration of a thumb nail caused by Curvularia lunata

Chronic paronychia associated with black discoloration of the left thumb nail in a 51 year old female caused by Curvularia lunata is reported for the first time. The keratolytic activity of the fungus in the nail and its complete clearance by topical clotrimazole are reported.

A clinico-pathological study of actinomycotic mycetomas caused by Actinomadura madurae and Actinomadura pelletierii

Twenty seven cases of actionomycotic mycetoma caused either by Actinomadura madurae or Actinomadura pelletierii have been described. Infection by A. madurae has been more common than A. pelletierii. Left foot in A. madurae and right foot in A. pelletierii infections were involved more commonly in adult males, whereas right foot of the females was frequently affected in A. madurae infection. Large, soft, white grains in A. madurae and small, firm, red grains in A. pelletierii were consistantly seen. Deep hematoxylin stained grains with scalloped margin and prominent eosinophilic club in A. madurae and such deep stained grains with smooth margin and horizontal cracks appearing as protions of a spherical mass in A. pelletierii were diagnostic. Large numbers of plasma cells and Russel bodies were also characteristic of A. madurae infection. Both the grains were stainable with Von Kossa method for calcium. Bone changes were similar in both the infections. Oral tetracycline produced soft tissue and bone resolution to almost normalcy in those who regularly consumed the drug any time from 2 to 6 years. Mild glucose intolerance, facial hyperpigmentation and urticaria were the side effects observed in a few. Two patients developed cataract following tetracycline therapy. The value of medical therapy with oral tetracycline in Actionomadura mycetomas is emphasized.

Basidiobolomycosis—A Case Report

A case of subcutaneous phycomycosis with clinical, histological and mycological studies is reported. An excellent result with oral potassium iodide therapy was observed.

Black grain mycetoma — 2 case reports

Two cases of black grain mycetoma, one owing to Madurella grisea and the other due to M. mycetomii have been reported. The clinical features appear to be less florid than that occurring in actinomycotic mycetoma. There was no bone involvement in either of the two cases. These two are the first cases of black grain mycetoma from our institution.

Nocardiosis. Two case reports

Two cases of Nocardiosis involving unusual sites are reported. The diagnostic value of the appearance of the organism in section is emphasized. The remarkable tolerance to sulphonamide drugs is noted.