Concluded Case

55 male known diabetes HTN on treatment presented with cough dyspnea and skin lesions since last 6 months. taking treatment as psoriasis. plz interpret CXR and skin lesions and guide further management.

4 Likes

LikeAnswersShare
Concluded answer

Destroyed... fibrocavitated...volume lost....left lung Media pulled to left Left dome pulled up Trachea pulled to left Level on left show lung abcess formation in any cavotory lesion Watch should be there for any fungal super added inf along with bacterial inf There are fair chances of having foul smelling expectoration due to anaroebic inf Any how treatment is symtomatic As pt is having skin auto immune disease ...so may be getting dteroids ...so.. We should be vigilant to see for reactivity of tubercular process

All Answers

Multiloculated cavitory lesions with hydropneumothorax lt side with hyperinflated lung rt side Skin lesions are psoriasis vulgaris Both problems at a time suggest autoimmune disease Since he is k c o dm/htn Rx for chest broadspectrum antibiotics and bronchodilators and diuretics and expectorants and inhalers For psoriasis lobate-s oint twice daily Tab loritidine 10mg 1od Tab dispred4mg 1tds Tab acitrin 25mg 1od Tab methotrexate 10mg weekly Case is to be monitored and reviewed every fortnightly

Valuable opinion
0

Multiple fibrocavitations left side Mediastinal shift to left side Trachea pulled left side Left CP angle pulled downwards Visible aortic knuckle Mild thoracic scoliosis RT HYPERINFLATION The lung disease may be a result of suppressed autoimmune skin disease i.e. psoriasis extensive ? pulmonary abscess ? ischemic lung disease ?COPD ? KOCHS ?CA LUNG ADV HRCT SPUTUM EXAMINATION R/M C/S COMPLETE HEMATOLOGICAL INVESTIGATIONS SYMPTOMATIC TREATMENT R/O HIV /SLE

Psoriasis vulgaris with pneumonitis lower & middle love, rule out HIV. Diabetes must be controlled simultaneously treat lung problem. Ref to a pulmonologist and a cardiologist

Thank you doctor
0

View 1 other reply

Left side multiple cystic /cavitory lesions in all zones..with ipsilateral pull of trachea and raised of done of left diaphragm ..suggestive of chronicity of the illness ...there's hyperinflation of the right lung...few infiltrates on right lower zone Psoriasis involving the lung causes bilateral infiltrates progressing to UIP ..cystic/ cavitations are unlikely secondary to psoriasis..however, owing to steroids and immunomodulatory agents given for the treatment, the patient is more likely to have infections including tuberculosis.. Please confirm from skin biopsy/ autoimmune profile about the exact skin etiology . Ascertain pattern of lung involvement with hrct chest..also send sputum for examination for etiology ...Any extra-dermatological manifestation/complication of psoriatic arthritis warrants immunosuppressive drugs.

3 ) X-RAY FINDINGS ARE.. MULTIPLE CAVITARY LESIONS ON LT.SIDE WITH HYDROPNEUMOTHORAX .. 1,2 ) PSORIASIS..

Tnx
0

Destroyed... fibrocavitated...volume lost....left lung Media pulled to left Left dome pulled up Trachea pulled to left Level on left show lung abcess formation in any cavotory lesion Watch should be there for any fungal super added inf along with bacterial inf There are fair chances of having foul smelling expectoration due to anaroebic inf Any how treatment is symtomatic As pt is having skin auto immune disease ...so may be getting dteroids ...so.. We should be vigilant to see for reactivity of tubercular process

Valuable opinion
0

View 1 other reply

Trachea shifted towards lt Lt cp angle blunted Fibrocalcified lesion present in lt lung wide mediastinum Old Koch's sequele/ aspergillosis Get Hrct chest for confirm Skin lesion suggest psoriasis Topical steroid and oral also Antihistamine

Thank you doctor
0

View 1 other reply

Multiple cavitary lesions on lt middle lower zone ..shifted trachea....few infiltrations in rt side also......long known case of psoriasis most likely on immunosuppresant drugs n steroids.....so most likely due to severe immunocompromised status....dx seems like pulmy aspergillosis.....plus empyema probably .............

MULTILOCULATED.... CAVITORY. LESIONS WITH HYDROPNEUMOTHORAX.... LT. SIDED SKIN. LESIONS. ARE..... PSORIASIS. VULGARIS

Multiple pockets of trapped air....? cavities ?bullae Trachea pulled to left Mediastinum pulled to left... CECT thorax shd be done

Load more answers

Cases that would interest you