quackery is rampant among many parts of india.many types of skin diseases and eruption can occur due to practices employed by quacks . many types of skin diseases and eruption can occur due to practices employed by quacks . various religious beliefs , socio - cultural and religious practices , and quackery to treat varied medical problems often result in a host of secondary dermatoses . with increasing civilization and migration of population , herein , we describe a case of quackery aimed to improve abdominal discomfort , however , leading to peculiar skin eruption thereafter . a 44-year - old immunocompetent married male was referred for an opinion on multiple strange appearing blisters on the abdominal wall since 3 days . on examination , multiple flaccid to tense bullae of size ranging from 1 to 3 cm over erythematous base arranged in a circumferential pattern with a well - defined erythematous margin were present on periumbilical area [ figure 1 ] multiple hemorrhagic blisters on abdominal skin in a periumbilical area with circumferential distribution on further enquiry , the patient gave the history of abdominal pain and loss of appetite since last 7 days for which he was investigated on the surgical side and was diagnosed to have a small bowel obstruction . an operative procedure of resection and anastomosis was planned by the surgical team . however , the patient refused to get operated and returned home and visited a traditional healer accompanied by his wife . the healer gave the patient some unknown pills to consume , which made him to lose his consciousness . the traditional healer then placed five burning lamps made of wheat dough over his abdomen in the umbilical region and then placed a utensil upside down over his abdomen covering those lamps . when the patient regained his consciousness , there was a temporary cessation of abdominal cramps , but the patient noticed multiple painful blisters over his abdomen in the later part of the day . we made a diagnosis of thermal burns resulting from burning lamps and managed the blisters symptomatically via draining and sterile dressings . we counseled the patient about graveness of his abdominal complaint and made him to get operated for obstructive pathology . quack  is a  fraudulent or ignorant pretender to medical skill  or a person who pretends , professionally or publicly , to have skill , knowledge or qualifications , he or she does not possess . in our case , the traditional healer placed the burning lamps around the umbilicus with a belief that disease ( evil forces ) may exit the body via natural body orifice ( umbilicus ) [ figures 2 and 3 ] . lamps made of wheat flour dough arranged circumferentially over periumbilical area ( the procedure was demonstrated on a ward attendant after due permission ) burning lamps and utensil used in the procedure ( not placed on actual patient due to ethical reasons )  branding  as a preventive or therapeutic measure for many diseases is widely practiced in many rural parts of india . practitioners of branding believe that the offending agent can get out of the brand site relieving the body of disease . . the practice may continue even in later part of life , as the local traditional healer administers the brand mark on different body parts based on the anatomical localization of disease pathology . tip of a hot metal rod , heated nails , wires , incense sticks , and hot bangles are the commonly used objects to brand the child . the forehead , face , chest wall , and abdomen are the usual sites of branding . the pediatric patient usually belongs to a poor illiterate rural family where branding is a continuing tradition prevalent through many generations . neem ( azadirachta indica )  is one of the most ancient known traditional ayurvedic medicinal plants and is considered to have numerous medicinal properties . various parts of neem tree are used to treat various dermatological conditions ( leprosy control , syphilitic sores and indolent ulcer , itching , skin ulcers , and eczematous dermatoses ) . however , a large dose of neem can cause adverse effects including rashes , itching , and swelling and , in more severe cases labored breathing . neem is considered to be unsafe in pregnancy when taken orally , as it can cause miscarriage . semecarpus anacardium ( biba )  , also known as  marking nut  , commonly used by washerman , is well - known for its value in ayurvedic and siddha system of medicine . it is believed to be helpful in treating illnesses related to the heart , blood pressure , respiration , cancer , and neurological disorders . however , it has been widely used by quacks for the treatment of rheumatic arthritis , nervous disorders to decrease pain , which often leads to irritation , painful blisters , and irritant contact dermatitis . in developing countries , neonatal tetanus and cord infections  continue to be an important cause of neonatal morbidity and mortality . infants with neonatal tetanus often have a concomitant cord infection , which points to a common cause ( unclean delivery and cord care practices ) . a wide variety of traditional practices and beliefs are associated with cord care . instead of cord clamp , unqualified midwives use blades of grass , bark fibers , reeds , or fine roots are used to tie the cord , which are often laden with clostridium tetani spores and increase the risk of neonatal tetanus . cord cutting / crushing is usually done with a variety of unsterile sharp instruments ( scissors , knives , broken glass , stones , sickles , or used razor blades ) . in most cultures , some kind of substance is applied to the umbilical stump to prevent bleeding from the stump , to promote separation of the stump , and to keep spirits away . cow , chicken or rat dung ; ash , oil , butter , spice pastes , herbs , mud , and ghee are the substances applied , associated with high risk of tetanus as they can be contaminated with bacteria and spores . this can help them avoid unnecessary investigations in case of dermatoses due to quackery and arrive at prompt diagnosis . practice of quackery can result in unusual dermatological eruptionsa thorough history and a replay of events can provide useful clue in diagnosis . practice of quackery can result in unusual dermatological eruptions a thorough history and a replay of events can provide useful clue in diagnosis . practice of quackery can result in unusual dermatological eruptionsa thorough history and a replay of events can provide useful clue in diagnosis . practice of quackery can result in unusual dermatological eruptions a thorough history and a replay of events can provide useful clue in diagnosis . practice of quackery can result in unusual dermatological eruptionsa thorough history and a replay of events can provide useful clue in diagnosis . practice of quackery can result in unusual dermatological eruptions a thorough history and a replay of events can provide useful clue in diagnosis .