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.

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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

Dear sir He's non diabetic and non HTN.
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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.

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? DYSHIDROTIC ECZEMATITS ECZEMA ? INFECTED PUSTULAR CONTACT DERMITITIS ONYCHOMYCOSIS with MYCOSIS Nails

? 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

ATYPICAL DERMATITIS OF BOTH HANDS SEVERE IN INTENSITY NEEDS URGENT DERMATO;OGICAL CONSULTATION URGENT DERMATOOGICAL CONSULTATION FORM OF SEVER

Dyshdrotic Eczema.

Its a case of acrodermatitis.

SUGGESTIVE OF DISHYDROTIC ECZEMA.... SECONDARY. TO I. C. D

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