Sanjiv Jain

Inoculation Lupus Vulgaris

An 11‐years‐old girl with lupus vulgaris on the right buttock following inoculation is described. The diagnosis was formed by the history, morphological characteristics, Mantoux test, histopathology, and was supported by an affirmative response to short course intensive chemotherapy (6 months). This route of infection acquires special significance with the worldwide‐spread of HIV infection.

In situ characterization of lymphocytic immunophenotypes and interleukin-2 receptors in cutaneous tuberculosis and leprosy–a comparative evaluation

The granulomas of lupus vulgaris (LV) were characterized by preponderance of CD4+ lymphocytes and a raised CD4+/CD8+ ratio. In contrast, in scrofuloderma (SF) the CD8 T‐lymphocyte subpopulation predominated and the CD4+/CD8+ ratio was significantly decreased. A higher percentage of lymphocytes expressed interleukin‐2 receptor (IL‐2R) in LV as compared with SF, indicating an activated cellular immune response in the former. Immunophenotypic changes in tuberculosis verrucosa cutis {TBVC) were intermediate between LV and SF. CD4+ lymphocytes were the main infiltrating T‐cell type in borderline tuberculoid leprosy (BT), while CD8+ lymphocytes predominated in the granuloma of lepromatous lepromatous (LL). The CD4+/CD8+ ratio and percentage of lymphocytes expressing IL‐2R was significantly higher in BT as compared with LL. These immunophenotypic findings suggest that in both cutaneous tuberculosis and leprosy there is a continuous spectrum with regard to cell‐mediated immunity depending on the clinical presentation.

Cutaneous drug reactions

Drug reactions are a legacy of the rapid strides made in the development of pharmaceuticals worldwide. It is, therefore, imperative to comprehend these reactions in order to prevent such episodes and subsequent recurrence and, also to create awareness among patients of such an eventuality. The pathogenesis of cutaneous adverse reactions to drugs is varied, and multifactorial. Immunological, non-immunological (pharmacological), toxic and genetic factors are some of the mechanisms involved in explanations of drug reactions. The types of mechanisms specified do not account for all drug reactions. Many factors interact to determine the ability of a drug to elicit an adverse reaction.

SCROFULODERMA AND CARIES SPINE

A 27-year-old woman was apparently well until 2 years ago, when she developed asymptomatic small, firm swellings in the neck. The swellings were mobile. In a few months, the overlying skin developed bluish discoloration and was adherent to the swellings. The swellings burst through the overlying skin discharging mucopurulent material. Ever since, the discharge oozed out intermittently through the sinuses. A few months later she developed backache; she also had difficulty in walking and bending. The practitioner prescribed medicine to which the response was poor.

Langerhans Cell Histiocytosis: A Case Report and Glimpses into Its Nomenclature

Class I Langerhans cell histiocytosis (LCH) is described in a two‐ and a half‐year‐old male. The initial expression of the disease was conspicuous by the presence of extensive pustular crusted rash and, later in its course, by purpura, diabetes insipidus, otitis media, enlargement of the liver and spleen, and infiltration into the lungs. The patient expired due to extensive hemorrhage over 24 hours.

Dyskeratosis Congenita: A Case Report

Dyskeratosis congenita, an uncommon situation in females, is described in a 30‐year‐old woman. The expression of the disease was partial and was characterized by mottled pigmentation, nail dystrophy, palmoplantar keratoderma, and hyperhidrosis.

Tuberous sclerosis and spina bifida occulta.

An interesting occurrence of tuberous sclerosis and spina bifida occulta is described, highlighting their unique and previously undescribed association in a 5‐year‐old boy.

Herpetic paronychia: rapid diagnosis by tzanck smear

Paronychia, an inflammation of the nail fold, may either manifest in the form of acute or chronic infection. The acute infection may follow a simple injury to the nail fold. Staphylococcus aureus and /3-hemolytic streptococci are the usual causative microorganisms. Occasionally, Herpes simplex virus (HSV) may be the etiologicai agent. The few case reports of the latter thus far are confined to medical personnel at a high risk [1,2]. HSV is shed in the saliva of 2.5% of normal individuals [3], and it may also be present in the bronchial secretions of patients with tracheostomies [1]. Dentists and otorhinolaryngologists are frequently exposed and may be infected through implantation at traumatised/abraded paronychium [4].