Sanjay K. Rathi

Topical corticosteroid-induced rosacea-like dermatitis: A clinical study of 110 cases

BACKGROUND Prolonged and continuous use of topical steroids leads to rosacea-like dermatitis with variable clinical presentations. AIMS To study the various clinical presentations of patients with topical corticosteroid-induced rosacea-like dermatitis (TCIRD), who had a history of prolonged and repeated use of topical steroids for reasons other than the known disease entities. METHODS A total of 110 patients were enrolled for the study over a period of 2 years, excluding all those with the known disease entity in which topical steroids were commonly used. Detailed history which also included the source and the type of topical steroid use was taken along with clinical examination. RESULTS There were 12 males and 98 females with their age ranging from 18 to 54 years. The duration of topical steroid use ranged from 4 months to 20 years. The most common clinical presentation was diffuse erythema of the face. Most of the patients had rebound phenomenon on discontinuation of the steroid. The most common topical steroid used was Betamethasone valerate, which could be due to its easy availability and low cost. CONCLUSION Varied clinical presentations are seen with prolonged and continuous use of topical steroids. The treatment of this dermatitis is difficult, requiring complete cessation of the offending steroid, usually done in a tapering fashion.

Post-kala-azar dermal leishmaniasis: a histopathological study.

BACKGROUND Post-kala-azar dermal leishmaniasis follows an attack of visceral leishmaniasis and is caused by the same organism, i.e. Leishmania donovani. METHODS In the present study, biopsy specimens from hypopigmented macules, nodules or plaques of 25 patients clinically diagnosed as PKDL were evaluated for epidermal and dermal changes and for the presence or absence of Leishmania donovani bodies (LDBs). RESULTS The hypopigmented macules showed a patchy perivascular and periappendageal infiltrate with no demonstrable LDBs in any of the biopsies. In the nodular and plaque lesions, the infiltrate was diffuse, beneath an atrophic epidermis (74%) and follicular plugging (95.6%) was seen in most biopsies. The infiltrate consisted of lymphocytes, histiocytes and plasma cells in decreasing order of presence. LDBs could be demonstrated in only 10 (43.5%) biopsy specimens from nodular and plaque lesions and were never numerous. CONCLUSIONS Histopathological features of PKDL are elucidated and discussed.

Lesional T-cell subset in post-kala-azar dermal leishmaniasis

Background  The pathogenesis of post‐kala‐azar dermal leishmaniasis (PKDL) is ill understood. This study was carried out to find the percentage of T‐helper and T‐suppressor cells in lesional tissue and their probable role in the pathogenesis of PKDL.

Localized acquired hypertrichosis following cast application

(w ww .m ed kn ow .co m) . Sir, Hypertrichosis in general means growth of hairs involving non-androgen dependent follicles that is considered excessive for the site and the age of a patient.[1] It can be divided into localized (congenital or acquired) or generalized (congenital or acquired). Localized hypertrichosis can be because of various reasons which may be due to repeated or prolonged inflammatory changes involving the dermis. Increased hair growth following cast application is an uncommonly reported phenomenon, though well known to orthopaedic surgeons.[2]