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Image Number 2677 (Allergic contact dermatitis)

 
Morphology:
Vesiculobullous

Diagnosis: Allergic contact dermatitis

Site: Heel

Sex: F

Age: 32

Type: Clinical

Description: Penetration of foot

Submitted by: Kiran Nabar

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Differential Diagnosis

History:

 This patient came with intensly pruritic vesiculo bullous  lesions on right foot dorsum, abdomen and right  forearm since 2 days. The lesions on abdomen were linear( streaky) in arrangement. That was a clue for phytodermatitis. There was no history of contact with plants or leaves hence I asked about any history of contact with marking nut ( anacardium).She gave positive history. She had a thorn prick on left foot heel 3 days back for which she had heated a seed of anacardium and while it was hot she pricked it with a needle and applied the oil, which came out of the seed, to the wound .( This is a usual practice in villages .Anacardium oil has got antibacterial and wound healing property). Hence when ever a patient comes with lesions suggestive of phytodermatitis (linear streacky vesiculobullous lesions on exposed areas) without history of contact with plants I ask history of marking nut application for any cut or wound. Though it is applied mainly on soles allergy is not seen on soles as it has very thick stratum cornium. Accitental / inadvertent spillage/contact of oil on glabrous skin leads to such presentation.



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