ABSTRACT
Glucocorticosteroid therapy can occasionally lead to a serious and debilitating complication called osteone-crosis or avascular necrosis. While a prompt diagnosis of this complication can help in preventing significant morbid-ity in the affected patients, dermatologists in general, are often not conscious of this facet of steroid-related problems. The precise mechanisms responsible for this disease are not fully understood nor its prevalence in derma-tological practice. An attempt has been made in this article to review the current understanding of its pathogenesis, the risk factors associated with its occurrence and the methods for its early diagnosis and treatment. An attempt is also made to formulate a set of guidelines useful to a dermatologist for the prevention of this disabling complication.
ABSTRACT
Palms and soles are considered immune to leprosy. A study was carried out to assess the frequency of lesions over palms and soles and to correlate their occurrence with various parameters. Two hundred eighty leprosy patients were screened for lesions over palms and soles. Palmo-plantar lesions were observed in 10% of the patients screened. Slit-skin smears and biopsies were done from routine sites and palmo-plantar lesions. Histopathology and slit-skin smear confirmed the presence of disease. Eight were in type I reaction, and 50% of patients with type I reaction screened showed lesions over palms and/or soles. The reason for this is not known; probably inapparent lesions become apparent during reactions. Lesions of various morphology were observed. Silky hand was observed in one case.