Young male 3rd decade, Recurrent infection, often treated (as claimed by the patient) successfully. His treatment involved a skin ointment containing combination of Corticosteroid, Antibiotic and an Antifungal. This is a common practice in many parts of India. Considering these to be 'Secret Illnesses', patients often see Chemist Shopkeepers for treatment and results in this. Lets discuss the diagnosis and what can be done to improve the knowldge about such situations.

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Tinea corporis. Clinical picture has changed due to excessive use of topical steroids. Treatment is 1.Stop topical steroids. 2.Use topical Sertaconazole. 3.Tab terbinafine 500 mg O.D for 1 month. 4.Tab Fluconazole 150 mg weekly for 3 months.

Illicit H/o Atopy such as allegic rhinitis , asthma, allergic conjunctivitis in patient or her relatives . H/o of dental prosthesis or fliiing . Because both lips are affected it is probably contact dermatitis . Atopic, irritant and allergic contact dermatitis frequently co- exist . Any application on lip could trigger the CD or perpetuate it . Toothpaste allergy could present as chelitis besides garlic, spices and food flavours . Nail Polish could be the cause also habit of chewing gums. Having said this the provisional diagnosis is ALLERGIC CD / and or/ ATOPIC DERMATITIS Stop all topicals including emollients . Give oral Methylprednisolone 16 mg OM ×4-6 wks.

Sir..I think this answer is for dr ayesha..
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Tinea Corporis n Cruris Annular arcuate erythematous lesion with active periphery showing papulovesiculation and central clearing is suggestive. The picture is slightly altered due to Injudicial use of steroid mixed cream available over the counter and often prescribed by some GPs.

Not all GP'S sir. Don't generalise. Hope you agree with me.
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Tinea corporis

Diagnosis - Tenia Corporis What can be done - 1. Pamphlets regarding the importance of avoiding the rampant use of Steroid creams 2. No over the counter sale of Steroid cream 3. News article about the side effects of topical Steroid 4. Banning the sale of combination Steroid cream

Tinea incognito. Resistant fugi due to irrational treatment. Personal hygiene. Single drug local preparation. Higher doses of oral anti fungal for a longer duration are required.

Tinea corporis.... Avoid local steroids by self initiating the disease...Better to apply terbinafine oint bd , luliconazol oint od ,tab.grisiofulvin 250 bd for 2weeks..Tab.avil HS... Follow the case after one week

IT'S A..CASE OF.. TENIA CORPORIS..

Tinea cruris keto400 mg of 4 ho week oint luliconazole od

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