This 20-year old male suddenly developed monomorphous papulopustular rash mainly on the trunk, shoulders and less on the face. Comedones were absent. He gave a history of taking an appetizer (a mixture preparation containing steroid, cyproheptadine and some tonics to stimulate appetite and to increase body weight) 3 weeks prior to the onset of rash. For the rash a medical sub-staff has prescribed an injectable steroid for the patient which caused further exacerbation of the rash. This scenario is encountered repeatedly during dermatological daily practice. Steroid acne is a folliculitis caused by the use of systemic and/or topical corticosteroids. Although other medications have been implicated in acneiform eruptions, steroid acne results in a distinctive clinical picture characterized by the sudden appearance of monomorphous papulopustules predominantly on the upper truck and arms, but also on the face. Comedones are not apparent.
A 46-year-old woman presented with a unilateral hyperpigmented lichenified plaques characterized by paroxysmal itching involved one leg of three years duration. Skin biopsy was in favour of LSC versus LP hypertrophicus.
A 35-year-old man presented with a generalized papular rash associated with severe itching especially at night. On examination the penis was severely involved with red papules, nodules and erosions. Three days treatment with 10% sulfur ointment resulted in great improvement.
A 50-year-old woman presented with multiple pruritic rounded and oval plaques with more active margins and less active centres of four months duration. The lesions involved the wrist, thigh and one leg. Excoriation marks were evident and concentrated more at the periphery of the lesions.
A 78-year-old man presented with an asymptomatic, irregularly-shaped rodent ulcer with a slightly-pigmented rolled up border involved the upper lip of 5 years duration. Incisional biopsy revealed nodulo-ulcerative BCC.
A 3-year-old toddler presented with pruritic penile papules of few weeks duration. O/E, One burrow can be seen on the prepuce. Family history of scabies was positive.
A 3-month-year old female infant presented with a solitary small oval superficial punched-out ulcer with crusted base involved the neck flexure of 10 days duration. Oral cephalexin and topical fusidic acid cream for 10 days has cured this ulcer.
