Hyperkeratotic lesions. Dx? Mx?

An 87-year-old male with hyperkeratotic lesion that has been present for the past 4weeks. Medical history: hypertension, type 2 diabetes mellitus (well controlled), chronic obstructive airways disease The vascular status of the patient is unknown at present. Due to unknown vascular status, I was apprehensive to debride this lesion. This patient has poor hygiene due to difficulties showering. Any idea of what this lesion could be and how it should be managed? Prescribed prednisolone tablets and Celestone cream in past but minimal improvement. The lesion is hard and is very painful. Suggestions are appreciated.

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In some cases, hyperkeratosis is the skin's response to rubbing or irritation. A corn or callus on your hands or feet is a form of hyperkeratosis. Keratin is a tough type of protein and is meant to help protect your skin. A bump or patch of thickened skin is known as a hyperkeratotic lesion. This can be removed with cryosurgery or with a scalpel. Inherited conditions. There is no cure for these conditions. To treat large areas of scaly skin, your doctor may suggest rubbing special emollients into the skin. Diabetic controll needs to be monitored. Vontinue steroid for short period with tapering of doses protocole
Crusted pyoderma with diabetic dermopathy Lesions need debridement Beside keeping good control of diabetes Rx tab lenazolinid 600mg 1bd Tab azithromycin 500mg 1od Locally mupirocin oint twice daily Once infection is resolved than primary lesions to be adressed
Thanx dr Vipin Bihari Jain
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Hyperkeratosis. Reassurance and counciling required. Rehydrate skin by applying moisturizer or emollient lotion locally. Antihistamine orally. Steroid orally and locally. Multivitamin and antioxidant orally. Keep the area clean and covered with sterile gauge.
Thanks Dr Vipin Bihari Jain
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Apparently Diabetic hyperkeratosis