30/F ,has developed this lesion for the past 2 days with edema.. no h/o fever..already she had previous h/o this type of lesion in her left upperlimb 2 months ago treated elsewhere..Dx and management?

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This is a case of cellulitis left leg ,with ulcer probably due to scratching. Recurrent cellulitis history present. Exclude Diabetes. Treatment is 1 Control diabetes meticulously with insulin if patient is diabetic. 2 Rest to the limb 3 Elevation of the limb 4 Oral antibiotics against Gram positive Gram negative and anerobes 5 Tissue lytics like chymotrypsin and trypsin 6 Oral antihistamines if there is itching 7 cleaning the wound with normal saline and 8Regular dressings

Dr Praveen Check for diabetic status of the patient. It looks like impending cellulitis. Immediate treatment is required. Cephalosporin or Linezolid should be initiated and saline soak dressing with Fucidic acid cream.

AGREE WITH DR AVITUS
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A local infective lesion. Potent antibiotic like Linezolid is required. Could be thrombangitis migrans as she had similar lesion elsewhere. It could be indication of some hidden malignancy. So also get an Ultrasound abdomen done

Cellulitis- check for diabetes- Higher antibiotics with debridement &cleaning of wound

Cellulitis. Will need debridement under anesthesia, after r/o diabetes, followed by regular dressings and limb elevation.

Small ulcer with local cellulitis. As TC >10,000/cmm- start antibiotics- cover gram positive cocci- linezolide or cefuroxime ,clindamycin, chymoral forte, NSAIDS , local dressing, -sometimes you may not get underlying cause but it is not must in most of the cases. Advice PP2BS/ HbA1c. Ask detail h/o 1) DM 2) animal bite- dog , cat 3) fresh water exposure 4) h/o recently on steroids 5) h/o malignancy, PVD ,

Similar lesion 2 mo back in upper limb, again in the leg, first R/o D.M. & any other immune deficiency cinditions. Rx with Culture sensitivity report is manditory. Use i.v. Antibiotics. Wound care with debritment. Dr Brahmananda.

infective ulcer with peripheral cellulitis unnoticed trauma may the cause. Do debridment of dead tissue . send pus for culture and sensitivity. Start antibiotics and anti inflamatory drugs . elevation of leg . local wound care .

Rule out diabetes.

Past history of similar lesion on hand is suggestive of papular urticaria and in this case superimposed with cellulitis due to ulceration on exposed site. Mgmt 1 all routine investigation 2 skin biopsy 3 pus culture and sensitivity 4 abs eosinophilic count 5 clean wound with h2o2 and Betadine if not sensitive and debride 6 being on ant. surface of tibia wound contraction and healing would be delayed therefore avoid secondary infection 7 higher antibiotics not necessary until proven necessary. Plain Mox and metro cover most of the offending organisms 8 cold fomentation to decrease inflammation 9 tab enzoflam for pain and swelling 10 limb elevation to reduce edema

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