Thanks everyone for your kind & valuable opinion. My D/D is Erosive Lichen Planus, my only clue were the lips lesion. Topical Triamcinolone & etc prescribed. Planning for imaging & biopsy on 14th day if ulcer don't heal.
Well, i think it to be a case of Grinspan syndrome, where hypertension, diabetes and oral lichen planus occurs together. But, i will keep lichenoid drug reactions as a d/d too. As yes this can be due to drugs taken for diabetes and hypertension. Provisional diagnosis- Oral lichen planus (Grinspan syndrome) D/d- Lichenoid drug reaction.
D/d Could be Non healing ulcer due to Diabetes Mellitus Traumatic Inflammatory ulcer ( induced by faulty restoration or sharp foreign body / ceramic has chip off ) Drug induced(aspirin) Erosive lichen planus (grinspan syndrome) Infectious Rx Patients medication should be reevaluated Reevaualtion of DM status Removal of prosthesis Rexidine m gel Ointment containing epidermal growth factor 60mcg Lycopene containing antioxidant therapy Prednisolone 20mcg twice daily
Gingivitis due to poor oral hygeine Nutrition deficency major apthos ulcer Lignocain gel tropical Corticosteroid tropical Corticosteroid oral 4 mg bd Good multivitamin with antioxident and lycopein Oral prophylaxis
Visible dyspeptic ulcer treat constipation if any . Give neurobion tab ,Folic acid ,b12 s l. Add cephalosporin if necessary .
Maintain oral hygiene, good mvbv , local lignocaine , corticosteroid
Some lesion may be mucocele, specially 37, due to either food lodgment or irritation, some of part seen like red erythromatous lesion on gingival areas, on lips may it be erosive lichen planus, but any history of hyposalivation, nutritional deficiency, any chronic systemic disseas??
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20 yr old male, h/o itching scalp and hairfall. No itching now. Acute hair fall of about 50per day since a week on changing shampoo. What advice to be given?Kavya Chikkanna7 Likes15 Answers
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Hello All of you very good evening. here I present a Rare Case. need your HELP. . a 40 yr lady came with complaining of hair loss specially at vertex with itching and scaly,thick lesions. (no psoriasis ) accompanying with grayish of hairs. wrinkles on face. she has RHD since 15 years on regular Rx. past history of 8 month of pregnancy abortion due to defective development of fetus. . Dr's told the couple when she got aborted not to have perception becoz of further complications may occurs to mother or child but parents refused and they give a birth to normal baby boy. after 4 months of delivery problem starts and diagnosed as RHD. Constitution :- emaciated, lean, thin. CHILLY PATIENT. HOUSEWIFE. . . TWO CHILDREN. normal. Mother :-RHD Father :- Diabetes. DESIRE :- rice, dal. thirst normal. perspiration :- scanty. skin :- unhealthy, dry. winter aggravates the complaints. No any Dreams. not affected by moon phases. past /h :- tubectomy since 10 yrs . menses :- regular, no any complaints. .O/H:- NAD. Mentals :- *gets Angry easily .to calm down she counts reverse no from 10 to zero. *insult intolerable . *can't tolerate Fake Blaming. *gets married due to her parents forced. against her will. *fear of snakes and dead bodies. . So PLZ help me with Probable Remedies, and AYUSH MANAGEMENT. NEXT STEP? THANK YOU. *Dr. Akshay Ingole8 Likes71 Answers
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HOMOEOPATHIC REMEDIES FOR HAIR LOSS AND BALDNESS ￼ Hair loss can affect just your scalp or your entire body. It can be the result of heredity, hormonal changes, medical conditions or medications. Anyone — men, women and children — can experience hair loss. Baldness typically refers to excessive hair loss from your scalp. Hereditary hair loss with age is the most common cause of baldness. Some people prefer to let their baldness run its course untreated and unhidden. Others may cover it up with hairstyles, makeup, hats or scarves. And still others choose one of the treatments available to prevent further hair loss and to restore growth. Causes--Most people normally shed 50 to 100 hairs a day. This usually doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time. Hair loss occurs when this cycle of hair growth and shedding is disrupted or when the hair follicle is destroyed and replaced with scar tissue. The exact cause of hair loss may not be fully understood, but it's usually related to one or more of the following factors: · Family history (heredity) · Hormonal changes · Medical conditions · Medications Family history (heredity) The most common cause of hair loss is a hereditary condition called male-pattern baldness or female-pattern baldness. It usually occurs gradually and in predictable patterns — a receding hairline and bald spots in men and thinning hair in women. Heredity also affects the age at which you begin to lose hair, the rate of hair loss and the extent of baldness. Pattern baldness is most common in men and can begin as early as puberty. This type of hair loss may involve both hair thinning and miniaturization (hair becomes soft, fine and short). Hormonal changes and medical conditions A variety of conditions can cause hair loss, including: Hormonal changes. Hormonal changes and imbalances can cause temporary hair loss. This could be due to pregnancy, childbirth or the onset of menopause. Hormone levels are also affected by the thyroid gland, so thyroid problems may cause hair loss. Patchy hair loss. This type of nonscarring hair loss is called alopecia areata (al-o-PEE-she-uh ar-e-A-tuh). It occurs when the body's immune system attacks hair follicles — causing sudden hair loss that leaves smooth, roundish bald patches on the skin. Scalp infections. Infections, such as ringworm, can invade the hair and skin of your scalp, leading to scaly patches and hair loss. Once infections are treated, hair generally grows back. Other skin disorders. Diseases that cause scarring alopecia may result in permanent loss at the scarred areas. These conditions include lichen planus, some types of lupus and sarcoidosis. Hair-pulling disorder. This condition, also called trichotillomania , causes people to have an irresistible urge to pull out their hair, whether it's from the scalp, the eyebrows or other areas of the body. Medications Hair loss can be caused by drugs used for cancer, arthritis, depression, heart problems, high blood pressure and birth control. Intake of too much vitamin A may cause hair loss as well. Other causes of hair loss Hair loss can also result from: Radiation therapy to the head. The hair may not grow back the same as it was before. A trigger event. Many people experience a general thinning of hair several months after a physical or emotional shock. This type of hair loss is temporary. Examples of trigger events include sudden or excessive weight loss, a high fever, surgery, or a death in the family. Certain hairstyles and treatments. Excessive hairstyling or hairstyles that pull your hair tight, such as pigtails or cornrows, can cause traction alopecia. Hot oil hair treatments and permanents can cause inflammation of hair follicles that leads to hair loss. If scarring occurs, hair loss could be permanent. Symptoms-Hair loss can appear in many different ways, depending on what's causing it. It can come on suddenly or gradually and affect just your scalp or your whole body. Some types of hair loss are temporary, and others are permanent. Signs and symptoms of hair loss may include: Gradual thinning on top of head. This is the most common type of hair loss, affecting both men and women as they age. In men, hair often begins to recede from the forehead in a line that resembles the letter M. Women typically retain the hairline on the forehead but have a broadening of the part in their hair. Circular or patchy bald spots. Some people experience smooth, coin-sized bald spots. This type of hair loss usually affects just the scalp, but it sometimes also occurs in beards or eyebrows. In some cases, your skin may become itchy or painful before the hair falls out. Sudden loosening of hair. A physical or emotional shock can cause hair to loosen. Handfuls of hair may come out when combing or washing your hair or even after gentle tugging. This type of hair loss usually causes overall hair thinning and not bald patches. Full-body hair loss. Some conditions and medical treatments, such as chemotherapy for cancer, can result in the loss of hair all over your body. The hair usually grows back. Patches of scaling that spread over the scalp. This is a sign of ringworm. It may be accompanied by broken hair, redness, swelling and, at times, oozing. ￼Risk factors--A number of factors can increase your risk of hair loss, including: · Family history · Age · Poor nutrition · Certain medical conditions, such as diabetes and lupus · Stress HOMOEOPATHIC REMEDIES Homoeopathic remedies are very effective for baldness and that can promote hair growth. Some of the main remedies are given below. BARYTA CARBONICA 30-Baldness in young people. The patients requiring this medicine are very timid and dull in nature and have very poor memory. The patients of baldness who have a history of throat complaints like tonsilitis (from suppression of foot sweat or from exposure to cold air) can be given this medicine. FLUORIC ACID 30- Baldness of old age or prematurely aged due to syphilis . Falling of hair in patches SULPHUR 200- Sulphur is another remedy that can be prescribed to those patients suffering from baldness who are extremely hot blooded and complain of excessive heat in body especially in the head, palms and soles. Another symptom that guides towards the use of sulphur in baldness cases is that the patient requiring this medicine have an aversion to bathing and are generally filthy – thus inviting plenty of long standing skin diseases. The patients requiring Sulphur show extra craving for sweets in food. LYOPODIUM CLAVATUM 200-Lycopodium clavatum, is also an excellent medicine used to treat baldness cases occurring prematurely and can be given to those patients who complain of some sort of gastric trouble like flatulence, constipation or liver problems along with baldness. The patients requiring Lycopodiumclavatum usually crave hot drinks, hot food and sweet things MANCINELLA 200- Baldness after severe acute diseases or at the scar of healed wound SILICEA 200-Silicea, is mainly given to those patients who suffer from baldness and complain of pain in head usually at the right side along with hair loss. The patients requiring this medicine are very sensitive to cold air and usually have very offensive sweat on the feet. Mentally the patients requiring this medicine are very headstrong and obstinate in nature PSORINUM 200-Psorinum is highly useful in treating the hair loss that has occurred due to eczematous skin lesions on scalp that discharge sticky and very offensive fluid. These kinds of discharges make the hair to stick together, which further leads to the hair getting tangled and ultimately destroyed. The patient requiring Psorinum feels excessive chill and desires to be warmly covered even in summers NITIC ACID 30- Falling of pubic hair due to syphilis or gonorrhoea MEZEREUM 30- Mezereum, is equally good for treating hair loss in cases where the hair is destroyed due to eczematous skin lesions of scalp. The patients requiring Mezereum will complain of thick crusty eruptions on scalp, along with a discharge of thick offensive pus resulting in matting of hair, breeding of vermin in them and eventually the eating away of the hair by discharges leading to hair loss. MERCURIOUS SOL 30-Mercurius Solubilis is yet another homeopathic medicine which plays a wonderful role in treating the hair loss due to eruptions on scalp where the discharge from eruptions is fetid and accompanied by burning type of pains in scalp. This medicine can be employed in those patients in whom profuse perspiration is present along with excessive salivation from mouth and an increased thirst for water. SELENIUM MET 30- Falling of pubic hair THUJA OCCI 200- Falling of hair due to dandruff. Here the dandruff is white in color KALI SULPHURICUM 30- It is also used for falling of hair due to dandruff. But here the dandruff is yellow in colour KALI CARB 30- Falling of hair due to dryness of scalp and dandruff NATRUM MURIATICUM 200-Hair loss after child birth.Natrummuriaticum can be given to those women who suffer from anemia and hair loss on even a slight touch of the hair, along with severe headache after the delivery of a child. The women requiring this medicine complain that the headache is worse in the heat of sun. The patient may show an inordinate craving for salty things.. PHOSPHORIC ACID 30-Phosphoric acid is prescribed when falling of hair occurs after an exhausting disease . Hair falls out from head, eye brows , eyelashes etc. PULSATILLA NIG. 30-Pulsatilla can be used by those women who suffer from excessive hair fall after delivery. The guiding factor for recommending this medicine is a complete absence of thirst for water and desire for fresh open air. The mental symptoms that are to be considered for its use are weeping tendencies on the slightest cause, and relief when someone gives consolation. Another marked symptom that guides its use in women suffering from hair loss is that such women cannot digest fatty foods SEPIA 200-Hair loss in the menopausal period.. The women requiring this medicine for hair fall have a history of long standing headaches. The women complaining of hot flushes followed by chills and perspiration and bearing down pains in the uterus at menopause along with hair loss can be given this medicine. The mental symptoms that significantly indicate the usage of this medicine by women suffering from hair loss at menopause are irritability of the utmost degree and indifferent behavior towards family members. BORAX 30- Hair loss in anemic patients.Borax can be given to those patients who complain of hair loss and are anemic. A frequent complain in such cases is that the hair is very thin and gets stuck together and form bunches, thereby making it difficult for them to be untangled and combed smooth and they are to be cut off. But as soon as these bunches are cut another group of bunches form. CINCHONA OFF.30-off.Cinchona officinalis can be given to those patients in whom hair loss is accompanied with anemia. People who suffer from hair loss due to Loss of blood in any form like bleeding from nose or excessive bleeding during menstruation or loss of blood after an injury due to accident leading to anemia can be given this medicine. The patients requiring this medicine usually complain of a weak digestion along with excessive flatulence. CALCAREA PHOS 30--Clacareaphosphorica is a useful medicine that can be used to treat hair loss in anemic patients – usually in anemic girls who grow too rapidly at puberty and suffer from hair loss and extreme headache along with acidity in stomach. FERRUM PHOS 30- Hair falls from the head due to anemia FLUORICUM ACIDUM 30-Fluoricumacidum is mainly used for hair loss in spots in a person of hot temperament, who is worse in any warm environment and constantly desires cold environment . Hair loss in bunches occurring during typhoid fever can be treated with this medicine. PHOSPHORUS 30-Hair loss during typhoid fever.The symptoms that guides towards its usage are patches of hair loss on scalp along with unusual craving for salty things, chicken, cold drinks and ice creams. The patients requiring Phosphorus are tall, thin and slender in physical appearance. CALCAREA CARBONICA 30- Calcreacarbonica is a great homeopathic remedy for hair loss .It can be prescribed to patients in whom the hair is lost in well defined patches, and constitutionally who are fair, fat and flabby in built. The other symptoms that stand out dominant to use this medicine are excessive chilliness with intolerance to slight draft of air, excessive perspiration on the scalp and unusual craving for boiled eggs. VINCA MINOR 30-Vinca minor can be used for the hair loss in spots whereby the white coloured hair grows back in the spots of hair loss. PIX LIQUIDA 30- Baldness due to diseases of the scalp. Scalp itches intolerably and bleeds on scratching SANICULA AQUA 200- Baldness which is chronic due to dandruffs and lots of itching THALLIUM 30-Thallium is effective for falling of hair after an acute , exhausting disease . It is prescribed when alopecia with profuse perspiration on the head is present. It is also useful loss of hair as an after effect of an atom bomb explosion. WEISBADEN 200- By the use of this remedy the hair will grow more rapidly than usual and becomes darker . New hair take place of the fallen hair rapidlyDr. Arpit Gupta9 Likes14 Answers
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Male patient 52 yrs old comes with c/o of mouth ulcers since 3_4years then t/t is done subsequently but the mouth ulcers reoccurs after some months With mild constipation..then from a week there is black and whitish spots after getting relief from mouth ulcers which are painfull and sensitive to touch..and neuropathic pain in both lower limbs(legs) especially at the thigh region only in the evening and night time.. K/C/O--Diabetes mellitus since 3 years(pt is on glimpride and metformin) Vitamin b12 is high and CBC report shows high pdw and mpv levels....reports attached with the case please give your valuable opinion and DX,Rx on the case. Thank you.. Dr. Prashant Mishra Dr. Dineshchandra Sharma Dr. Kute Ankush Dr. Ashok Leel Dr. Shivraj Agarwal Dr. D K GuptaDr. Atul Bhamre2 Likes10 Answers
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35 years male patient having such lesions since last 2 years. No history of smoking or alcohol. Non diabetes not on any medication. Painless. Diagnosis and treatment. Vegetarian.Dr. Salim Merchant3 Likes23 Answers