Sir, According to History, Pt has a P/H/of PTB--- Black Scabs, Oozing for long duration(10yrs)--- Could B a Case of TUBERCULOSIS VERRUCOSA CUTIS, Also known as LUPUS VERRUCOSUS, PROSECTOR"S WART, which appears 3 - 4 Wks, Inoculation by MICOBACTERIUM TUBERCULOSIS in PREVIOUSLY INFECTED N IMMUNOCOMPETENT INDIVIDUAL--- D/D- -LUPUS VULGARIS, another form of CUTANEOUS TUBERCULOSIS, may persist for long duration--- - FUNGAL INFECTION, like BLASTOMYCOSIS N CHROMOBLASTOMYCOSIS DIAG: BIOPSY, Posetive Culture for Acid -fast bacilli, PPD Test, HIV, ELISA--- RX: - ISONIAZID, RIFAMPICIN, PYRAZINAMIDE, ETHAMBUTOL or STEPTOMYCIN--- SURGICAL EXCISION SOS Thanks.
Thank you my dear CUROFIANS.. History of PTB, As per visuals shows Multiple Hyperpigmented nodular patches with shallow Ulcerative lesions with irregular borders on limited only on lower 1/3 of the both limbs including calf muscles and permenant scars with difficult to walk due to deformity in the ankle and meta tarsals more favour to ERYTHEMA INDURATUM.... More common in women with long duration of PTB. Addison's disease, renal CARCINOMA and peripheral neuropathy are common associated problems. To ruled out HIV and HCV also. Diagnosis by strong positive of Mantoux test. But can't find out the bacelli in the skin. Combination therapy MDT.. INH, Ethambutol and Rifampicin for first 9 months. Daily dressings Good Nutrition. Potassium Iodide applications Surgical advises should be taken from surgeons and suggest suitable antibiotics after culture and Sensitvity.
May be may I suggest this case as Extensive multifocal lesions of tuberculosis verrucosa cutis To do CBP CRP to rule out CTD ELISA HIV KOH staining to rule out fungal infection ZN staining will be helpful for further work up Thanks for wonderful case daddy.
Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
Kindly go for Doppler study to rule out any vascular anomaly
Dry Beri Beri . Substitute with Thiamine + . multivamins muitiminerals + Antioxidants. Required . Probably INH inductio
Interesting case I shall waite the reply of experts
Bilateral Stasis Eczema & Ulcer?
Might be a case of cutaneous TB .SKIN BIOPSY should be done to confirm the diagnosis.till then regular dressing
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Friends today I am discussing about Vitiligo or leucoderma. Vitiligo also called as 'leucoderma' is an autoimmune disorder wherein the immune system of the body attacks the healthy cells and, in turn, starts affecting the body. The condition is characterised by white patches on the skin that develops as a result of melanocytes within the skin. These are the cells that are responsible for the skin pigment melanin that gives colour to your skin. The white patches appear when the melanocytes die off. The condition is called vitiligo, or leucoderma, or white leprosy. Symptoms Usually pale and white spots, patchy areas of depigmented skin appear. This is generally found in those body parts that face sun exposure. It usually occurs on hands, wrist and facial areas. If a white pigmentation already exists on your skin & you get hurt all of a sudden thereby developing similar white patches on the skin, then you should immediately visit a doctor. Remember that the patches are painless and it does not even cause any sensation of itching. But, with the sun's exposure, it may cause irritation and even sometimes a burning sensation. Myths VS Facts Myth 1: Vitiligo is an outcome of the wrong combination of foods, for instance, milk consumption shortly after eating fish can bring on the disorder. Fact: Factually, vitiligo has no link with the diet. It is irrational to deprive patients of the sour foods like lemon, curd, tomatoes, and pickles in the hope of declining the possibility of the disease. Myth 2: People with vitiligo disorder are lesser in their mental or physical proficiencies. Fact: Vitiligo is limited entirely to the skin. It has no relationship with or does not influence or affect any other organs. Myth 3: Vitiligo is a kind of leprosy and is communicable. Fact: Vitiligo is in no way linked to leprosy. It is not infectious or contagious and, hence, cannot pass on from one person to another. 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It must be noted that the description offered herewith is neither complete nor exclusive; as there is flexibility on the part of a qualified homeopath to make prescription based on one’s clinical judgment. Besides some of the following ingredients, the product contains Dr Shah's international Patented, Research-based, highly effective medicines. Dr Shah's patented molecules Kali CarbonicumSiliceaArsenicum Sulfuratum FlavumSyphillinumNitricum acidumCarcinosinHydrocotyle AsiaticaNatrum MuriaticumPhosphorus The following photos simply demonstrate how homeopathic medicines stimulate re-pigmentation. Please click photos to enlarge. Vitiligo on hands (Re-pigmentation demonstrated with research-based molecules at Life Force.) Kali Carbonicum: Potassium carbonate undergoes the process of potentization to evolve into a powerful deep acting homeopathic remedy called Kali Carb. Kali carb is a polychrest drug i.e. having effects on multiple organs and systems in the body. 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It has discoloration of the skin in blotches that are pale or white in color. It is also a good remedy for eczematous lesions which are moist and have intense itching with corrosive discharge. Pyoderma and urticaria also find a solution to this drug. Its sphere of action also extends to catarrhal affections and asthmatic states. A deep acting drug which has been known to give good results in Leucoderma (vitiligo). Syphillinum: Syphilinum belongs to a group of homeopathic drugs called as Nosodes which are prepared from disease products or diseased tissues. The remedy prescribed does not contain the original drug substance in the material form but it contains only the dynamic curative powers of that substance. This is achieved through the process of potentization in homeopathy. Syphillinum is a deep acting, polychrest remedy affecting multiple systems of the body. 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Nitricum acidum is a deep acting, constitutional remedy which positively influences the gastrointestinal tract, nerves, glands, skin, bones, etc. Its one of the commonly used drugs for vitiligo, warts, ulcers, fissures, gastritis, hemorrhoids, bony and rheumatic affections, malignancy, cachexia, etc. Carcinosin: It's the beauty of the homeopathic system of medicine to be able to use not only plants, animal products, and minerals but also certain disease products and diseased tissue for curing various ailments of patients. These are called as Nosodes. Here is a remedy prepared from the material derived from the carcinoma of the breast. It must be borne in mind that the actual medicine does not contain any part of the original substance in the material form. Only the dynamic powers of the original drug substance are present in the final medicine. Carcinosin is a deep acting constitutional drug having many indications and a very broad spectrum of action. It is useful for a wide range of disease processes, all of them cannot be described here, but a few of them are discussed here. It positively influences mind, lungs, heart, eyes, skin, bones and joints, nerves, etc. It is one of the commonly used remedies for diseases like vitiligo (Leucoderma), urticaria, lichen planus, styes and chalazion, hair loss, asthma, insomnia, trigeminal neuralgia, etc. Homeopathy believes that the genetic predisposition or inherent susceptibility is usually the root cause of a wide range of diseases and Carcinosin in one such remedy which is used to combat these genetic tendencies effectively. Hydrocotyle Asiatica: This is a remedy that is prepared from the plant called Indian Pennywort. The tincture from the whole fresh plant is used for the preparation of this remedy. After undergoing the process of Potentization, the curative powers of this remedy are brought forth. This is one of the very good remedies for vitiligo. It is supposed to stimulate the process of pigmentation. It is also beneficial for other skin problems such as psoriasis, lupus, leprosy, acne and other disorders of the skin in which there is much exfoliation of the skin. This medicine is often prescribed in combination with a constitutional medicine or other deeper acting medicine to get the best effect. Natrum Muriaticum: Natrum Muriaticum is an interesting example of homeopathic medicine prepared from a common food substance, the common salt, sodium chloride. As a rule, the common salt undergoes a special procedure called potentization, whereby its inner healing power is activated to make it available for healing. Constitutionally, this medicine has a broad spectrum of action and is useful for a wide range of disease processes affecting the skin, gastrointestinal organs, nose, lungs, kidney, metabolism, muscles, head, hormonal system, etc. It is one of the commonly used remedies for hair loss, fissures-in-ano, urticaria, migraine, eczema, lichen planus, vitiligo, asthma, etc. Natrum muriaticum is frequently prescribed in cases of vitiligo and is one of the very good remedies for the same. Phosphorus: This is a wonderful remedy prepared by the potentization of inorganic phosphorus. After undergoing the process of potentization, the latent healing powers of this drug are brought to the surface and it proves to be a wonderful remedy capable of curing a wide range of diseases. Phosphorus predominantly acts on the skin, gastrointestinal tract, hepatobiliary system, blood, kidneys, bones, lungs, nervous tissue, etc. It is frequently used in the homeopathic treatment of vitiligo (Leucoderma), hair loss, nephrotic syndrome, hepatitis, cirrhosis, hemorrhagic tendencies, respiratory infections, osteomyelitis, paralytic symptoms, etc. Few of its common skin symptoms are Loss of pigmentation in spots, white discoloration of the skin. It is also used for skin disorders where the patient has much itching and burning of the skin; in urticaria, psoriasis. It is also a good drug for hemorrhagic spots occurring on the skin at various places.Dr. Rajesh Gupta5 Likes17 Answers