Kerosene-Induced Panniculitis in Iraqi Patients

Abstract

Background: Kerosene is a common household stuff that has been used as accidental oral poisoning material in children and as suicidal attempt in adults. In the last decade intradermal kerosene injection has been commonly used to induce dermatitis artefecta as a part of emotional upset. Objective: To evaluate the clinical cases of intradermal kerosene injection in Iraqi patients. Patients and Methods: This is a descriptive case study that had been conducted in Department of Dermatology Baghdad Teaching Hospital, Baghdad, Iraq during the period from Jan. 2003 to Dec. 2012. History and full clinical examination were performed including all sociodemographic aspects associated with this condition. Psychiatric evaluation was done for each patient. Results: All eleven patients had single lesion except that two had two lesions. They were distributed on accessible areas on the limbs. The exact diagnosis was not reached for at least few weeks after kerosene injection. The patients denied any kerosene injection, but after a while they all admitted that the cause of their rash, severe emotional tension was observed at the time of kerosene injection as they had sociopsychological disturbances. The initial rash was erythematous indurated tender plaque that was gradually increasing in size simulating the picture of panniculitis and then followed by rupture of lesion and associated pyoderma, forming chronic discharging ulcer. Patients were managed by topical and systemic antibiotics until complete resolution leaving a big ugly scar that was treated by topical steroids to improve its cosmetic appearance. Conclusions: Kerosene intradermal injection is an increasing problem among Iraqi adult females and it should be suspected in any patient with chronic discharging ulcer on accessible areas like limbs.