Man is always obsessed with fair skin since ages. Beauty, it is said, is skin deep. Not so anymore for consumers especially in India who demand from their beauty products more than just a superficial whitening of their skin tone for a short duration. Hydroquinone is the ?rst choice of topical bleaching agents used in treatment of melasma. It is widely prescribed by physicians and often used by patients without prescription. The principal adverse effects of its chronic use are confetti-like depigmentation and exogenous ochronosis. Exogenous ochronosis is an infrequent dermatosis characterized as a dark blue hyperpigmentation localized where the causing agent was applied. It may be caused by the use of systemic medications such as antimalarials and by the use of topical substances such as phenol, resorcinol, benzene, hydroquinone, which is a phenolic compound with depigmenting action. The pathophysiology of this process is not well clear up to this moment, and the therapeutic measures are not satisfactory either. We hereby, reporting a case of 29 years old female who had been using hydroquinone continuously for six years for fairer complexion and ended up with a night mare.
Epidermolysis bullosa (EB) is a genetically inherited severe skin disease involving dermal-epidermal junction. Based on the appearance and involvement, it is grouped into simplex, junctional & dystrophic forms. These disorders represent heterogeneous phenotypes and are correlated with a variable range of complications, from localized skin fragility to neonatal death. Genetic testing had made a precise diagnosis and it requires only supportive and symptomatic therapy. Here we report an atypical case of dystrophica epidermolysis bullosa in a 6-year-old male child. Epidermolysis bullosa (EB) is a general term used for heterogeneous group of congenital, genetic blistering disorders. It has a wide spectrum of clinical presentations. 1 It is characterized by induction of blisters by trauma, exacerbation of blistering in warm weather and healing with scarring. EB can be categorized under three major groups - epidermolysis bullosa simplex (EBS), junctional epidermolysis bullosa (JEB) and dystrophic epidermolysis bullosa (DEB). EB simplex has an incidence and a prevalence rate of 10.75 and 4.65, 2.04 and 0.44 of junctional EBs and 2.86 and 0.99 of dystrophic EBs and recessive dystrophic EB 2.04 and 0.92 respectively.2 The dystrophic forms are characterized by deformities of the skin including coalescence of the fingers, nail changes and milia formation.3 This case report highlights the rare presentation of recurrent episodes of blisters and limb deformities in 6 - year - old male children.
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