45 yr male complaints of burning sensation and pain in affected fingers. not a known case for HTN and T2DM but pt is alcoholic.This skin lesions present since five yrs. what are your views, Dx, Tx and management of it.
Dr. Sunil It's DYSHYDROTIC ECZEMA It is due IRRITANT of contact chemicals. Diabetes and HTN may be exaggerated the condition. Poor respond to treatment. So good glycemic control and HTN will give good relief. Treatment" Avoid contact allergens. Sitz bath of affected parts. MUPIROCIN cream Covered by HYDROCORTISONE cream. Cap Amoxyclov 625 mg bud for 7 days. Tab antihistamines daily night
Good answers doctors, Now I can add few more important things regarding this case. My impression is better to discuss about Differentials of this case. One by one exclusion method. Differentials are: 1) DYSHYDROTIC ECZEMA ( Pomphylox) exclude by asking history of contact allergens. Allergy skin testing..positive and biopsy, 2) Psoriasis....it's pustular psoriasis Here Acrodermatitis continua of Halipoea is variant of pustular psoriasis exclude this by clinical presentation and Radiographic changes of distal phalanges mainly focus on resorption of the distal phalanges. 3) Dyshidroform bullous pemphigoid..... DIF tests positive for Ig G and Complement C3 fixation. 4) Keratosis exfoliating.....by clinical examination and patch test which is negative. 5) Fungal infections ( infected Tinea mannum and unguim)......exclude by KOH test positive 6) Nutritional dermatitis .....by history and SCORAD index. 7) Lichen planus.....exclude by clinical presentation and Biopsy And Hepatitis C antibidy test which is trigger of LP.
? DYSHIDROTIC ECZEMATITS ECZEMA ? INFECTED PUSTULAR CONTACT DERMITITIS ONYCHOMYCOSIS with MYCOSIS Nails
Dyshidrotic ECZEMA How is dyshidrotic eczema treated? Moisturizing lotion or cream. This helps treat dry skin. Steroid ointment. This can reduce inflammation. Calcineurin creams. These may also reduce inflammation. Oral steroid medicine. ... Draining of very large blisters. ... Treatment with psoralen and ultraviolet light (PUVA).
? Acrodermatitis Continua of Hallopeau
Yes he could be a case of psorasis But can a d/d of syringomylea and be considered? Or could it be a contact dermatitis
Alcoholic peripheral neuropathy duputrens contracture noted 5 th finger / rx thiamine 100 mgs daily / do b12 / b 6 levels / folic acid / alcoholic nutritional deficiency
D Eczema Inj Tricort 40mg start Tan Itroconazole 200mg Tab Fexafenadine 120mg bd Tab Cefuroxime 500mg bd
ATYPICAL DERMATITIS OF BOTH HANDS SEVERE IN INTENSITY NEEDS URGENT DERMATO;OGICAL CONSULTATION URGENT DERMATOOGICAL CONSULTATION FORM OF SEVER
How do you get rid of dyshidrotic eczema? Treatments may include: Moisturizing lotion or cream. This helps treat dry skin. Steroid ointment. This can reduce inflammation. Calcineurin creams. ... Steroid medicines taken by mouth (oral). ... Draining of very large blisters. ... Treatment with psoralen and ultraviolet light (PUVA). ... Other medicines.
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