Chemical peeling--evaluation of glycolic acid in varying concentrations and time intervals

Thirty-one patients with melasma, 4 with superficial post acne scarring and one each with xeroderma pigmentosum and epidermal naevus were studied to know the efficacy of glycolic acid for chemical peeling in varying concentrations and time intervals such as 35% (4 minutes), 52.5% (3 minutes), 70% (2 minutes) at varying intervals upto 6 months. These patients were in the age group of 17-44 years. These patients were followed up regularly. Results showed significant improvement when peeling was done with 52.5% glycolic acid for 3 minutes in melasma, 70% glycolic acid for 2 minutes in superficial post acne scarring.     

Efficacy of co-trimoxazole in Donovanosis. A preliminary report.

Co-trimoxazole (Septrin, Wellcome) was prescribed in a dose of two tablets twice daily for the treatment of 10 patients with Donovanosis. All the patients responded well to this treatment, and the ulcers healed completely within 10 days in eight patients and within 14 days in the remaining two. Ten days' treatment with 40 tablets of co-trimoxazole is suggested as sufficient to treat Donovanosis. No adverse reactions were noted in any patient.     

Wiedemann-Rautenstauch syndrome

Wiedemann Rautenstauch (WR) syndrome is a rare autosomal recessive neonatal progeroid syndrome with only few published case reports. We describe a neonate showing clinical features of WR syndrome with peeling of skin, and presented with weak cry and breathing difficulty since birth.     

Further evidence of the efficacy of co-trimoxazole in granuloma venereum.

One hundred and sixteen patients with granuloma venereum were treated with cotrimoxazole two tablets twice daily. All the patients responded; most of them required treatment for 10-15 days. Only two patients had recurrences, which were probably due to reinfections. No side effects of the drug occurred. Co-trimoxazole is considered to be the treatment of choice for granuloma venereum because of its high efficacy, few side effects, easy administration, and absence of any risk of masking concomitant syphilis.     

Incidence of lymph node and adnexal metastasis in endometrial stromal sarcoma

Objective

To determine the incidence of adnexal and lymph node (LN) metastasis in newly diagnosed endometrial stromal sarcoma (ESS).

Methods

We identified all cases with a diagnosis of ESS evaluated at our institution from January 1, 1980 to October 31, 2009. All uterine pathology was reviewed at our center. High-grade or undifferentiated tumors and ESS arising in extrauterine sites were excluded. Pertinent clinical data were abstracted from electronic medical records. Appropriate statistical tests were performed using SPSS16.0.

Results

We identified 94 cases of ESS. LN metastasis was identified in 7 (19%) of 36 patients who underwent LN evaluation. Six of the 7 cases with LN metastasis had lymphovascular invasion (LVI). LVI status was not reported in the other case. Five of the 7 patients with LN metastasis had grossly positive LNs with or without other gross extrauterine disease. Of 20 patients with disease grossly limited to the uterus and grossly normal LNs, 2 (10%) had LN metastasis. Both of these cases had LVI and extensive myoinvasion. Eighty-seven cases (93%) underwent salpingo-oophorectomy. Adnexal metastasis was identified in 11 (13%) of 87 cases, all manifested by gross adnexal tumor and occurring in patients with other gross pelvic extrauterine disease.

Conclusion

The incidence of LN metastasis in ESS is commonly associated with gross extrauterine disease, extensive myoinvasion, and LVI. Since myoinvasion and LVI status often are not assessable at the time of hysterectomy, LN dissection remains a reasonable option at primary surgery. The rate of adnexal metastasis appears to be negligible in the absence of gross adnexal and extrauterine tumor.