Kimura’s disease (KD) is a rare, benign chronic inflammatory disorder of unknown etiology, predominantly affecting young Asian males. It typically presents with painless subcutaneous nodules in the head and neck region, often accompanied by lymphadenopathy, peripheral eosinophilia, and elevated serum IgE levels. We report a case of an 18-year-old male with multiple lobulated, non-tender swellings over the bilateral retroauricular regions and left cheek persisting for eight years. Histopathology from a peri-auricular lesion revealed hyperplastic lymphoid follicles with germinal centers, interfollicular eosinophilic infiltrates, and eosinophilic deposits. Laboratory tests showed marked eosinophilia and elevated IgE. Imaging demonstrated bilateral cervical lymphadenopathy and parotid gland involvement. A diagnosis of KD was made, and the patient responded well to oral corticosteroids. This case underscores the diagnostic challenges posed by KD, particularly in differentiating it from malignancies and angiolymphoid hyperplasia with eosinophilia. Recognition of this entity is crucial to avoid misdiagnosis and ensure appropriate treatment.

Antitubercular treatment (ATT) is associated with multiple cutaneous adverse drug reactions. Second-line ATT is also associated with numerous adverse reactions; however, cutaneous reactions are under-reported. Oral drug provocation (ODP) in multidrug-resistant tuberculosis is challenging because of the paucity of time and the risk of developing secondary drug resistance in the case of interrupted medication. In this paper, we report a case of drug reaction with eosinophilia and systemic symptoms caused by cycloserine in an 18-year-old girl, which was confirmed with ODP and a patch test.

A young boy with high-output diarrhoea, who was extremely lethargic and irritable, presented with unusual perianal plaques extending to the thighs. Close clinical examination and basic laboratory investigation confirmed the diagnosis. Appropriate treatment resulted in rapid resolution of the skin lesions and improvement in his altered mental status within 72 h.

A 67-year-old female with type-2 diabetes mellitus presented with recalcitrant painful oral erosions and violaceous chest lesions, that responded minimally to oral corticosteroids. Due to history of decreased appetite, weight loss and poor therapeutic response, further evaluation was performed, revealing elevated C-Reactive Peptide, Desmoglein-3 antibody, Carbohydrate Antigen 19-9, and intraperitoneal lobulated homogeneously enhancing nodal mass, the latter indicating lymphoma. Histopathology from oral mucosa was suggestive of paraneoplastic pemphigus. The patient was referred to oncology department for further management. This case underscores the importance of thorough evaluation in elderly patients with recalcitrant mucocutaneous lesions with atypical histopathology.

Papulosquamous lesions in an elderly female with multiple co-morbidities often pose diagnostic challenge. We present an interesting case of anti-tubercular treatment (ATT) induced sub-acute cutaneous lupus erythematosus. The patient presented with papulosquamous lesions in generalised distribution, which showed interface dermatitis on histopathology. The serology for anti-nuclear antibodies, anti-Ro and anti-La was positive. The rash resolved spontaneously after stopping all the suspected drugs. Oral provocation was performed with first line anti-tubercular drugs and ethambutol was found to be the culprit drug, which was later confirmed by reappearance of skin rash by inadvertent ingestion of one dose of ethambutol by the patient.

International Journal of DermatologyEarly View Letter to the Editor Primary infertility in leprosy: a neglected underdiagnosed consequential manifestation Gajanand M. Antakanavar, Gajanand M. Antakanavar orcid.org/0009-0001-1580-0858 Department of Dermatology, Maulana Azad Medical College, New Delhi, IndiaSearch for more papers by this authorAmar Bahadur, Amar Bahadur Department of Dermatology, Maulana Azad Medical College, New Delhi, IndiaSearch for more papers by this authorTanvi Dev, Corresponding Author Tanvi Dev [email protected] orcid.org/0000-0003-2425-0226 Department of Dermatology, Maulana Azad Medical College, New Delhi, IndiaSearch for more papers by this authorShashank Rahangdale, Shashank Rahangdale Department of Radiology, Maulana Azad Medical College, New Delhi, IndiaSearch for more papers by this authorHarpreet Singh, Harpreet Singh Department of Medicine, Maulana Azad Medical College, New Delhi, IndiaSearch for more papers by this author Gajanand M. Antakanavar, Gajanand M. Antakanavar orcid.org/0009-0001-1580-0858 Department of Dermatology, Maulana Azad Medical College, New Delhi, IndiaSearch for more papers by this authorAmar Bahadur, Amar Bahadur Department of Dermatology, Maulana Azad Medical College, New Delhi, IndiaSearch for more papers by this authorTanvi Dev, Corresponding Author Tanvi Dev [email protected] orcid.org/0000-0003-2425-0226 Department of Dermatology, Maulana Azad Medical College, New Delhi, IndiaSearch for more papers by this authorShashank Rahangdale, Shashank Rahangdale Department of Radiology, Maulana Azad Medical College, New Delhi, IndiaSearch for more papers by this authorHarpreet Singh, Harpreet Singh Department of Medicine, Maulana Azad Medical College, New Delhi, IndiaSearch for more papers by this author First published: 16 June 2024 https://doi.org/10.1111/ijd.17326 Conflict of interest: None. Funding source: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1Gunawan H, Achdiat PA, Rahardjo RM, Hindritiani R, Suwarsa O. Frequent testicular involvement in multibacillary leprosy. Int J Infect Dis. 2020; 90: 60–64. 10.1016/j.ijid.2019.10.013 CASPubMedWeb of Science®Google Scholar 2Grabstald H, Swan LL. Genitourinary lesions in leprosy, with special reference to the problem of atrophy of the testes. JAMA. 1952; 119: 1287–1291. 10.1001/jama.1952.02930310023005 CASPubMedGoogle Scholar 3Sinha S, Singh S, Mathachan SR, Savitha B, Sardana K, Malhotra P. Case report: successful outcome of primary infertility with multidrug therapy in a long-standing case of hypogonadism resulting from lepromatous leprosy: shattering the dogma of irreversible infertility in leprosy. Am J Trop Med Hyg. 2022; 106: 47–50. 10.4269/ajtmh.21-0536 Web of Science®Google Scholar 4Nigam P, Mukhija RD, Gupta AK, Dayal SG, Goyal BM. Gonadal involvement in leprosy-study of gynaecomastia, testicular and epididymal involvement and therapeutic efficacy of indigenous drugs. Hansen Int. 1984; 9: 10–20. 10.47878/hi.1984.v9.35571 CASPubMedGoogle Scholar 5Milardi D, Luca G, Grande G, Ghezzi M, Caretta N, Brusco G, et al. Prednisone treatment in infertile patients with oligozoospermia and accessory gland inflammatory alterations. Andrology. 2017; 5: 268–273. 10.1111/andr.12300 CASPubMedWeb of Science®Google Scholar Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation