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



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

Lichen planus

Sir as far as I read Lichen planus should have characteristic wickhem's strai and is mainly manifested on floor surfaces of hands...it don't have to go anything with edema


@Elocon ointment with antihypertensive drugs along with diruetics to control edema

T. Unguium with chill blains

Onychomycosis in hand with LSC .agree with Dr SK Das

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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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.

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!!!

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