Contact Dermatitis Due to Quackery.

Sir,

Widespread myths and superstitions among the people of our country has caused the emergence of dermatoses putting dermatologists in confusion and sometimes misdiagnosis if the patient does not give proper history. With all varieties of communities and secularity in our country, there are a certain group of people, especially people with the lack of knowledge about health education and awareness usually fall under prey of such malpractices. Another important factor that has led to the widespread emergence of this problem is the financial constraints. Quackery and poor medical care overlap but are not exactly identical.

A 52-year-old female came to our outpatient department with complaints of lesion over back, abdomen, and bilateral forearms for 1 week. According to the patient before 15 days a quack was being called for generalized pain and weakness she was experiencing. The quack related these symptoms due to some blood impurities. He counseled the patient that by putting an instrument over her body at various places, he will extract all impure blood and she will be alright. After 3–4 days, the patient started developing burning and itching over those sites. There was no history of any other comorbidity. No history of any drug or food allergy was present. There was no history of recent drug intake. Cutaneous examination revealed 13 well defined erythematous patches with multiple linear cuts arranged in rows horizontally over the patch indicating the blades present on the instrument. Associated erythema and exfoliation of skin were present surrounding the patch; 2 on bilateral forearms [Figure 1], 1 on abdomen [Figure 2a] and 4 patches over upper back [Figure 2b], and 6 patches on the lower back [Figure 2c]. The patient was diagnosed as a case of contact dermatitis and was been given antihistaminics with topical antibiotic and steroid. The patient was advised to bring the instrument used by the quack on the next follow-up, but she did not turn up. According to the description by the patient and the morphology of lesions, we could find a photo from Internet of instrument, round with blades on it. [Figure 3] which may be the cause of contact dermatitis.

Figure 1

Well-defined erythematous patch with linear cuts inside the patch arranged horizontally over bilateral forearms hinting to the possibility of blades in the probe used

Figure 2

(a) Single well-defined erythematous patch over abdomen, (b and c) Multiple well-defined erythematous patches over upper and lower back

Figure 3

Suspected instrument

“Quackery” derives from the word quacksalver; someone who boasts about his salves. Dictionaries define quack as a pretender to medical skill; a charlatan; and one who talks pretentiously without sound knowledge of the subject discussed.[1] These definitions suggest that the promotion of quackery involves deliberate deception, but many promoters sincerely believe in what they are doing. The Food and Drug Administration defines health fraud as the promotion, for profit, of a medical remedy known to be false or unproven.[1] Quackery entails the use of methods that are not scientifically accepted. The reason for its prevalence in a country like India is the lack of health education, lack of awareness among common people, and blindly following the superstitions. Even though such practices are very common in India, only a few are being reported. A case report on thermal burn induced by placing burning lamps over abdomen by a quack to relieve abdominal pain is also reported.[2] There is an urgent need for addressing these practices and taking actions against them. The main step toward bringing awareness is health education regarding common dermatological entities. The dermatology community should actively plan strategies to come against such practices which in turn will help to avoid unnecessary investigations in case of dermatoses due to quackery and will also help to arrive at correct diagnosis at the earliest.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.