Atopic dermatitis (AD) is often treated with multiple modalities, including topical medications such as corticosteroids and topical calcineurin inhibitors (TCIs). The aim of this study was to describe the natural history of the utilization characteristics of topical treatment in those with AD. We conducted a longitudinal study of the first 4,105 children with physician-confirmed mild to moderate AD enrolled in an ongoing postmarketing safety study of pimecrolimus. Information was obtained from participants every six months using a questionnaire. Drug utilization was solely determined by the physician and patient. Over the three years of our study, an increasing number of individuals reported at least 6 months of complete control of their disease, without the continued use of a topical medication. While all study participants used pimecrolimus at the start of the study less than 40% continued to use it after 3 years of study participation. If an individual was still using a topical medication after three years of follow-up, it was most likely a topical corticosteroid. For those who continued to use pimecrolimus, the use was limited to about 60 grams of pimecrolimus in 6 months. Community-based use of topical pimecrolimus to treat AD is limited both with respect to the duration of exposure and amount or total dose of the exposure. If a topical therapy is persistent, it is most likely to a topical corticosteroid.

CSB stain is a better stain for rapid diagnosis of dermatophytoses because of ease of performance, rapidity of detection, better appreciation of morphology of fungal elements, and cost effectiveness.

Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder of keratinization caused by homozygous mutations in the gene encoding lysosomal protease cathepsin C (CTSC). It is clinically characterized by transgredient palmoplantar keratoderma (PPK) and periodontitis. A 15-year-old boy presenting with PPK from the age of 6 months and late-onset periodontitis that began at the age of 12 years is described. Mutation analysis revealed a homozygous nonsense mutation (p.Y304X) in exon 7 of the CTSC gene. Late-onset periodontitis in a patient with Papillon-Lefèvre syndrome is a rare phenotypic variation.

Background: In the treatment of phrynoderma, various nutrients have been tried in different dosages and routes with variable therapeutic outcomes.Aims: The present study was undertaken to compare the efficacy of various nutrients in the treatment of phrynoderma. Settings and Design:An open label randomized controlled study was conducted in the out-patient department of Dermatology in a tertiary care hospital. Material and Methods:The patients were divided into group of five and each patient received one of the five regimens [10 injections of Vitamin A 1 lakh units, intramuscularly (IM) on alternate day, 10 injections of Vitamin B complex, 2cc IM on alternate day, 2 table spoon of safflower oil, two times daily with meals, Tab Vitamin E 400mg once daily, and only topical keratolytic (salicylic acid 3% ointment) two times daily] respectively. The first four regimens also received topical keratolytic. The primary outcome measured was therapeutic response at the end of regimen. The response was graded based on the percentage of flattening and decrease in number of lesions. Less than 25% improvement was graded as poor, 26-50% improvement as moderate, 51-75% improvement as good, and more than 75% improvement as excellent response. In the statistical analysis, comparison was done using Chi-square and Fisher's exact test.Results: A total of 125 patients were included in the study with 25 patients each in five regimen groups. There were 79 (63.2%) males and 46 (36.8%) females with a ratio of 1.72:1. The age of the patients ranged from 3 to 26 years with mean of 10.1±4.3 years. Out of 125 patients, 105 completed the study. In regimen 1 and 2, significant number of patients showed good to excellent response whereas significant number of patients in remaining regimen showed moderate to poor response with a p value of <0.05. The therapeutic response to Vitamin A and Vitamin B complex therapy was significantly better than other regimens.Conclusion: Intramuscular injections of Vitamin A or Vitamin B are effective in the treatment of phrynoderma. Addition of topical keratolytics helps in faster clearance of keratotic lesions.