Intrastromal injection of voriconazole may be used as a modality of treatment for managing cases of recalcitrant fungal keratitis.

Childhood vitiligo differs from adult vitiligo in many clinical parameters. The objective of the current study was to study the clinicoepidemiologic profile of childhood vitiligo and to compare various clinical characteristics of childhood- and later-onset vitiligo. The clinical presentation of vitiligo was examined and analyzed in 762 individuals attending the Dermatology Clinic of Government Medical College, Haldwani, a referral center for the Kumaun region of Uttarakhand state, India, between January 2006 and December 2010. Of the 762 individuals with vitiligo, 268 (35.2%) were children: 152 (56.7%) female and 116 (43.3%) male. The mean age of onset of vitiligo was 6.9 years. A family history of vitiligo was found in 24.3% of children. The most common site of onset was the head and neck (36.9%), followed by the lower limbs and trunk. The most common type of vitiligo observed was acrofacial vitiligo (38.1%), followed by vulgaris, segmental, focal, and mucosal. Leukotrichia was observed in 32.5% of children and Koebner's phenomenon in 24.3%. On comparison of childhood- and later-onset vitiligo, there were statistically significant differences (p < 0.05) in sex, family history, type of vitiligo (segmental and vulgaris), and site of onset. Atopic dermatitis was one of the important cutaneous diseases associated with childhood-onset vitiligo. Thirty-five percent of all patients with vitiligo were children (≤12 yrs). Childhood-onset vitilgo differs from later-onset vitiligo in many clinical parameters such as sex, family history, types of vitiligo, and sites of onset.

Most ocular injuries in children are preventable and occur from unsupervised games like bow and arrow and firecracker, which can lead to significant visual loss.

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Background:Topical corticosteroids (TC) are being misused widely on the face without a prescription from the dermatologist.Aim:To evaluate the misuse of TC-containing preparations on the face and the adverse effects due to its application.Materials and Methods:A questionnaire-based analysis was done among patients attending the dermatology outpatient department of a tertiary care hospital between March 2014 and March 2015. Patients with various facial dermatoses were asked about their current use of topical preparations and on further followup questioning, those who revealed the use of TCs (25g or more) continuously or intermittently for a minimum duration of four weeks were included in the study and observed for local adverse effects.Results:A total of 410 patients were observed, 306 were females (74.6%) and 104 were males (25.3%). One hundred and seventy-eight patients (43.4%) used topical steroids alone, 124 (30.2%) used creams containing TC, hydroquinone, and tretinoin, 108 (26.3%) used creams containing a combination of TC, antibiotic, and/or antifungal. One hundred and seventy-six patients (42.9%) bought TC or TC containing creams over the counter on their own, without the prescription of a dermatologist, 35 (8.5%) were recommended TC by a beautician (beauty parlors), 82 (20%) by their friends, family members, or neighbors, 75 (18.2%) by a non-dermatologist practitioner, and 42 (10.2%) by a dermatologist.Limitations:The sample size was small.Conclusion:Dispensing of TCs must be regulated in India; they should only be issued against a doctor's prescription.

Referenc e Organism Source of literatur e Type Common causes Common risk factors Characteristic Manifestation Treatment Outcome Other ocular manifestations 27-33 Pythium spp. Case series Filamentous fungus P. insidiosum, CL, farming, contaminated water and trauma, thalassemia Necrotic ulcer with surrounding dot-like and tentacle-like corneal infiltrates Azithromyc in, clarithromy cin, minocyclin e, tigecycline, TPK Poor, Recurrences are common Scleritis 36,44,45 Alternaria spp.

Our study suggests that the UCS therapy may be a better alternative to AMT in acute moderate to severe (grades III, IV and V) ocular chemical burns, as it avoids surgical manoeuvre in already inflamed eyes.