Jessner’s lymphocytic infiltration of skin is an uncommon disorder characterised by benign accumulations of lymph cells in the skin. It is of unknown aetiology and presents as erythematous papules and plaques on the face, neck and/or back, with possible itching of the skin surrounding the lesions. The lesions may remain unchanged for many years and then spontaneously disappear, without residual scarring. Current literature on this topic are limited and numerous treatments have been tried with limited success. We report a recent case of Jessner’s lymphocytic infiltration seen in our practice and discuss the histology and our approach to management.

Adult onset Still’s disease (AOSD) is a sporadic complex autoinflammatory syndrome first described in 1971.1 It is characterised by high spiking fever, polyarthritis, sore throat, lymphadenopathy, hepatosplenomegaly, serositis, and evanescent skin eruptions.1,2 It is associated with life-threatening complications too. Diagnosis of AOSD is laborious as it requires extensive investigations to exclude infections, autoimmune diseases and malignancy. Here we illustrate a young female who exhibited a turbulent presentation of ASOD.

Overlap syndrome is a term used to describe a condition wherein a patient has features of more than one classic inflammatory rheumatic disease like systemic lupus erythematosus, polymyositis, scleroderma and rheumatoid arthritis. Individuals with an overlap syndrome may, but need not meet, complete diagnostic criteria for one or more than one classic rheumatic disease. Mixed connective tissue disease is a specific subset of overlap syndrome wherein patients have antibodies to the U1 small nuclear ribonuclear protein (anti- U1RNP) and clinical features like hand edema, synovitis, Raynaud phenomenon, acrosclerosis and biologically or histologically proven myositis. We came across an interesting case showing clinical features of both Systemic Sclerosis and Discoid Lupus erythematosus (DLE). On complete evaluation, a final diagnosis of Diffuse Systemic Sclerosis - DLE overlap was made on the basis of histopathopathological and serological findings. Patient was started accordingly on systemic and topical medications and responded well.

Histiocytic proliferation of the skin can be categorised into Langerhan and non-Langerhan types. Benign cephalic histiocytosis (BCH) is a rare cutaneous non-Langerhan histiocytosis typically affecting infants and young children. We report a case of benign cephalic histiocytosis in a boy who, at seven months of age, presented with multiple yellowish papular eruptions on his face. Over the course of 18 months, the lesion spread to his trunk and upper extremities, sparing the mucous membranes, palms and soles. There was no systemic involvement identified. A histopathologic examination of the skin lesion showed diffuse infiltration of histiocytes within the superficial dermis intermingled with scattered eosinophils and small lymphocytes. Immunohistochemical studies showed that the histiocytes were diffusely positive for CD68. Langerhan markers CD1a and S100 were negative. The correct distinction between BCH and other histiocytic proliferations of the skin is important because BCH has a self-limiting clinical course with a tendency of spontaneous remission.

Nocardia species are gram-positive, aerobic, acid-fast bacteria which exist as saprophytes in nature. Invasive disseminated infections are particularly common in immunocompromised or debilitated hosts. Superficial infections with Nocardia species occur as a result of local trauma and contamination of the wound. Clinically, it may manifest as an acute infection (abscesses or cellulitis), mycetoma, or sporotrichoid infection. Herein we report a rare case of cutaneous nocardiosis following surgery mimicking a hypertrophic scar.

Maduramycosis1 is chronic infection of cutaneous and subcutaneous tissue caused by bacteria and fungi. It involves skin, subcutaneous tissue and bones.2 Here we report a case series of 14 patients of mycetoma describing their epidemio-clinical features and laboratory investigations. The most common clinical presentation in the patients were infiltrated subcutaneous swelling with multiple discharging sinus tracts (fistulas). Lesions were located on the foot in all the cases.

The use of GBL in dermatology education is not uncommon. GBL provides education to audiences around the world, wherever their learning environment allows them. The paper serves to present the experience of a medical student who developed a GBL program for malignant melanoma (MM) without prior skills in the development of GBL software or computer programming. The commercial GBL software used is ‘Chat Mapper’. The program can be published in HTML and embedded in Moodle. It allows the creation of non-linear branching dialogue trees. The users will interact with a virtual physician which discusses the clinical features, risk factors, management, staging and prognosis of MM. A 6-minute GBL program was practical to have a basic coverage of MM. To limit learner fatigue, the program is completed with audio, graphics and dialogue menus. It tailors to English-speaking users with visual and auditory learning styles. A straightforward navigating system can accommodate users at all levels of computer literacy. The program is compatible with laptop, desktop but not all phones. A period of one week was used to master the software, resolve any technical issues and to develop this program. Users who completed the program will be able to know more about MM. The program can be viewed at: https://tlderm.webnode.com/. Physicians may consider integrating GBL programs into routine practice. The development, however, might be hampered by the time factor, cost factor and the need for technical experts.

Camphor, a waxy white sublimable chemical, widely used worldwide by various communities for many religious purposes. Here we report a clinical image of self-inflicted injury from burning camphor on the palm resulting in burns. It also highlights the sociocultural pattern of this injury and need of psychopathic and therapeutic help of the patients.

Autoimmune blistering diseases (AIBD) represent a group of rare and chronic disorders with significant impact on quality of life (QoL). The aim of this study was to assess the validity and reliability of the Malay translation of the autoimmune bullous disease quality of life (ABQOL) questionnaire.

Keloid scars have always been a therapeutic challenge. Lasers due to their versatile action are being tried in the management of hypertrophic scars and keloid. Use of Nd:YAG laser especially in dark skin types is justifiable but sufficient data is not available.