45 year old female with complaints of recurrent itching and lesion over the hand and chest..consumed different medication from various dermatologist ..applied clobetasol..emoderm..haloderm and tablets like atarax and steroids..this lesion is mainly on exposed areas..it was initially seen 10years back but for 2years it's on & off..patient also complaints of joint pain..and decreased appetite. She also underwent radiation 10years back for thyroid tumour. Any newer treatment modality or ointments!? DIAGNOSIS

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this case to looks like a case of mismanagement. I don't think it will be curable. do symptomatic treatment. investigate joint pains by excluding different kind of joint diseases. Carry out RAT, serum uric acid total protein and double strand DNA. I have only read about radio active iodine treatment for malignant thyroide condition. treat joint pain according to cause or symptomatically. no newer treatment I know of, make pt comfortable.

Sun rays allergies with secondaries with deficiency disease Tab Erythromycin TID for one week . Tab Fluconazole 150 weekly for for 6 weeks Tab Levocetrizine + Fexofenadine OD . Tab Vitamins A 600000 in divided doses in 6 doses . Tab Vitamins B C E OD for 3 months . Tab Calcium pantothenate OD. for two months UV protection cream Elovera application use cotton clothes & umbrella in sun light

dear Dr Abib,pt has started this thpe of lesion b4 10yrs as she copleted the ttment of radiation so think in this way if any ttment is useful

bullous eczema post radiation.tt. OMP of5mg betamethasone ,mometasone+ fusidic acid LA

IF patient is having associated joint pain forgot more than 6 week duration, then do ANA BY IFA. IF ANA is positive, then evaluate for CTD.

Tinea corporis Antifungals internally & externally for a minimum period of 3 weeks (non-stop).

pls give him multivitamin tablets antihistamine drug then start septilin tablets, Himalaya it gives best results to patients like this

why septiline sir.action sir?
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Plz mention 1. Occupation 2.relation with sun 3. On some long time rx4. Rule out RA factor or some autoimmune factors n antibodies . 5. Actinic LP

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