Dermatitis cruris pustulosa et atrophicans revisited: our experience with 37 patients in south India.
BACKGROUND
Dermatitis cruris pustulosa et atrophicans (DCPA) is a distinctive type of chronic superficial folliculitis, with a number of unique features such as its peculiar symmetric localization to legs, extreme chronicity, resistance to therapy, and inevitable alopecia and atrophy.


METHODS
All patients with DCPA, attending the Dermatology Outpatient Department at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Hospital, Pondicherry, from December 2006 to June 2008 were included. Parameters recorded were detailed history and examination, hemogram, erythrocyte sedimentation rate, random blood sugar, skin biopsy and cultures from pus and carrier sites (nares, axillae and gluteal fold).


RESULTS
37 patients were studied (35 males and 2 females). Sixteen patients (43.24%) belonged to the 21-30 year-old age group. The disease most commonly began on the legs (81.1%). Majority (78.38%) had a disease duration of less than 5 years. Itching was the most common symptom (89.19%), followed by bleeding and scaling, with no significant systemic symptoms. The lower limbs were involved in all patients. Eleven patients (29.73%) had involvement of other sites--beard, axillae, chest, moustache, abdomen, and eyebrows. Pustules, papules, and scaling were seen in all patients, followed by wiry roughness, atrophy, alopecia, and pigmentation. Aggravating factors included use of full-length synthetic trousers, occupational exposure to potential irritants, and season (summer). Pus culture from the folliculitic lesions grew Staphylococcus aureus in 32 (86.49%) patients. Twenty one patients (56.75%) were carriers of S. aureus in one or more sites.


CONCLUSIONS
DCPA is a chronic folliculitis of the legs, with a multifactorial etiopathogenesis, in which staphylococcal carrier status may be a new potential pathogenetic factor.
Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Sowmya
S
Kaimal
Mariette
M
D'Souza
Rashmi
R
Kumari
Subhash Chandra
SC
Parija
Sujatha
S
Sistla
Bhawana Ashok
BA
Badhe
D000328:Adult; D002908:Chronic Disease; D003872:Dermatitis / Q000382:microbiology / Q000473:pathology; D005260:Female; D005499:Folliculitis / Q000382:microbiology / Q000473:pathology; D006801:Humans; D007194:India; D008297:Male; D055815:Young Adult