59 yr old with swelling of both the legs and itching since 9 months not a known case of DM or HT. please dx and treatment



This case looks like a case of chronic eczematous dermatitis. Try to find out the cause if possible. Ruleout Diabetes Hypertension Hypothyroidism Alcoholism AIDS Any immunodeficiency cause History of Chemotherapy History of occupation particularly working in fields example farmer Exposure to chemicals like detergents,etc. Fungal infections . Treatment is Treat the cause Oral Antihistamines Topical application of Steroids. Topical Emollients Moisturisers

Check peripheral pulse. Do color Doppler both legs.

I think Eczematus dermatitis. Investigate him .... cbc, bsr, S.creatinine, b.urea, T3,T4,TSH,IgE. Now treat symtometically. TAB.Fluconazole 150mg od for 3 days than 1 tab.wkly.for 7 wks. TAB.prednisolone 20mg.bid for 10 days. TAB.cefuroxime 250mg bid for 10 days. Cosvate cream apply locally 2 times daily.. And Wait 4 blood report

Stasis dermatitis (Varicose eczema ) Gravitational eczema. Rule out venous valvular insufficiency. DVT. Advice colour doppler for both legs. 1.Emolients 2.Topical high potent steroids 3.Compression stockings. 4.Orally antihistaminic 5.Keep the legs raised when sleeping.

Ecz dermatitis Investigate for pedal oedema

Eczema tus dermatitis probably with bacterial infection, rule out hypothyroidism, varicose veins, obesity, chemical contact if any, t/t with antibiotic , local antifungal cream, raise the foot end till swelling reduce completely, also rule out faleriasis and then treat accordingly to the cause

Tab Itraconazole 200mg od week 7days Tab Defcort 8mg bd 7days Tab Fexofenadine 120mg bd 15day Inj Tricort 40mg start

Eczema.Rule out general causes.Allergen analysis followed by Desensitization is real treatment.Local Steroid applications, antipruritics and Antibiotics when required are suppressive measures

Eczematouss Dermatitis.


Bila. Dry dermatitis with ? Dvt , adv RFT,LFT, S.PROTEINS , BILATERAL LIMB VENOUS AND ARTERIAL DOPPLER , thyroid profile , cbc , 2decho .etc

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