Concluded Case

80 years old presented with intense itching since 2 months. History suggested that the patient repetitively scratch more at night. On examination there were 2 types of lesions seen. Blood crusted lesions and healing lesions predominately at hands, feet and lower leg (Figure 1-3). Treated twice for scabies with no improvement. Drug reaction and any cause of essential itching were rule out by investigations. Negligible improvement with antihistamines and soothing creams. What could be your diagnosis for itching?

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Concluded answer

Neurotic Excoriations Self-inflicated skin lesions produced by repetitive scratching without underlynig physical pathology. The patient often has a comorbid mental illness like anxiety or mood disorder. The lesions are grouped at sites of body that are easily accessible and usually exposed such as extremities, face and upper back. It is suspected cause of itching after excluding all possible causes of itching like in this case.

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Neurotic Excoriations Self-inflicated skin lesions produced by repetitive scratching without underlynig physical pathology. The patient often has a comorbid mental illness like anxiety or mood disorder. The lesions are grouped at sites of body that are easily accessible and usually exposed such as extremities, face and upper back. It is suspected cause of itching after excluding all possible causes of itching like in this case.

Thes lesions are LPC secondarily infected with scabies Hence my advice will be treat scabies first and shift on regular treatment for LPC R/o diabetes

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Scabies d/d Eczematous dermatitis

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* Scabies with secondary infection ** Senile Eczematous dermatitis.

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Is the patient a case of DM ? Looks like drug reaction . What are the medicines this man is taking? ? SJ ,? Bullous phemphigoid, / Bullous impetigo

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Scabis...rxtended to secondary infection.

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SUGGESTIVE OF SENILE PRURITUS AND... INFECTED SCABIES...... AND... RULE OUT.... STEROIDAL. USE AND D. M...

Scabies with secondary infection

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DIABETIC ULCERATIVE INFECTION

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Scabies with secondary inection

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