TUBERCULOSIS OF THE SKIN IN HONG KOKG (A REVIEW OF 160 CASES)

SUMMARY.— 160 cases of tuberculosis of the skin seen in the Government Dermatological Clinics in Hong Kong are reviewed.
Tuberculosis verrucosa was the commonest form and accounted for 46% of cases. The onset was below the age of 20 in 77% of these patients.
The distribution of the lesions differed from that reported by most recent authors. The knees, thighs and buttocks were commonly affected.
In 3 of 9 cases of papulonecrotic tuberculid in men the penis was involved.
The degree of sensitivity to tuberculin appeared to be similar in all forms of cutaneous tuberculosis.
Pulmonary infection was associated in about 10% of cases of cutaneous tuberculosis.
The factors possibly responsible for the differences between the present and other series of cases are briefly discussed.     

THE SKIN CHANGES IN SCLERODERMA (SYSTEMIC SCLEROSIS)

Scleroderma (systemic sclerosis) may be subdivided into an acrosclerotic form (Types 1 and 2) and a diffuse form (Type 3) on the extent of the skin involvement. The acrosclerotic form has generally a relatively good prognosis and the diffuse form a poor prognosis. Although there is a general tendency for the skin sclerosis to progress, the change may be slow and may halt. Other skin manifestations include pigmentation, telangiectases, calcinosis, hyperkeratoses and various forms of ulceration. Recent studies on electron microscopy and biochemical findings in scleroderma skin are described. They indicate the presence of young collagen.     

DERMATOLOGICAL MANIFESTATIONS IN HIV-INFECTED PATIENTS AT A TERTIARY CARE HOSPITAL IN A TRIBAL (BASTAR) REGION OF CHHATTISGARH, INDIA

Background:

Cutaneous disorders during HIV infection are numerous and skin is often the first and only organ affected during most of the course of HIV disease. Some Cutaneous disorders reflect the progression of HIV disease; though the relation is still controversial.

Aims:

The objective of this study, conducted at a tertiary care centre in Bastar, Jagdalpur, is to estimate the status of cutaneous manifestation in HIV-infected patients and its relationship with CD4 cell counts.

Methods:

We enrolled 137 HIV positive subjects. Demographic information such as age, gender, weight, height, socioeconomic status, and educational status were recorded. Laboratory parameter (CD4 counts) and treatment regimen were noted. Patients were examined for skin disorders by a dermatologist. Data were analyzed using chi-square test for categorical variables.

Results:

Majority of the patients were from rural area (65.69%) and belonged to a low socioeconomic and educational status. 30.65% of the patients were housewives, 23.35% drivers, and 16.78% labourers. Predominant mode of transmission was heterosexual contact (94.16%). Most common HIV-related dermatological manifestations were seborrheic dermatitis (74.16%), xerosis (52.5%), generalized skin hyperpigmentation 56 (46.67%), onychomycosis 53 (44.16%), pruritic papular eruption 27 (22.5%), oral candidiasis 21 (17.5%), photo dermatitis 21 (17.5%), and scabies 4 (3.33%). Significant correlation with low CD4+ cell counts was found for oral candidiasis (P < 0.0001) and Kaposi''s sarcoma (P = 0.03), while other disorders such as seborrheic dermatitis (P = 0.22), xerosis (P = 0.25), and onychomycosis (P = 0.08) were not statistically significant.

Conclusion:

This study showed high prevalence of dermatological manifestations in HIV-infected subjects, and they occur more frequently with progression of HIV and decline in immune functions. Therefore, early diagnosis and management of skin disorders can improve the quality of life of HIV-infected subjects.     

AN IN VIVO AND IN VITRO STUDY OF THE CYCLOPHOSPHAMIDE-INDUCED ENHANCEMENT OF CONTACT SENSITIVITY TO 2,4-DINITRO-1-CHLOROBENZENE (DNCB)

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