Subcutaneous route is a reliable alternative for ACTH-stimulated steroid profiling.

Purpose: Intramuscular acton prolongatum is most often used as an alternative for intramuscular or intravenous tetracosactide for ACTH stimulation in some countries. Intramuscular administration of acton prolongatum is cumbersome whereas intended intramuscular acton prolongatum or tetracosactide may often turn subcutaneous. Hence, we compared the subcutaneous ACTH-stimulated steroid profiling with those of the intramuscular routes.

Severe childhood SLE with refractory autoimmune hemolytic anemia-a therapeutic challenge.

Paediatric Systemic lupus erythematosus (SLE) constitutes 10 to 20% of cases of SLE with more severe disease and higher mortality. We report a case of an adolescent girl with SLE with multisystem involvement who was started on hydroxychloroquine and oral prednisolone. However, due to persistent worsening of skin lesions and falling cell counts, pulsed dexamethasone was initiated which showed improvement in the skin lesions, cell counts, proteinuria and pleural effusion but there was a persistent fall in the haemoglobin.

Concurrent Diagnosis of Chronic Lymphocytic Leukemia and Plasma Cell Myeloma: Report of 2 Cases and Differential Diagnostic Considerations.

BACKGROUND Simultaneous occurrence of chronic lymphocytic leukemia (CLL) and plasma cell myeloma (PCM) is an uncommon hematological condition, with most patients presenting in late adult life. When these diagnoses occur concurrently, it often poses diagnostic challenges to the pathologist, with other important differential diagnoses including lymphoplasmacytic lymphoma, marginal-zone lymphoma, and chronic lymphocytic leukemia with plasmacytoid differentiation. Ancillary studies are indispensable in arriving at a reliable diagnosis in this clinical scenario.

Epidermodysplasia Verruciformis (Lewandowsky and Lutz's Dysplasia).

A woman in her twenties, with a non-consanguineous marriage, presented to the dermatology clinic with asymptomatic lesions on her face, neck, trunk, and extremities for the past 12 years. The general physical and systemic examination was unremarkable. Cutaneous examination revealed multiple hypopigmented to a few hyperpigmented, slightly scaly tinea versicolor-like macules distributed predominantly on the neck, upper portion of the back, and distal parts of the extremities (Figures 1-5).