Thursday, January 28, 2010

Dermatitis Medicamentosa

It was closing time when Shabbir came in. Seeing me getting ready to leave, he said, ‘doctor saab, 'I will come some other time, it is nothing urgent’ But his face was tense and I was pretty sure that there was something important he wants to discuss and at the same time he was trying to avoid and postpone the consultation. ‘I have plenty of time, especially for my friend Shabbir’ so saying I took him inside and made him sit down and said, 'now you tell me what is the problem’.

Shabbir, when the incident occurred, was a young man of thirty [twenty five years ago] and an up and coming business man. His work took him to many cities of the country. He had a young wife and a two year old daughter and I was pretty close to the family having been the doctor even for his parents.

He would not begin his story right away and needed some more prodding from me. And at last he began in Urdu. When one is in serious trouble it is the mother tongue that comes to the rescue and not the acquired language English which he usually spoke whenever he met with me. Urdu is a rich language which developed over centuries in this country and it has borrowed liberally from Persian, Hindi and Sanskritand many local dialects. The fun is that the language spoken in north India is different from that spoken in south ad even in south Urdu spoken in Hyderabad is different from one spoken in Bangalore. 'Doctor saab, I feel shy to tell you this trouble I am having since six months, I have gone to many doctors before coming to you’ he stopped to catch his breath and resumed, I got his problem when I went to Bombay on business and since then what to tell you, my life has become one hell’ he stopped. 'You still have not told me your problem’ I said. ‘Yes, yes I am coming to that, please don’t scold me, you know mw I am not such a person but this one time mistake happened'. ‘What mistake happened’ I asked him. ‘Woman mistake’ he said virtually breaking down. I came back from Bombay and my skin there began burning and I was too scared to see you so I went first to Dr-- and he gave me ointment and tablets. I took them for one week. I felt no better and he sent me to hospital specialist who did all tests for VD [Venereal Disease] and gave me injections and some more ointment. I felt little better but the skin peeling continued. I have seen another doctor and even tried homeopathy. You don’t know the tension I am going through, I have not touched Nafiza [his wife] and she is very angry and thinks that I am seeing another woman [bibi bambdy mar is the word he used], you please help me’.

I asked him to undress and had a look at his genitals. The penile and scrotal skin was abraded and covered with whitish scabs. There was no evidence of severe infection. I had a look at the prescriptions he was carrying. He had been given all possible antibiotics that were available in the market and extensively investigated and treated for venereal disease. There was no definite evidence of VD except for the history of having had sex with a strange woman. I asked him to stop applying the two types of ointments he was using liberally and just to wash the skin with soap once a day and see me after one week. When he came after a week he looked much relieved. The skin looked far better. Another week of doing nothing, Shabbir’s allegedVenereal disease got completely cured!

What had happened was that he had developed allergy to the ointments he was applying and those days we used to call this condition, 'dermatitis medicamentosa’. Our Shabbir did not have VD but DM.

Peace once again prevailed in the Shabbir household and has remained so since then!

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