Actinomycosis is a chronic, progressive, suppurative infection, prevalent over the neck, thorax or abdomen. As it rarely occurs with few clinical symptoms, its diagnosis requires a high index of clinical suspicion. We report a case of primary cutaneous actinomycosis affecting the back. The patient was treated with benzyl penicillin and sulfonamides and showed no recurrence at 1 year follow-up.

Lepromatous leprosy and sarcoidosis have varied clinical manifestations. These two diseases are sometimes mistaken for each other in their clinical, histopathological and laboratory parameters, but their coexistence is seemingly quite rare and paradoxical. We present a 40-year-old female with newly diagnosed lepromatous leprosy and subcutaneous sarcoidosis.

Over the last decade, the usage of hair color is gradually increasing from adolescents to the geriatric population. In the elderly population, more use of hair color due to graying of hairs exposes them to chemicals such as para-phenylenediamine (PPD). Many cases are reported regarding various manifestations of allergic contact dermatitis due to PPD compound present in hair color. It is noteworthy that, in the elderly the use of antidiabetics and antihypertensives, makes them vulnerable to cross-reaction or interaction with drugs and chemicals. We report a case that highlights the adverse reaction to hydrochlorothiazide in a PPD sensitive individual.

Background: Topical corticosteroids is a boon and also a bane in treating chronic skin conditions. The risk of cutaneous infections due to topical steroids increases with their potency, dose, and duration of treatment. Herein, we present a case series of severe debilitating infections secondary to topical steroid abuse. Materials and Methods: We came across five cases of severe skin infection following the prolonged application of topical steroids. These cases gave a history of the use of steroid creams for persistent skin conditions and the inability to visit the hospital due to the prevailing COVID-19 pandemic. Observations: We came across two cases of crusted scabies, two cases of Fournier’s gangrene, and a case of erosio interdigitalis blastomycetica. These cases had been using topical steroids for a prolonged period for other dermatological conditions. Conclusion: We propose that, as crusted scabies and erosio interdigitalis blastomycetica mimic various other papulosquamous disorders, a KOH examination is a diagnostic tool. Topical steroid abuse is one of the predisposing factors for Fournier’s gangrene. Key words: Topical Steroids; Crusted Scabies; Fournier’s Gangrene; COVID-19

Localised morphea is an autoimmune sclerosing disorder of unknown aetiology. Various triggering factors are known to be associated with the disease including infections, vaccination, autoimmune disorders, and trauma. Amongst the infections, the common causative organisms associated with morphea are Borrelia burgdorferi, varicella, and Epstein-Barr virus (EBV). EpsteinBarred morphea presents as an initial inflammatory stage and a later inactive stage. It is characterised by sclerosis of skin with hyper or depigmentation. The antibiotics effective against borrelia infection are benzyl penicillin, doxycycline, and ceftriaxone. These antibiotics are tried in the treatment of localised morphea. Ceftriaxone is one of the best antibiotics preferred to treat borrelia infection at all stages. Apart from its antibiotic properties, it also has an anti-inflammatory and collagen remodelling properties. All five cases of localised morphea reported here were biopsy proven, Antinuclear Antibody (ANA) and Rheumatoid Arthritis (RA) factor negative. All the cases were treated with weekly single intramuscular dose of ceftriaxone 250 mg. After eight weeks there was remarkable improvement in the induration and pigmentation of the lesions.