Background:Sertaconazole is a new, broad spectrum, fungicidal and fungistatic imidazole with added antipruritic and anti-inflammatory activity that would provide greater symptomatic relief and hence would be beneficial in improving the quality of life for the patient with dermatophytoses.Aims and Objectives:To compare efficacy and safety of sertaconazole, terbinafine and luliconazole in patients with dermatophytoses.Materials and Methods:83 patients with tinea corporis and tinea cruris infections were enrolled in this multicentre, randomized, open label parallel study. The initial ‘Treatment Phase’ involved three groups receiving either sertaconazole 2% cream applied topically twice daily for four weeks, terbinafine 1% cream once daily for two weeks, luliconazole 1% cream once daily for two weeks. At the end of treatment phase, there was a ‘Follow-up Phase’ at end of 2 weeks, where the patients were assessed clinically and mycologically for relapse.Results:Of the 83 patients, 62 completed the study, sertaconazole (n = 20), terbinafine (n = 22) and luliconazole (n = 20). The primary efficacy variables including change in pruritus, erythema, vesicle, desquamation and mycological cure were significantly improved in all the three groups, as compared to baseline, in the Treatment and Follow-up phase. Greater proportion of patients in sertaconazole group (85%) showed resolution of pruritus as compared to terbinafine (54.6%); and luliconazole (70%), (P < 0.05 sertaconazole vs terbinafine). There was a greater reduction in mean total composite score (pruritus, erythema, vesicle and desquamation) in sertaconazole group (97.1%) as compared to terbinafine (91.2%) and luliconazole (92.9%). All groups showed equal negative mycological assessment without any relapses. All three study drugs were well tolerated. Only one patient in sertaconazole group withdrew from the study due to suspected allergic contact dermatitis.Conclusion:Sertaconazole was better than terbinafine and luliconazole in relieving signs and symptoms during study and follow up period. At the end of ‘Treatment Phase’ and ‘Follow-up’ Phase, all patients showed negative mycological assessment in all three treatment groups suggesting no recurrence of the disease.

Ten cases of entomophthoromycosis encountered in a period of 4 years in Tamilnadu are reported. Basidiobolomycosis accounted for eight cases and was seen predominantly in children. Two cases of conidiobolomycosis were seen in elderly patients. Potassium iodide was the drug of choice in the treatment of entomophthoromycosis. All our patients, except one, responded with complete resolution of their lesions.

Epithelioid hemangioendothelioma is an intermediate-grade vascular tumor arising from the vascular endothelium, which usually arises in soft tissue, and skin involvement is extremely rare. We report a case that presented with primary cutaneous tumor involving the whole limb and was present since birth.

Dermatophytosis was detected in 42% of 100 renal transplant recipients screened, of whom 17% had the infection for more than 1 year. Tinea cruris and tinea corporis were the common clinical types observed. Tinea unguium presented as proximal subungual white onychomycosis (PSWO) in 3% of patients. The lesions in the majority were non-inflammatory, scaly and without central clearance. The commonest isolate was Trichophyton rubrum.

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.

White Piedra is a superficial fungal infection of the hair caused by Trichosporon asahii. It is also known as trichomycosis nodosa or trichomycosis nodularis. We report two cases of White Piedra in a mother and her daughter for the rarity of such occurrence.

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Hyper IgE syndrome (HIES) is a rare immunodeficiency syndrome characterized by a triad of cutaneous abscesses, mostly caused by Staphylococus aureus; pneumonia; and raised IgE levels. Nonimmunological associations include course facial features, multiple bone fractures, joint hyperextensibility, and retained primary dentition. Patients require long-term antibiotic therapy. We report here a classical case of HIES with rare associations of natal teeth, bilateral cervical ribs, and conductive deafness. The patient was being treated with monteleukast and dapsone.