Scleredema adultorum of Buschke associated with hypothyroidism and liver cirrhosis

Scleredema adultorum of Buschke is a rare disorder of the connective tissue, involving the skin. Here, we present a 61-year-old male, who is a known case of compensated liver cirrhosis with a past history of being treated for autoimmune thyrotoxicosis, who presented with complaints of alopecia, skin tightening, dry skin, pruritus, and woody indurated plaques on the skin of the upper back, shoulder, and arms. Skin biopsy of the arm revealed the characteristic features of scleredema. He was extensively evaluated for known literature-cited causes of scleredema, and the work up revealed a negative result. He was also found to be hypothyroid on presentation. Hence, we present a case of scleredema occurring in a patient with hypothyroidism and chronic liver disease, which to our knowledge is being described for the first time in literature.

Botryomycosis

Botryomycosis is a rare chronic bacterial granulomatous disease that usually involves skin and rarely viscera. Main etiological agent is Staphylococcus aureus and less commonly Pseudomonas spp., Escherichia coli, Proteus spp., Streptococcus spp. We here report a case of 32-year-old male with polymicrobial botryomycosis on forehead and on frontal scalp. Culture from lesions revealed growth of S. aureus initially. Partial resolution was achieved with cefadroxyl and clavulanic acid, rifampicin, and linezolid. Subsequent repeat culture revealed E. coli sensitive to netilmycin. Slow and steady resolution was achieved with surgical debridement and combination therapy of injectable netilmycin and oral sufomethoxazole and trimethoprim for a prolonged period.

Pyoderma gangrenosum

Four patients aged 8, 35, 45 and 50 years (3 males and 1 female) were admitted to SCBMCH, Cuttack, skin and VD Department with multiple, painful, non healing phagadenic ulcers over body and not responding to the conventional therapeutic agents. The female patient was having severe seropositive rheumatoid arthritis. Pus culture was negative in all the cases. All the patients responded well to corticosteroid given systemically, but one male patient was having recurring episodes and ulcers healing hardly. He was given topical oxoferrin (TCDO) topically twice daily along with other supportive therapy. He responded well.

Mycobacterial cervical lymphadenitis in childhood

A study of 190 children of chronic cervical lymphadenitis showed tuberculous etiology on histopathological examination in 92 (48.4%) and bacteriological evidence of mycobacterial infection (smear and/or culture) in 42 (22.1%). Of these 42, twelve (28.6%) showed histopathological diagnosis of non-specific lymphadenitis. Positive culture for mycobacteria was obtained in 40, of which 30 (75%) were typical M. tuberculosis and 10 (25%) were atypical mycobacteria. The most predominant species of typical mycobacteria was M. scrofulaceum (60%) followed by M. avium intracellulare (40%). There was no remarkable difference in the histopathological pattern of those in which M. tuberculosis was grown and those in which bacterial growth was that of atypical mycobacteria. The diagnosis of chronic cervical lymphadenitis should therefore be taken a step beyond histopathology, up to complete bacteriological examination, especially to confirm the cases of mycobacterial lymphadenitis caused by atypical mycobacteria.

Primary intraosseous meningioma of orbit and anterior cranial fossa: a case report and literature review

Primary intraosseous meningiomas of the skull base are rare. Extensive involvement of the skull base by the tumour may result rarely in loss of vision. Surgical management requires extensive decompression and reconstruction. A case of primary intraosseous meningioma of orbits and anterior cranial fossa presenting with painless proptosis and loss of vision is presented here and the literature reviewed.

Changes in the corneal Na-K ATPase levels in eyes stored in moist chamber at 4 degrees C

This report deals with a chronological measurement of Na-K ATPase enzyme activity in human and bovine corneas stored in a moist chamber at 4 degrees C. Paired human and bovine eyes were sterilized by the standard eye bank procedure and stored up to 6 days. At the desired time, the corneal endothelium was assayed for Na-K ATPase activity. The protein content of each tissue sample was also determined. In a parallel set of experiments, the viability of identical stored corneas was determined by trypan blue and alizarin red staining technique, and morphometric analysis was done to quantify the extent of the corneal endothelial damage. The human corneas showed that there was a significant progressive decrease in the Na-K ATPase activity as the storage time increased. The decrease was related to morphological endothelial damage.

Significance of placental pathology in transplacental haemorrhage

Placentae were examined from 120 women whose pregnancy and delivery was normal, from 264 women whose pregnancy or delivery was complicated, and from 98 women who were Rh-negative without antibodies and 35 women Rh-negative with antibodies. The presence of Kline's haemorrhages, intervillous thrombi, infarcts, and retroplacental haemorrhages was positively correlated with the presence of foetal cells in the maternal circulation. When there were no maternal antibodies transplacental haemorrhages occurred occasionally in the absence of such placental lesions but more frequently when these lesions were present. Moreover, the greater the number of lesions in a placenta the greater the size of the transplacental haemorrhage. In Rh-negative women with antibodies the observed incidence of transplacental haemorrhage was significantly less despite an appreciable increase in placental lesions.