Successful treatment of perianal warts in a child with 5% imiquimod cream

Treatment of anogenital warts in children is difficult. Commonly used therapeutic regimes can be painful, variably effective and recurrence rates are high. Imiquimod is a recently developed imidazoquinolin heterocyclic amine that is an immune response modifier. Topical imiquimod has been used successfully to treat anogenital warts in adults. This case documents the effective use of topical imiquimod in the treatment of perianal warts in children.

Tuberculosis verrucosa cutis on the sole of the foot

We report an unusual case of tuberculosis verrucosa cutis on the plantar aspect of the foot that had been present for more than 40 years in a 62-year-old Indian man. He had a grade IV positive Heaf test and a normal chest radiograph. Mycobacterium tuberculosis was successfully cultured from the third biopsy taken from the lesion. This case demonstrates the indolent nature of the lesion and stresses the importance of taking adequate biopsies for microbiological culture when there is a high index of suspicion for M. tuberculosis. The diagnosis of tuberculosis verrucosa cutis should be based on history and evolution of the disease, cardinal morphological features and histopathological characteristics. Response to anti-tuberculosis drugs may be of assistance.

Lipoatrophy semicircularis induced by trauma

Lipoatrophy semicircularis is thought to be a rare condition characterized by band-like horizontal depressions of the skin typically involving the lower limbs. Previous literature has suggested that repetitive trauma to the lower limbs could explain this condition; however, no direct causal link has ever been clearly established. There have also been several reports where no preceding history of trauma could be found. In our series we report seven cases of lipoatrophy semicircularis representing over one-third of the staff in a particular office. We propose that the most logical explanation for the indentations present in these individuals is repetitive trauma to their thighs by the sharp edge of the desks. The consistent nature of the distance between the floor and the horizontal indentations on the lower limbs despite differences in height weight and body mass index support this theory. It is likely that this condition is more common than initially thought.