A boy aged 13 years was brought to me for the following complaints Crusty yellow scaly eruption on face, scalp, both extremities and back since 13 years Frequent coryza and sneezing aggravated by cold. History of presenting illness         The boy had reddish patches over the face and neck with fever. The complaint accompanied with diarrhoea. Local applications suppressed the lesions and fever also subsided. After few days vesicular lesion started which turned into pustules. They became very crusty and covered with yellowish scabs, oozing a thin, non offensive watery fluid. Itching is mild and aggravated night. Hair mating is another complaint noted without hair loss  Past History:         The boy had yellowish agglutination in the eyes every day morning, noticed immediately after birth. This aroused suspicion of opthalmia neonatorum, since the family history elicited with exposure .The boy also had discharges from his ears.  Family History :         Father has frequent urinary complaints and apthous ulcers. he had extra marital relationship with many ladies. Mother also complained frequent vaginal discharges with urinary complaints. Had suffered severe urticaria < dust and pollen. Sister had suffered from similar episodes in childhood. None of the paternal and maternal relation have suffered from Diabetes Mellitus, Hypertension, Tuberculosis and cancer Personal history : Non vegetarian No physical deformities other than nystagmus but mentally sluggish does not know to write; to speak with others; while questioning becomes shy and answers, slowly cannot understand clearly, patient is not talking clearly, speech therapy, given at Jipmer hospital, pondicherry. Poor memory, obstinate, fair complexion, tall slender body; frequent cracks over upper & lower lips. physical generals : Non vegetarian Ambithermic Good appetite Regular bowel habits Normal thirst & urine Increased perspiration in face Have good sleep with no dreams  local examination :         Enlarged cervical lymphnodes, nodular, firm painless. treatment history :         Had treatment a various hospitals, finally at Jipmer Hospital, Pondicherry. They diagnosed as Erythroderma secondary to Atopic Seborrheic Dermatitis. Topical applications and internal medications were tried. Investigations           The blood parameters are normal and imaging studies for abdomen also normal Case Analysis & Totality : Sycosis -Chronic desquamation, scaly, crust formation. Gonorrhoea - Family history of Opthalmia neonatorum followed by nystagmus Frequent otorrhoea Thin, watery, yellow discharge Dullness of mind, sluggish, difficulty of thinking and comprehension. Skin - yellow, crusty, scaly, eruption with oily base. Rubrics (Kent Repertory                                                                   1. Generality - Sycosis 2. Mind - Dullness- Sluggish difficulty of thinking, comprehension                                  3. Ear - Discharge -Yellow                                                                                       4. Skin - Eruption - discharge yellow                                                                        5. Skin - Eruption - crusty yellow                                                                        6. Skin - Eruption - scaly yellow                                                                        7. Skin - Eruption - Desquamation                                                         8. Face - cracks - Lips                                                                             9. Eye - Nystagmus                                                              After repertorisation, Kali sulph was selected   First Prescription                                               23-12-2018 Rx    Kali Sulph 30C tds for one week          A photograph was taken, Refer the back wrapper   Follow Up 1                                           14-2-2019         Eruption++         Scales + Rx    Placebo   Follow Up 2                                        20-5-2019         No changes Rx    Kali sulph 30 / 3 dose   Follow Up 3                                     22-6-2019         Eruption reduced          Scales reduced          Ear discharge - stopped  Rx    Placebo            The patient is better no recurrence so far and still on placebo and under observation  Discussion and Conclusion          Kali sulph is an efficacious remedy in case of chronic exfoliative skin disorders with a strong sycotic base. 

Hair Transplantation...Lets change the personality n confidence

A preterm,35 wks neonate delivered by LSCS to primigravida mother with non-consanguineous B.wt-2.3kg in our OT today Apgar 6,8,8 at 1,5 &10min respectively Generalized erythema & edema over whole body, absence of eyebrows, deformed nose,fish-like scales, ?Collodion Syndrome, ?Lamellar Ichthyosis Autosomal Recessive type; Non-bullous congenital Ichthyosiform Erythroderma

A male child of age 6 year presented in OPD with erythematous patches of hair loss with itching and sometimes pain.According to history obtain from his parents the lesion is improving after medication and aggregate after stopping medication prescribed by their doctor. Suggest diagnosis and management.

5 yr old boy with white forelock and blue eyes . On further examination sensorineural hearing loss present . What is the probable diagnosis ?