Anti-tubercular therapy (ATT) induced exfoliative dermatitis-A case series.

Tuberculosis is a serious contagious disease mainly affecting the lungs and is common in the developing countries. The essential component of all antitubercular regimens include Isoniazid, pyrazinamide as first-line drugs. A serious cutaneous adverse drug reaction namely exfoliative dermatitis (erythroderma) is associated with isoniazid use though uncommon but is common among pyrazinamide users. Here we report 3 cases of tuberculosis patients on antitubercular therapy (ATT) for 8 weeks, came to hospital OP (outpatient) with severe generalized redness and scaling with itching distributed all over the body and trunk. Immediately ATT was discontinued and all the three patients were administered antihistaminic and corticosteroid. The patients recovered within 3 weeks. To confirm ATT induced erythroderma and narrow down the offending agents, sequential rechallenge with ATT was done and again these patients had similar lesions erupt all over the body only with isoniazid and pyrazinamide. Antihistamine, steroids were started and the symptoms resolved and completely recovered within 3 weeks. Prompt withdrawal of the culprit drug along with appropriate medications and supportive measures is necessary for good prognosis. Physicians must be judicious while prescribing ATT especially, isoniazid and pyrazinamide as these can precipitate fatal cutaneous adverse reactions. Strict vigilance may help in early detection of this type ADR and timely management.

Monkeypox outbreak in the post-eradication era of smallpox.

Human monkeypox (MPOX) which recently hit the headlines is a rare, emerging zoonotic disease, only next to smallpox yet never attended adequately to halt the epidemic outbreak threat. MPOX is caused by Orthopox virus, which is a double-stranded, linear DNA virus, transmitted from infected animals, commonly rodents to humans. Monkeypox is endemic to the tropical jungles in Central-West Africa; occasional cases reported in other nations could be due to people traveling from endemic regions of MPOX. Transmission may occur via direct contact with human body secretions, cutaneous or mucosal lesions in the mouth or throat or respiratory droplets, and contaminated objects. Typical MPOX symptoms are fever, lymphadenopathy, skin rashes, intense headache, muscle, back pain, etc. Lesions can range from a few to numerous and may be filled with clear or yellowish fluid that later dries up or crusts, eventually falling off. MPOX is often considered as infrequent and self-limiting; nonetheless, the latest sporadic reports call for urgent vigilance, precautionary preparedness, and immediate response. Paucity of the data available about MPOX virus diversity and incomplete information on validated management protocols instigate a sense of impending danger and loom large as a global health emergency. MPOX is a completely preventable infection, and this article will cater to the need for creating general awareness and developing cutting-edge surveillance measures to curtail the spread of the disease. Genomic investigations of new cases of MPOX must be undertaken to check for mutations which can lead to higher human susceptibility. Local health stakeholders and clinicians should emphasize early identification and give out appropriate treatment as per the existing protocol.