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Mucormycosis is a rare angioinvasive fungal infection commonly found in immunocompromised individuals, especially in an intensive care setting. Rhino-orbito-cerebral (ROCM) form is the most common presentation in patients with diabetes mellitus in India. A high index of clinical suspicion in picking up early subtle clinical signs such as periorbital edema, sinusitis, and ophthalmoplegia coupled with an aggressive management plan including systemic antifungals and surgical debridement of invaded tissue can often avert an otherwise fatal outcome in susceptible patients. We report a case of ROCM in a 37-year-old male with diabetic ketoacidosis.

Background: Leprosy is a chronic communicable disease caused by Mycobacterium Leprae. Despite the multidrug regimen against this formidable pathogen for nearly four decades, leprosy remains a public health scourge. The World Health Organization has intensified its efforts to eliminate leprosy by launching “Global Leprosy Strategy 2016–2020. Notwithstanding, India had accounted for 60% of new cases globally in 2016. Aims: The aim of this study is to describe the clinical and epidemiological spectrum of leprosy patients encountered at a tertiary care center in Western Maharashtra. Settings and Design: Record-based, retrospective, descriptive study. Methods: Case records of leprosy patients treated at a tertiary care hospital over 10 years were studied. Two hundred and thirteen cases that fulfilled the World Health Organization's 1998 case definition of leprosy and whose case records were replete with a basic demographic, case history, examination, and treatment details were included in the study. Statistical Analysis: Data were compiled in MS Excel and analyzed with the SPSS statistical software version 20. Results: Majority (87.3%) cases were multibacillary leprosy. A significant number of patients had borderline tuberculoid leprosy (71.5%). Meantime taken for the diagnosis, i.e., time taken from the onset of symptoms to diagnosis was 271.74 days. Contact tracing could be elicited in only 1.4% of cases. A light-colored numb patch was the most common clinical presentation in 79% of patients. 96.7% of patients had peripheral nerve thickening, of which, the ulnar nerve was the most frequently involved (93.5%). Ninety-nine (46.5%) cases had documented leprosy reactions. Grade 2 disability accounted for 23% cases with claw hand as the most common deformity in17.4%. Conclusions: The present study provides an insight into disease burden as well as the effectiveness of health services at a tertiary care hospital in Western Maharashtra. The study also highlights the importance of early diagnosis and management of leprosy and reactions, thereby minimizing deformities and disabilities.

Leprosy has a wide range of clinical manifestations, which sometimes imposes a clinical challenge and may lead to misdiagnosis. Interactions between leprosy and human immunodeficiency virus (HIV) have been little studied and poorly understood to date. However, coinfection still poses dilemmas in leprosy as to the occurrence of the immune reconstitution inflammatory syndrome manifesting as clinical leprosy and reversal reactions, higher chances of relapse after the successful completion of the multidrug therapy (MDT) and drug interactions between MDT and antiretroviral therapy. Furthermore, coinfection can lead to atypical clinical manifestations of leprosy. Herein, we describe a rare presentation of leprosy in a patient of HIV infection who reported with papulosquamous lesions over both upper and lower limbs histopathologically consistent with Hansen's disease.

Introduction: Skin biopsy is an indispensable tool in dermatological diagnosis.Various factors that influence the outcome of a biopsy include information recorded on the histopathology request form by the treating dermatologist to the reporting pathologist. Conversely, a good biopsy report is vital for the clinician to arrive at a diagnosis. Materials And Methods: The present study was conducted at a tertiary care hospital in the form of a retrospective investigation of histopathology requisition forms and reports of skin and mucosal biopsies done over a period of one year.If the pathological diagnosis was definite and matched one of the clinical diagnoses, it was grouped under the category definite and consistent. If the pathologist gave a descriptive diagnosis that matched one of the clinical diagnoses, it was grouped under the category descriptive and consistent. If the pathologist gave a definite diagnosis that did not match any of the clinical diagnoses, it was grouped under definite and inconsistent and if the pathological diagnosis was descriptive and did not match any clinical diagnoses, it was grouped under descriptive and inconsistent. Data analysis was done using R Statistical Software v3.6.0 (R Statistical Corp, Vienna, Austria). Level of significance was set at p

Hansen's disease is a chronic infectious granulomatous disease with varied clinical presentation. Histoid Hansen's disease is an important emerging lepromatous subset of Hansen's disease known to mimic varied dermatoses. Occurrence of reactions, especially erythema nodosum leprosum (ENL), is rare in this form of leprosy. We report a case of Histoid Hansen's disease with initial presentation of ENL while undergoing management for infertility.

Hansen's disease is caused by Mycobacterium leprae. The disease is known to involve the visceral organs including the testis apart from the skin and nerves in the lepromatous pole of leprosy due to widespread hematogenous dissemination of lepra bacilli. Furthermore, there can be testicular pain during the type 2 reaction in Hansen's disease. Filariasis is a disease caused by the parasitic nematode, Wuchereria bancrofti. This infection most commonly results in lymphedema and secondary vaginal hydrocele with an associated epididymo-orchitis. Acute epididymo-orchitis is either seen in the acute phase or as a part of secondary bacterial infections. The particular interest of this paper is to report the case of Hansen's disease who presented with testicular pain and posed a diagnostic dilemma when his pain did not respond to the standard mode of treatment and an alternate rare diagnosis was sought. This case report also emphasizes the need of reconsideration of diagnosis when the patient is not responding to standard therapy.

A 4 year old boy presented with history of itchy raised lesions on body of 2 years duration. Though parental consanguinity was not present, his elder brother had similar complaints. Dermatological examination revealed multiple hyperpigmented papules with a central keratotic plug distributed mainly over face and extensors of upper and lower extremities. Koebnerisation was present. Skin biopsy revealed perforating collagen bundles in the upper dermis and epidermis which was confirmed by Van Gieson staining. Patient was being treated with topical retinoids and intralesional corticosteroids with minimal relief.