malaria: third edition bd gupta and rk maheshwari

INDIAN PEDIATRICS 162 VOLUME 51__FEBRUARY 15, 2014

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Topical Corticosteroid Abuse

A 5-year-old girl presented to us with an asymptomaticwhite lesion on her cheek since the last four months.There was a history of application of over-the-countermedications prior to appearance of the lesion, due toinsect bite. Cutaneous examination revealed ahypopigmented circular patch of diameter 6 cms (Fig. 1).It was surmounted by fine scales and the center of thepatch showed multiple erythematous papules.Telangiectatic changes were not appreciable. There wasneither loss of sensation over the patch nor any nerveenlargement. There was no similar lesion elsewhere in thebody. The patient did not give any history of atopy. Scalp,nails and mucosae were normal. On the basis of theclinical findings, a diagnosis of steroid abuse was made.She was prescribed emollients and asked to stopapplication of any other ointment. Gradual clearance ofthe lesion in the follow-up visits re-inforced ourdiagnosis.

Steroid is a crucial pharmacotherapy offered bydermatologists in a wide array of diseases. Topical andintralesional glucocorticosteroids can produce localeffects, including telangiectasias, atrophy andhypopigmentation. The close clinical differentials in our

FIG. 1 Hypopigmented scaly patch surmounted byerythematous papules.

case were: pityriasis alba (ill defined hypopigmentedpatch and features of atopic dermatitis), pityriasisversicolor (perifollicular hypopigmented macules andpatches, more prominent on sweating) and leprosy (lossof sensation, reduced sweating, nerve thickening).

ANUPAM DAS, DIPTI DAS AND NILAY KANTI DASDepartment of Dermatology, Medical College and Hospital,

Kolkata, West Bengal, India.anupamdasdr@gmail.com

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Malaria: Third EditionBD GUPTA AND RK MAHESHWARI

Pages: 342: Rs. 295/-.

This book is a good compilation ofevery aspect of malaria in childrenand adults. The topic is discussed

extensively in its 15 chapters. The chapter onmalariometric indices and statistics is the highlight of thebook. Two aspects in this book need some modifications:current epidemiology in India (though there is a drop in

overall malaria cases but P. falciparum to P. Vivax ratio isincreasing), and management section needs updating.The authors have given the latest recommendations onmanagement as per the guidelines for diagnosis andtreatment of malaria in India, 2011, by National VectorBorne Disease Control Program but treatment fromprevious guidelines is retained at some places. Thisneeds revision as all cases of falciparum malaria should betreated by Artemisinin- based combination therapy(ACT) only.

JAYDEEP CHOUDHURYDepartment of Pediatrics,

Institute of Child Health, Kolkata,West Bengal, Indiadrjaydeep_choudhury@yahoo.co.in