Dermatitis Cruris Pustulosa et Atrophicans in India

Harman, R.R.M.

doi:10.1111/j.1365-2133.1968.tb11926.x

Cited by 7 publications

(69 citation statements)

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“…Harman, [3] in 1968, reviewed DCPA and studied it extensively among 15 outpatients in the Ibadan province of Nigeria. He gave a detailed clinical description of the lesions of DCPA, calling it the "Nigerian shin disease."…”

Section: Introduction Introductionmentioning

confidence: 99%

“…However, there are a number of inflammatory diseases involving the hair follicle, the etiology of which are complex or uncertain, with the role of bacterial Kaimal, et al Dermatitis cruris pustulosa et atrophicans involved skin, without any systemic symptoms. [2,3] HISTORICAL PERSPECTIVE HISTORICAL PERSPECTIVE Follicular diseases resulting in permanent alopecia and scarring have been known to physicians for over a 100 years. In the last century, French dermatologists described a number of these conditions under various names: pseudopelade (Brocq, 1885), folliculitis decalvans (Quiqaud, 1888) and acne decalvante (Lailler, 1884).…”

Section: Introduction Introductionmentioning

confidence: 99%

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Dermatitis cruris pustulosa et atrophicans

Kaimal¹,

D’Souza²,

Kumari³

2009

Indian J Dermatol Venereol Leprol

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Dermatitis cruris pustulosa et atrophicans (DCPA) is a distinctive type of chronic superficial folliculitis, primarily affecting the lower limbs. It is characterized by symmetrical follicular pustules of both legs, with cutaneous edema, resulting in alopecia, atrophy and scarring. It was first described by Clarke, from West Nigeria, in 1952 and well illustrated in his book "Skin diseases in the African," under the initial label of "Nigerian shin disease." Subsequently, it was described in India as well, in 1964, and continues to be a problem in dermatology clinics across the country. It is predominantly a disease of men and has a high prevalence in some geographical regions; up to 3-4% in Madras, South India. Some unique features that distinguish DCPA from banal pustular folliculitis include its peculiar localization to the legs, extreme chronicity, resistance to therapy and inevitable alopecia and atrophy of the involved skin, with little postinflammatory hyper- or hypopigmentation. Further, even in the presence of extensive lesions, there are no systemic features. Coagulase-positive Staphylococcus aureus is known to have a role in the etiology of DCPA, but the exact etiopathogenesis still needs to be elucidated. Immunological postulates such as hypergammaglobulinemia have been put forward to explain the chronicity of the condition. A number of therapeutic agents have been tried in various studies, including cotrimoxazole, psoralen with ultraviolet A (PUVA) therapy, ciprofloxacin, pentoxifylline, rifampicin, dapsone, minocycline and mupirocin (topical) with variable success rates. Although a well-recognized entity in dermatology clinics in tropical countries, DCPA has received little attention in the dermatological literature and has only a few studies to its credit. Its unique clinical picture, unclear etiopathogenesis and resistance to therapy afford a vast scope for further investigation and study.

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Section: Introduction Introductionmentioning

confidence: 99%

Section: Introduction Introductionmentioning

confidence: 99%

Dermatitis cruris pustulosa et atrophicans

Kaimal¹,

D’Souza²,

Kumari³

2009

Indian J Dermatol Venereol Leprol

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“…Harman observed psuedofolliculitis barbae in 9% of study population. 4 Pruritis is the main symptom as reported by the earlier studies bilaterally symmetrical lesions are the common presentations. 9,10,13,[16][17][18] Our patients complained of pustules (68%) and pruritis (18%); surprisingly, only men complained of pain, not women.…”

Section: Therapeutic Outcomementioning

confidence: 65%

“…Resistance to penicillins were reported by Harman et al (75%) and Tiwari et al (87%). 4,18 Positive treatment response to ciprofloxacin was reported by Balachandran et al (91.30%), but there was no significant difference in the time taken for remission compared to placebo (Cipro Vs. placebo, 44.5 vs 40 days). 15 Treatment options have evolved from Puvasol and cotrimoxazole to fluoroquinolones.…”

Section: Therapeutic Outcomementioning

confidence: 87%

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Clinico-etiological profile and antibiotic sensitivity pattern of chronic folliculitis: a common but less focussed disease of tropics

Pasha

Gunda

2018

Int J Res Dermatol

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Background: Chronic folliculitis (CF), a common disease of the tropics caused by Staphylococcus aureus (SA) is a less focussed therapeutic area.Methods: We estimated the prevalence of CF, clinical types, seasonal variation through this prospective observational study and carried out routine laboratory investigations, gram stain, KOH mounting, Tzanck smear, and culture and sensitivity (C&S).Results: Of 50 patients (prevalence 1.2%), 44 were men. Mean age was 36.5 years (range 18-55 years). Patients were from lower socioeconomic class (7%), comprised of unskilled (82%) workers, and presented with pustules (6%) and pruritis (18%). Dermatitis cruris pustulosa et atrophicans (78%) and folliculitis barbaetraumatics (6%), lesions on the lower limbs (74%), and beard area in men (18%), human immunodeficiency virus infection (8%) and diabetes mellitus (4%) were common observations. Shorter duration (6-8 months) was reported in more number of women (4/6,) while men (35/44) had a long-standing disease (8 months-2 years). Six had a duration of >2 years. Summer aggravated the symptoms (90%). Contact with soil, cow dung, intake of animal protein, excess alcohol, excessive sweating were the precipitating factors. Culture positive coagulase negative SA (98.0%) was the most common isolate. Organisms were sensitive to ceftriaxone (9%), cepholathin (7%) and resistant to penicillins (68%); there was no resistance against gatifloxacin, imipenam, vancomycin, and teicoplanin. Twenty seven patients had a complete cure.Conclusions: CF is a recurrent condition with seasonal variation, predominantly involves legs, and affects adult labourers. Avoiding aggravating factors (trauma) is helpful in achieving the treatment goal and minimising recurrence. Prescription of Antibiotics should be considered after testing for C&S.

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