Leprosy Mailing List – January 21, 2014
Ref.: (LML) Facial Erythematous Patches
From: H K Kar, New Delhi, India
Dear Dr Pieter,
Referring to the letter of Dr. Rao concerning facial erythematous patches: we often encounter such problems of persistence of erythema on old treated patches of PB cases who also had history of type 1 reactions (T1R) for months together, particularly if the lesion is on the face.
If the histopathological examination after RFT still shows the features of T1R, few weeks of oral steroid is required instead of local steroid application. In addition, I always prefer to prescribe Sun blocking agent local application, (best is calamine with zinc lotion) over the face to protect the lesion from UV light. The erythema very slowly disappears after a period of few months. In case of no histopathological features of T1R, only local calamine application is sufficient which should be applied for few months. Local application of topical calcineurin inhibitors like tacrolimus or pimecrolimus is worth trying at night.
Regards,
Dr (Prof.) H K Kar
Director and Med. Superintendent
P.G.I.M.E.R. and Dr Ram Manohar Lohia Hospital
Baba Kharag Singh Marg
New Delhi-110001
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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