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20 yrs old female presented with this rash and b/l pain in the hands. As per her this rash in the hands gets worse during winters and started at the start of winter as a discolouration and progressively increased to a point that now she has pain in her hands. Her reports showed: decreased platelet count (less than 15000), decreased RBCs and normal TLC. Mcv was decreased as well. She was diagnosed as a case of ITP by some practitioner and was transfused platelets 3 months ago. What other questions do we need to ask to come a definite diagnosis? What are the investigations to be advised ? What’s the diagnosis ? And treatment options?

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? CHILBLAINS .. ? VASCULOPATHY ..

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Chillblain Vasculitis Keep hands warm Put woollen gloves Nsaid orally

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Bruhad manjishtahdi kashay syrup 20ml bd Khadir powder Half teaspoon bd Amyron tab 2bd Galo ghan tab 1bd SH tab 1bd Locally, alovera gel for 2 to 3 week, after that, Galo ghan tab 1bd Ashwgandha tab 2bd amyron tab 2bd for 2 to 3 months.

?? Lupus

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Exfoliative Dermatitis

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Eczematous dermatitis

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Chilblains. With Melasma. Adequate clothing. For improving hematology status, evion, Becosule, Autrin. Healthy diet.

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?chilblains Tablet Treantal 400 TDS for 2 weeks Tablet Clavam 625 TDS for 10 days Tablet zerodol p bd for 5 days Pan 40 OD Betadine solution hot socking for 30 min with betadine for 2 weeks