Introduction: Topical corticosteroids (TCS) are widely misused. Uncontrolled use of steroids can cause undesirable adverse effects especially on face. Aim: The aim of this study was to assess the skin manifestations of TCS misuse over the face in the patients attending dermatology outpatient and to analyze various factors contributing to such misuse. Methods and Methods: A total of 200 patients with facial dermatoses using topical steroids over face for minimum period of 1 month, reported between June 2010 and May 2011 were enrolled in the study. Details about the usage of topical corticosteroids and their side effects were recorded. The patients were educated about the misuse. Results: Majority of the patients were females (71%). The most common reason for misuse was acne (61%) followed by use as a fairness cream (23%). The average duration of usage was 6 months to 1 year, longest being 8 years. The drug most commonly misused was Betamethaone Valerate (71%). The commonest side effect noted was acne form eruptions (52%) followed by steroid dependent face (SDF) (36%). There were no cases of allergic contact dermatitis or perioral dermatitis. The exacerbation of the lesions on stoppage of steroid cream (90%) fairness effect (10%) were the reasons for continued use. (100%) were unaware of side effects of topical steroids. Conclusions: Steroids have been misused by patients on their own or by doctors for various reasons. Hence the awareness about their correct usage is essential.
Introduction: Herpes zoster (Hz), which presents as localized, painful cutaneous eruption is a common clinical problem, particularly among adults of above 50 years of age and immunocompromised patients. It results from reactivation of varicella zoster virus. Aim: To analyze the clinical pattern of herpes zoster with special emphasis to the precipitating factors and incidence of post herpetic neuralgia. Material and Methods: 100 clinically diagnosed cases of herpes zoster, attending the Dermatology department of MVJ Medical College and Research Hospital Bangalore, India from a period of June 2010 to May 2012 were included in the study. The clinical pattern of herpes zoster with special emphasis to the precipitating factors and incidence of post herpetic neuralgia were analyzed. Results and Conclusion:The study showed a male preponderance. Age group varied from 8-80 years. 42% of the total patients presented during summer season when the incidence of varicella is also high. Past history of chicken pox was present in 68% of the patients. 11% of the patients were on immunosuppressive treatment. 8% of the patients had associated diabetes mellitus and 7% showed HIV seropositivity. Thoracic dermatomal involvement was seen in majority of patients. Most commonly observed complication was post herpetic neuralgia which was encountered in 36% of the patients and most of these patients were (77%) were above the age of 60years. IntroductionHerpes zoster (HZ), which presents as localized, painful cutaneous eruption is a common clinical problem, particularly among adults of above 50 years of age and immunocompromised patients. It results from reactivation of varicella zoster virus (VZV). After primary infection of varicella, the virus persists asymptomatically in the ganglia of sensory cranial nerves and spinal dorsal root ganglia. As cellular immunity to VZV decreases with age or because of immunosuppression, the virus reactivates and travels along the sensory nerves to the skin, causing the distinctive prodromal pain followed by eruption of the rash [1]. Clinical presentation is dependent on rapidity of immune response and ranges from typical zoster to scattered vesicles, zoster sine herpete or disseminated zoster. It is a cause of considerable morbidity, especially in the elderly and can be fatal in immunocompromised or critically ill patients.
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