Oil massaging of the newborn has been a custom in India for ages. A variety of oils have been used for this purpose. Recently, it has gained popularity in the western countries as well.

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Topical therapy is first line of treatment for mild to moderate atopic dermatitis (AD) which is the commonest form of the disease in India. Avoidance of overbathing, use of a synthetic detergent preferably with a slight acidic pH is recommended. Regular use of a moisturiser preferably containing an occlusive and a humectant which perfume free is to used liberally. Topical corticosteroids are the most important pillars of topical treatment of AD. Understanding the proper and judicious use of topical corticosteroids is of prime importance. The choice of the molecule, frequency and amount and method of application and whether or not to use combination and the proper monitoring will decide the optimum outcome to the treatment. Concomittant long term use with gradual tapering of corticosteriod is recommended. Mild recurrences can be controlled by monotherapy. Proper and judicious use of all the elements of topical therapy is needed for successful treatment outcome.

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Blueberry Muffin Baby is term given to characteristic eruption in neonates, often present at birth, comprising widespread, purple, erythematous, oval or circular macules, papules and nodules reflecting dermal erythropoiesis seen in a number of congenital infections, notably rubella, cytomegalovirus, coxsackie B2 infection, parvovirus B19, congenital syphilis, toxoplasmosis, rhesus incompatibility. Nonketotic Hyperglycinemia (NKHG) is an inborn error of glycine degradation in which large quantities of glycine accumulate in body tissues, including CNS, and has been associated with "Blue-Berry Muffin" Baby. We report an infant with blue berry muffin lesions associated with Non Ketotic hyperglycemia (NKHG). To the best of our knowledge Blue berry muffin baby with Non Ketotic hyperglycemia has been rarely reported in Indian literature.

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Cervical chondrocutaneous branchial remnants are rare and badly known lesions, located in the lower third of the lateral neck. They are similar in appearance to preauricular tags. Histologically, the lesion per definition presents as a choristoma. Treatment involves complete surgical removal in order to make an exact histopathological diagnosis. The authors report two cases, review the literature and discuss embryologic and diagnostic aspects.

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Aims and Objectives: This study attempts to find out the incidence of childhood psoriasis and the mean age of onset of the disease in children. Materials and Methods: A complete analysis of the out patient records of patients with psoriasis who had attended the Dermatology out-patient department for a period of 8 months between September 2011 and April 2012 was done. All the demographic details were collected and the age at presentation of the disease was also noted. Observation and Results: The incidence of childhood psoriasis was thus observed to be 17.15%. The incidence of psoriasis in male children and female children was thus observed to be 49.15% and 50.84% respectively. The mean age of onset of childhood psoriasis in boys was observed to be 12.8 years and in girls, it was observed to be 13.8 years. The male female ratio was observed to be 1:1.03. Conclusion: The incidence of childhood psoriasis is thus seen to have an increasing trend in recent times. Whether this translates into an increase in morbidity needs to be analyzed further through a larger study.

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Background: Erythroderma is generalized inflammatory disorder of skin manifesting with erythema and scaling affecting more than 90% of skin surface. The causes vary from place to place. It is important to establish the underlying cause wherever possible for proper management. Aim: The aim of this clinical study is to find out the etiological causes in the pediatric age group, i.e., 0-15 years. Materials and Methods: A total of 14 erythroderma patients of both sexes were included into the study between August 2008 and July 2010. Detailed history, general physical examination, mucocutaneous examinations and investigations were performed and recorded. Results: Out of 14 cases, 10 (71.4%) were boys and 4 (28.6%) were girls. Age range was between 1.5 years and 14 years. The most important cause of erythroderma in our study was found to be drugs especially for epilepsy followed by atopic eczema, psoriasis, ichthyosis and crusted scabies. Conclusion: Erythroderma in children although rare requires urgent attention as it can become life threatening if mismanaged and misdiagnosed. In our study, drugs turned out to be the most common cause so drugs should be given to minimum in children as far as possible.

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Tumoral calcinosis is an uncommon disease characterized by periarticular soft-tissue hyperplasia and calcification. Large joint such as hip, shoulder and elbow are most commonly involved. This entity usually manifest in adolescent females as slowly growing, painless, mobile soft-tissue tumor like mass around the large joint that may interfere with joint function when large. A familial predisposition has been reported. Exact cause is not known, but there is deposition of calcium phosphate with normal calcium and elevated phosphorus levels. Here, we report a case of 15-year-old female presented with symmetrical, recurrent swellings on various joints with milk like fluid extrusion and scar mark of previous excision.

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Kawasaki disease is a multisystem vasculitis predominantly involving skin and cardiovascular system. In our patient, a 35-day-old female infant presented with fever, abdominal distension, altered sensorium, seizures of 6 days duration. The baby was not responding to conventional antibiotics. Subsequently, she developed rash with vesicles over the perineum and over the palms and soles, edema of hands and feet and fissured lips. The rash appeared 4 days after the onset of systemic symptoms. As per the American Heart Association guidelines for Kawasaki disease, our patient had a fever of 6 days duration and four of the five diagnostic criteria for Kawasaki disease and hence it was a case typical of Kawasaki disease. On investigation, cerebrospinal fluid showed features of aseptic meningitis, urine examination suggested sterile pyuria, with no electrolyte imbalance and no demonstrable foci of infection. Hence, we hereby are presenting a very rare case of Kawasaki disease in a female infant of 35 days; probably the youngest reported so far from India.

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Cutis marmorata telangiectatica congenita (CMTC) is a congenital cutaneous vascular anomaly evident as persistent cutis marmorata, telangiectasia and phlebectesia. Klippel-Trenaunay-Weber syndrome (KTW) consists of port wine stains, varicose veins and limb hypertrophy. A term baby was delivered shocked with an extensive cutaneous malformation resembling a port wine stain with hypertrophied forearm and fingers. Deep substance hemangiomas were seen in the liver raising the possibility of KTW syndrome. With resuscitation over the next few days, the malformation evolved into a more marbled appearance with axillary phlebectesia. This along with the presence of syndactyly raised the potential for CMTC but did not explain the liver hemangioma or bony hypertrophy. In this case, there some features of CMTC and some of KTW syndrome raising the possibility of their coexistence in the same case. Sturge-Weber syndrome, KTW syndrome and CMTC may be included in a spectrum of vascular diseases that are associated with other developmental defects of the mesoderm during embryonic life. The variability in presentation with overlap, which is seen in these conditions, may have a common pathophysiology explained by the Happle gene hypothesis.

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Nevus anemicus is an uncommon, localized, congenital vascular malformation. It occurs due to hyper sensitization of an area to the circulating catecholamines with normal histology. A giant nevus anemicus of this magnitude has not been reported until date and we report this unusual case of giant nevus anemicus in a 4-month-old male child.

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Introduction: Atopic dermatitis is an enigmatic chronically relapsing dermatosis which is difficult to quantify. Present scoring systems have their inherent limitations. Aims and Objectives: To evaluate and compare the scoring systems SCORAD and SASSAD for atopic dermatitis and to correlate values with clinical and hematological parameters. Materials and Methods: Fifty patients of atopic dermatitis were selected and assessed at presentation and at four weeks using SCORAD and SASSAD. Appropriate haematological investigations were done at the time of assessments. The data obtained was assessed statistically. Results: The changes in both the SCORAD and SASSAD correlated with the changes in clinical and hematological profile. Conclusion: SCORAD seems to be a better scoring system as it addresses both the subjective and objective parameters.

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Introduction: Various medications have been tried to induce regression in hemangioma. We tried to find out the benefits of oral prednisolone versus propranolol in these lesions. Objectives: The objective of this study was to assess the effect of oral prednisolone and propranolol in infantile hemangioma (IH) and also to compare their efficacy. Materials and Methods: This was a prospective study from January 2008 to December 2012. Patients of hemangioma in high risk location with dimension >5 cm and/or area >20 cm ² were included. Patients were randomized into Group A receiving oral prednisolone 5 mg/kg/day in tapering doses, Group B receiving oral propranolol 3 mg/kg/day and Group C receiving both. Patients were evaluated for response and P < 0.05 was considered to be significant. Results: A total of 69 cases were included. Patients in each group were 24, 22 and 23 respectively. Mean age at presentation was 32 weeks (range 6-48 weeks). Therapy was initiated at 30.1 ± 9.2 weeks for 14.9 ± 2.1 weeks. Average tumor size at initiation was 28.2 ± 5.6 cm ² in Group A, 24.9 ± 2.2 cm ² in B and 22.7 ± 2.1 cm ² in C. There was a significant response to treatment in Group A (P = 0.04) and insignificant in B (P = 0.07) and C (P = 0.06). Conclusions: Oral prednisolone is a viable treatment option in the management of high risk IH and there is no added benefit of using propranolol either alone or in combination in the treatment of these cases. A large randomized controlled trial is needed to further validate this observation.

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