25 years female pain and itching unable to walk black scabs and oozing lesions since .10 years. history of pulmonary TB Dx and Rx?

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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.

Nice to hear after a long time Sir
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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.

Thank you for your compliments and good suggestion deepunana.
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Kindly go for Doppler study to rule out any vascular anomaly

Thank you doctor
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Dry Beri Beri . Substitute with Thiamine + . multivamins muitiminerals + Antioxidants. Required . Probably INH inductio

Thank you doctor
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Interesting case I shall waite the reply of experts

Thank you doctor
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Bilateral Stasis Eczema & Ulcer?

Might be a case of cutaneous TB .SKIN BIOPSY should be done to confirm the diagnosis.till then regular dressing

Thank you doctor
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Eczematous

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