Chemical peeling--glycolic acid versus trichloroacetic acid in melasma

Melasma continues to be a therapeutic challenge. 100 patients of melasma not responding to conventional depigmenting agents were divided into 2 groups, one treated with 55-75% glycolic acid (68 patients) and the other with 10-15% trichloroacetic acid (32 patients). Applications were made after every 15 days and response assessed clinically along with relapse or hyperpigmentation after 3 month follow up period. More than 75% improvement was seen in 30%, and 50-75% improvement in 24% patients. Response with TCA was more rapid as compared to GA. Chronic pigmentation responded more favourably to TCA. Relapse and hyperpigmentation was more-25% in TCA as compared to 5.9% GA. Sun exposure was the most important precipitating factor followed by pregnancy and drugs.     

Ectrodactyly

A rare case of ectrodactyly or lobster claw without any other ectodermal involvement is presented. His family history was non-contributory.     

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.