71 y/o newly diagnosed CHF with these skin lesions on all limbs (calves, feet, forearms and knees). Non-pruritic in nature. Concomitant dx include DM II, hyperlipidemia and metastatic prostate cancer. Any idea what this could be apart from dry skin with cracking due to fluid restriction and edema?


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?? Erythema Craquele / Leukocytoclastic Vasculitis / Perforating Dermatosis
Vasculitis Anti-neutrophil Cytoplasmic Antibody (ANCA) and Skin biopsy along with other routine tests.  ANCA positive is important marker for small vessel vasculitides. However rule out any Infective focus like Infective Endocarditis . Infective Endocarditis can exhibit ANCA positivity and mimic vasculitis, presenting a diagnostic and treatment challenge.
D/d perpheral vasculopathy 2 diabetic dermopathy
Thanx dr Pushkar ji Bhomia

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Petechia Vasculitis
There is gross oedema of the limb associated with multiple patechiae It is suggestive of thrombocytopenia Gross oedema is secondary to hear failure check WBC count and platelet count prothrombin time with INR Sacubitril with valsartan has been proven highly effective for heart failure and it can be considered for treatment of heart failure
Case of prostrate cancer with this symptoms mainly correlates to Lymphatics involvement metastasis due to edema of the limb . This is mainly due to stasis of lymph skin appears like petechial rashes .need complete evaluation of this patient for further medication .
Needs further investigation and evaluation to conclude diagnosis and treatment plan. Secondary to prostatic cancer and ailments related to blood and heart can be the cause of oedema and patachial rashes.
Thanks Dr shivraj Agarwal

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Pl.post CBC/ Kidney Function test / Liver Function test.May it be.. Plattletes decreased.../ Raised liver enzymes. / Compromized Renal function../PCA.../ S.Elecrytes../ HBA1C..
Purpuric lesions Antiplatelets may be responsible Diabetic dermopathy is DD Need to do CBC, BT, CT ,PT ,PS
Thrombocytopenia. Edema due to CHF. Need admission and investigations.
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