45 year female n/o of htn nd dm c/o generalized edema*2months past history -nad plz help for diagnosis nd rx

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First looks older than her age .Both hands dorsal aspects can be seen are erythematosus and oedematous with distrophic nail changes. Chronic contact dermatitis with onychomycosis of finger nails. Avoid soap and detergents as far as possible.use cotton Gloves or plastic hand glove then put on proline or latex hand Gloves during handling of water soap and detergents. Liberal amount of moisturizer such as Emolene creAm four times a day Clobetasol ont such as Tenovate not twice a day over affected parts only for one month Short course of antibiotic such as tab C/o amoxyclav 625 twice a day for 5 days.

T.unguium,give pulse therapy of itraconazole along with topical application of amorolfine
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Order Sr. Creatinine, Sgpt and immune markers ANA and anti-scl antibodies as the patient appears to be suffering from some systemic vasculitides probably scleroderma with classical sausage fingers.

Poor nutritional status with bilateral claw hand ( hansen's) Please enquire about previous drug history ( hansen's) Investigation with respect to her nutritional status

Exclude aneamia .hypoproteanimea. rft cbc lft. Peripheral blood smear . Review.

Should evaluate cbc proteins creatinine ana profile for any evidence of systemic sclerosis nail scrapping if required,thyroid profile,urine for microalbuminuria,2d echo for any pulmonary hypertension

Leprosy with fungal onychomycosis ungum. Lateral aspect of eyebrows missing hairs, leonine facies, subcutaneous cellular oedema. Nails show leprotic onychomycosis with fungal tinea ungum. Treatment should include anti leprotic treatment with systemic antifungal Griseofulvin tablets 650 mg, twice a day, after meals for minimum 6 months. Apply Steroid creams on skin for minimum 2 weeks. Tab. Prednisone 10 mg, twice a day for 1 week to improve conditions rapidly. Good Luck. Wishing a Speedy Recovery!!!

Onychomycosis in hand with LSC .agree with Dr SK Das

Malnurished Systemic sclerosis Anemia Onychomycosis

Diet and any wt loss history urine exam cbc microalbumiuria thyroid profile Esr s proteins to be done

Looks malnuritioment With fungal inf Give antifungal Colostrum Vit C CoQ10 &if hypoproteinemic give A G

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