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What Causes Rough Hyper Pigmented Areas On Face After Using HH Sone Cream?

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Posted on Mon, 9 Jun 2014
Question: I am advised : caps aceret 25mg, tab vozet 5mg & HH sone cream. My skin gets red at a particular spot followed by softness of that part & then water oozes out slowly from that spot. It is spreading. My doctor at Ambani hospital in XXXXXXX advised that some changes due to pollution. Some are telling fungi problem. I am taking isotroin 20 mg in place of aceret due to cost affordability while others 2 are same as advised. After applying cream skin becomes dark & then leaves a spot. This is continuing. Kindly advise.
doctor
Answered by Dr. Dr. Kakkar (22 minutes later)
Brief Answer:
Hypertrophic Lichen Planus

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your query and i have looked at the pictures.

I would keep a possibility of Hypertrophic Lichen Planus. It presents as itchy, raised, hyperkeratotic/rough, hyperpigmented papules and plaques, mostly on the shins. The lesions resolve with post-inflammatory hyperpigmentation and some atrophy/de-pigmentation.

It is not a fungal infection.

Isotretinoin/Isotroin 20mg is one of the drugs of choice to treat hypertrophic Lichen Planus. Topical HHsone contains Mometasone furoate which is a steroid. Whereas, is an antihistamine for symptomatic control of itching.

You are on the right medication, though I would have preferred clobetasol propionate ointment (Tenovate ointment) in place of mometasone furoate cream (HHsone cream) because Hypertrophic Lichen Planus responds better to an application of a super-potent steroid like clobetasol propionate ointment (Tenovate ointment) rather than to a mid-potent steroid like mometasone furoate cream (HHsone cream).

regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Kakkar (27 minutes later)
When I remain at my home in village clean environment then no further spreading. Now, my wife is also suffering with this problem. How long treatment will be there.
Why this problem occur? Why it has happened to me? What to do so that it does not spread to my other family members. I remain very stressful. If it gets fine after suppose 6 months. Then whether any chance of reoccurrence. Whether any diet related problem? What is the future for family planning related issues. What to for wife treatment. Some advise bitterguard for its treatment. Kindly advise. What effect will be on future generation. What to do so that it does not happen again to me or my family. Whether this disease can spread with other person because of touch or inhabiting with other. How much long treatment it will be? Other advisable remedies etc
doctor
Answered by Dr. Dr. Kakkar (11 minutes later)
Brief Answer:
L P

Detailed Answer:
Hi.

Lichen Planus(L P) is not related to the change of environment. The disease is not contagious either, so your wife developing a similar problem is a co-incidence. I would suggest that she consults a dermatologist for a confirmatory diagnosis, whether she has the same condition or something else.

The disease has a self limiting course and resolves on proper treatment. There can be few recurrences, more so in those who are not adequately treated or non-complaint with the treatment. However, they can be appropriately managed in the same way.

It is not inheritable disease, so future generations are not at risk. Diet has no role whatsoever.

Once the disease has improved significantly (i.e the patches settle down and don't itch) usually within 2-3 months, Isotretinoin can be discontinued and only topical steroids would suffice.

The natural course of L P is to leave behind post-inflammatory hyperpigmentation/black patches after resolution. Pigmentation may take a long time to resolve. You could use a mid potent steroid (mometasone furoate) to hasten the resolution of pigmentation

regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Kakkar (23 hours later)
Good evening Dr Kakkar.

Symptoms:
itching, inflation since years below chest, cirrhosis/psoriasis, small red dots on palms, white patches on nails, tiredness even if sleep from 4 to 12 hours, weight loss fast if little negligence in diet, loss of appetite but take good quantity of food because of fear to deliver in case of marital or family responsibilities, anxiety, stress, persisting irritated behavior, bulging of belly, pain in joints like left leg ankle can make a cracking sound as and when & as many times as I want to make with just little movement of leg, pain in joints, pain in heels when I get up in morning, pain in legs if stand for 10 minutes, pain in legs if press against with palms, loss of memory, delayed clotting of blood, bleeding in intestine sometimes, bleeding of gums sometimes, dizziness, nausea, fast weight loss if even little negligence in diet, not feel hungry but take food because of fear of delivering my marital & family responsibilities.

Since my wife also infected as I discussed with you yesterday with exactly similar signs with similar features like tirednesss, irritating behaviour, loss of memory etc. Since this hepatis C is viral and contagious. I have seen this as exactly like my problem.

I & my wife were also not vaccinated during childhood for any disease.

Also, I think that instead of pustules (because I referred videos of infected persons mild to serious) this is psoriasis/cirrhosis. Since same medicine is prescribed for this condition also; so I strongly doubt this as initial stage of hepatitis C.

Because off inflammatory feeling under chest I treated it as heart problem but got diagnosed at XXXXXXX medical institute but found none after ECG, X ray etc.

Also, I thought that it may be because of calcium deficiency but on an average I take 1 litre of milk, curd, buttermilk etc; so seems hepatitis C.

I will be highly indebted to you as most of the times I remain frustrated, very low confidence etc.

Kindly find the attachment with name hepatis C in this case attached herewith.

Thanking you,

Yours faithfully,
+91-0000
doctor
Answered by Dr. Dr. Kakkar (29 minutes later)
Brief Answer:
L P

Detailed Answer:
Hi.

Hepatitis C is one of the cause of L P but it is not the sole one and not all hepatitis C patients will have L P.

Most of the patients of L P have no underlying cause and it is so uncommon to have LP because of hepatitis C, that routine testing for Hepatitis C is not even warranted in case of LP.

However, if you are really concerned about Hepatitis C, you can get yourself and your wife tested.

Isotretinoin/acitretin is prescribed in psoriasis as well(but not in cirrhosis). Isotretinoin/Acitretin are vit A derivatives, and has multiple indications like Hypertrophic L P, Psoriasis, Acne, Palmoplanter keratoderma, Darrier's disease etc etc. L P is just one of these indications.

Please don't be so worried about your skin problem, it is not at all serious and would resolve on treatment. The rest of the systemic symptoms that you mentioned are most likely related to anxiety, in my view. You can consult an Internal medicine specialist regarding all these symptoms.

regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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What Causes Rough Hyper Pigmented Areas On Face After Using HH Sone Cream?

Brief Answer: Hypertrophic Lichen Planus Detailed Answer: Hello and welcome to healthcaremagic I am Dr. Kakkar. I have gone through your query and i have looked at the pictures. I would keep a possibility of Hypertrophic Lichen Planus. It presents as itchy, raised, hyperkeratotic/rough, hyperpigmented papules and plaques, mostly on the shins. The lesions resolve with post-inflammatory hyperpigmentation and some atrophy/de-pigmentation. It is not a fungal infection. Isotretinoin/Isotroin 20mg is one of the drugs of choice to treat hypertrophic Lichen Planus. Topical HHsone contains Mometasone furoate which is a steroid. Whereas, is an antihistamine for symptomatic control of itching. You are on the right medication, though I would have preferred clobetasol propionate ointment (Tenovate ointment) in place of mometasone furoate cream (HHsone cream) because Hypertrophic Lichen Planus responds better to an application of a super-potent steroid like clobetasol propionate ointment (Tenovate ointment) rather than to a mid-potent steroid like mometasone furoate cream (HHsone cream). regards