ABSTRACT
Chikungunya means “that which bends up,” indicating severe incapacitating arthritis or polyarthralgia. It is a viral infection caused by the chikungunya virus (CHIK V) belonging to the family Togaviridae and is transmitted by the mosquitoes Aedes aegypti and Aedes albopictus. It is a self-limiting condition with a high fever of up to 40°C (104°F), debilitating arthritis/polyarthralgia, and cutaneous involvement. CHIK V virus affects the joints causing tenosynovitis and enthesopathy presenting as arthralgia. Leprosy is also associated with the loss of sensation, arthritis/arthralgias including involvement of several joints and tenosynovitis specially during reactions. Apart from leprosy, numerous other conditions can present with loss of sensation, which must be ruled out while considering leprosy. We report two patients with chikungunya who presented with a loss of sensation like leprosy
ABSTRACT
Background: Kumkum, made with turmeric and slaked lime along with colour enhancing dyes is known to cause allergic contact dermatitis. The possible contact allergens in kumkum include turmeric, Sudan-1, 4-aminoazobenzene, brilliant lake red R and cananga oil. We report patch test results among patients with suspected contact hypersensitivity to kumkum. Objective: To identify the allergen causing kumkum induced allergic contact dermatitis by patch testing and to advise patients about organic kumkum which doesnot contain colour enhancing dyes. Methods: Eighteen patients with suspected contact hypersensitivity to kumkum were patch tested with undiluted kumkum, undiluted turmeric, Sudan-1 (95%), 4-aminoazobenzene and allergens of the Indian Standard Series. Results: Of the 18 patients, 14 patients had patch test positivity to kumkum and 4 had a negative reaction to kumkum. Patch test with other suspected contact allergens showed positive reaction to turmeric in 4 patients, Sudan-1 in 3 patients and 4-aminoazobenzene in 2 patients. Among the allergens of the Indian Standard Series, positivity to nickel and fragrance mix was seen in 5 and 2 patients respectively. Positive reaction to PPD, chlorocresol and parthenium was seen in 1 patient each. Limitation: Small sample size. Conclusion: Allergic contact dermatitis to kumkum occurs both due to the dyes (added for enhancing the colour) and turmeric. All patients with suspected allergic contact dermatitis should be patch tested with kumkum, turmeric and dyes, based on which alternative non-allergic material could be advised. Kumkum dermatitis can also occur due to various other allergens, for which too patch testing should be done.