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To the Editor: A 36-yr-old, nonsmoking, Hindustan female presented with complaints of dyspnoea without coughing which had persisted for several months. The complaints started after a bout of pneumonia a few months previously. Her medical history was unremarkable. She did not suffer from asthma, nor did asthma run in the family. She worked at an administrative office. Physical examination showed no abnormalities; in particular, the auscultation of the lungs was normal. A screening laboratory examination, including complete blood count, renal function and liver function tests, was normal. A chest radiograph showed nodular lesions in both lungs (fig. 1a⇓). FIGURE 1. Radiodiagnostic imaging. a) A chest radiograph showing multiple nodular lesions in both lungs. b) A high-resolution computed tomography scan showing a diffuse nodular image in both lungs. Interlobular septa and pleura were normal.Because of the abnormal chest radiograph, a second patient history was carried out and revealed a remarkable twice daily bathing ritual where she used large amounts of cosmetic talcum powder. After bathing the patient powdered her whole body with talcum powder, a ritual she had carried out since her childhood. Ancillary laboratory investigations including angiotensin converting enzyme, total immunoglobulin E and anti-cyclic citrullinated peptide were all negative. A high-resolution computed tomography (CT) scan of the thorax showed a diffuse nodular image in both lungs. Interlobular septa and pleura showed a normal pattern (fig. 1b⇑). Pulmonary function tests showed a restrictive pattern, with a normal diffusion capacity. Bronchoscopy …

Talcosis due to abundant use of cosmetic talcum powder