Nidhi Yadav

Prevalence of topical steroid misuse among rural masses

Background: A lot of cosmetic and Ayurvedic products containing unlabeled depigmenting agent and steroids are available readily over the counter sale. The side effects of these products are not documented and can lead to adverse effects of continuous usage. Objective: By this study, we aimed to find out the true nature of the above problem and its implication in the Indian rural scenario. Methodology: All patients attending dermatology department during the period of 3 months from May to June 2013 for skin diseases were enquired about unsupervised use of any cosmetic product on their facial skin, duration of use, any side effect experienced through the prescribed questionnaire. Results: Total 50 patients were recruited for the study. Out of which, 48% were males and 52% were females. Seventy-four percent of people had applied topical products/steroids in an attempt of attainment of fair complexion, 14% for melasma, 8% for acne induced hyperpigmentation, and 4% for dark circles. About 80% people had obtained one or the other products over the counter sale, 8% had followed the attractive advertisements, 8% had started the application on the recommendation of friends/family while only 4% people had correctly gone through the proper channel to consult a dermatologist. Conclusion: The problem of topical products or steroids abuse is rampant and significant, and unless and until immediate steps are taken to root out this problem from our setup, the condition will become worse all the more.

Leprosy elimination: A myth busted.

Background: Leprosy is mainly a chronic infectious disease caused by Mycobacterium leprae. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and eyes. Though the target of leprosy elimination was achieved at national level in 2006 even then a large proportion of leprosy cases reported globally still constitute from India. Aim and Objective: To study the clinico-epidemiological profile of new cases of leprosy in a rural tertiary hospital. Materials and Methods: Thirty-five newly diagnosed cases of leprosy presented in out-patient/admitted in the department of Dermatology, Venereology and Leprosy (between September 2012 and August 2013) were included in the study. Detailed history regarding leprosy, deformity, sensory loss, skin smear for AFB and histopathological examination were done in every patient. Results: The incidence was more in age group of 20 to 39 years (48.57%) and 40 to 59 years (37.14%). 68.57% were males. 48.57% cases were found to have facial deformity and ear lobe thickening was found to be pre-dominant form of facial deformity. Ulnar (88.87%) and common peroneal nerve (34.28%) were the most commonly involved nerves. The split skin smear examination was found to be positive in 27 out of 35 cases. On histopathological examination 10 patients (28.57%) were of lepromatous pole (LL), 4 (11.43%) were of indeterminate, 6 (17.14%) were of tuberculoid type (TT), 4 BT (11.4%) and 1 BL type (2.8%). Conclusions: This study helps in concluding that leprosy is still not eliminated. Active surveillance is still needed to detect the sub-clinical cases and undiagnosed cases.

Becker's nevus with neurofibromatosis type 1.

Neurofibromatosis type 1 is an autosomal dominant disorder which primarily affects the growth and development of neural cell tissues. It presents as multiple tumor-like growths over the skin that arises from the nerves and is associated with other abnormalities like pigmentation over the skin and bone deformities. Becker′s nevus or hairy pigmented epidermal nevus is a benign cutaneous hamartoma which is characterized by hyperpigmented macule with hypertrichosis. It is rarely associated with neurofibromatosis. We report a 22-years-old male with coexistent Becker′s nevus and type 1 neurofibromatosis.

Dermatoses due to quackery: A case snippet and concise review of literature

A wide prevalence of socio-religious, cultural, and tribal practices in India often leads to a multitude of skin conditions, which can misled the dermatologists in arriving at a diagnosis. With increasing globalization and migration, the practice of indigenous customs and traditions are crossing boundaries, making it imperative for the dermatologists to be acquainted with the cutaneous side effects of these practices. Here, we report a unique case of thermal burn in a circumferential pattern over the umbilical region, a result of the placement of burning lamp over umbilicus to alleviate abdominal discomfort.

Extrafacial melasma over forearms

1. Niv D, Maltsman‐Tseikhin A. Postherpetic neuralgia: The never‐ending challenge. Pain Pract 2005;5:327‐40. 2. Oaklander AL, Bowsher D, Galer B, Haanpää M, Jensen MP. Herpes zoster itch: Preliminary epidemiologic data. J Pain 2003;4:338‐43. 3. Zografakis C, Tiniakos DG, Palaiologou M, Kouloukoussa M, Kittas C, Staurianeas N. Increased density of cutaneous nerve fibres in the affected dermatomes after herpes zoster therapy. Acta Derm Venereol 2014;94:168‐72. 4. Oaklander AL, Cohen SP, Raju SV. Intractable postherpetic itch and cutaneous deafferentation after facial shingles. Pain 2002;96:9‐12. Cite this article as: Mittal A, Srivastava A, Balai M, Khare AK. A study of postherpetic pruritus. Indian Dermatol Online J 2016;7:343-4. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Symmetrical drug related intertriginous and flexural exanthema after ranitidine therapy: A probable causal association in an 18-year-old girl

Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) is characterized by symmetrical erythema involving the gluteal and intertriginous areas in the absence of systemic involvement.[1] Penicillin and cephalosporins are the most common agent responsible for this eruption.[2] We report herein a case of SDRIFE showing symmetrical erythema predominantly on the major flexural areas that developed after taking ranitidine tablets and was probably associated with the use of ranitidine.

Hailey-Hailey disease.

The prevalence of Hailey–Hailey disease (HHD) also known as fami l ia l benign chronic pemphigus is 1:50,000.[1] It is an autosomal dominant disorder caused due to mutation in ATP2C1 gene.[2,3] The gene encodes an adenosine triphosphate–powered calcium pump in the Golgi apparatus of epidermal cells.[4] Faulty calcium pump action leads to disorganized function of desmogleins, which are calcium-dependent adherence proteins (cadherins). Flaccid vesicles or bullae are the primary lesions in Hailey–Hailey disease. These lesions rupture easily leaving behind macerated erosions. Most commonly Hailey–Hailey disease

Hansen's disease and HIV coinfection with facial nerve palsy.

There are very few published reports of HIV leprosy co infection in India in spite of having a large burden of both leprosy and HIV. Herein we are reporting a case of co-infection of Hansens disease and HIV with facial nerve palsy.

Pityriasis lichenoides et varioliformis acuta (PLEVA)

We report a case of a 3-year-old male child presenting with a polymorphous generalized eruption consisting of crusted maculopapular lesions all over body except for face and mucus membrane. Histopathology showed interface dermatitis along with perivascular infiltrates chiefly comprising of lymphocytes and extravasated red blood cells, indicating the diagnosis of pityriasis lichenoides et varioliformis acuta. He was treated with dapsone and eryhthromycin with success.

Lesch-Nyhan Syndrome in an Indian Child.

Hypoxanthine guanine phosphoribosyl transferase-1 (HGPRT-1) leading to Lesch-Nyhan syndrome (LNS) is one of the important causes of self-mutilation. Hereby, we report a case of LNS in a three and half-year-old male child, who presented with characteristic self-mutilating behavior. He had history of developmental delay, difficulty in social interaction, attention deficit and features of autism. His serum blood biochemistry was normal except for low hemoglobin levels and raised serum uric acid levels. With a diagnosis of LNS, the child was treated with allopurinol. With various modalities of physical restraint, his self-mutilating behavior came under control and currently the patient is being followed up.