There is no reason why ichthyosis (?) Should present acutely in a 50 yr old pt. The h/o oozing eczema like description of lesions stated cannot be underscored. Eczema like lesions are never seen in icthyosis. The scale which should be thick and hyperkeratotic is not there. In short it can no be called icthyosis. Two other findings reported - the raised CRP and hypoalbuminemia needs to be examined if they can be fit into overall diagnosis. Attention is drawn to the papular lesions, topped with a central black dot (dried up vesicle) suggestive of " papular urticaria" such lesions are seen on the forearms and dog bitten teg. Now why eczematisation in papular urticaria ? Both are allergic manifestations and here I hazard the guess that the pt might be atopic. Papular urticaria is cosier ed a marker of atopy. So h/o asthma, food and drug allergies as well as nasal and ocular allergies should be sought, which strengthens atopic background. Raised CRP, and hypoalbuminemia are both reported in atopic dermatitis. Test for esonophil count and serum ig E levels for more colloboration of atopic diathesis. In my view dog bite is as the cause is pt's misconceived conjecture and the ampicillin salbactum are not the culprits. Now why eczematisation (subacute ) ? Probably the pt might have applied a topical ointment or even a musquito repallent causing contact eczema. Or it could be a dessiminated secondery eczema. Cases on Curofy are difficult to solve because of lack of comprehensive presentation of the facts and followup feedback, often. If h/o allergy/ atopy and h/o applying some external medication go a long way to confrm the above suspected diagnosis. Queries are welcome. No better alternative linking up all data given.
Icthyosis Rx moisturisers and astringents Oral tab Levocetrizine5mg 1bd for 5to7days than 1od If response is poor Clop-s nano lotion can be applied along with
Ichthyosis vulgaris the inherited ichthyosis include ichthyosis vulgaris, recessive X-linked ichthyosis, autosomal recessive congenital (ARCI) Congenital bullous ichthyosiform erythroderma (CBIE) ichthyosis ,spastic paralysis, development delay nd degenerative retinitis are some I.e of syndrome ichthyosis
Icthyosis Rehydrate skin by applying moisturizer Cream or astringents. Levocet 5 mg BD Clean area with diluted betadine lotion apply calamine lotion and than lobate s oint+ muprocine onit in 3:1 ratio BD locally. Multivitamins and antioxidants orally. Improve general health and personal hygiene.
See papular urticaria lesions more clearly in the last picture which , I think holds the key to the proposed diagnosis above.
IT'S A CASE OF.. ICHTHYOSIS ..
Ichthyosis:A group of skin disorders characterised by dry, scaly or thickened skin
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Friends today I am discusing about Eczema . Homeopathic Medicines for Eczema There is a great scope of treating eczema with homeopathy, which takes a mild, gentle approach to treat eczema. Homeopathy treats eczema in two phases: in the first phase, the medicines control itching. In the next phase, they heal the lesions and control further progression of eczema. They also work wonders in case of eczema attended with complaints of hay fever and asthma. Prominent names in this category are Graphites, Sulphur, Petroleum, Mezereum, and Natrum Mur. These medicines for eczema are natural and therefore, safe from any adverse side-effects. They can be taken by persons of all age groups. Homeopathic Medicines for Eczema 1. Graphites – Top grade Medicine for Eczema Graphites is one of the top grade medicines for eczema. Graphites works well in case of both dry eczema and moist eczema. The key symptoms to look out for in dry eczema before prescribing Graphites are – excessively rough, dry skin attended with intense irritation. In moist eczema, the skin eruptions will ooze moist, sticky fluid where Graphites will show results. Graphites also works well for eczema between fingers and toes oozing glutinous discharge. It is also a good choice of medicine for eczema of eyelids with red margins and scaliness. 2. Natrum Mur – For Eczema in Bend of Limbs For eczema in the bends of limbs, Natrum Mur falls in the category of highly rated medicines. The bends of limbs include those behind the knee and folds of skin between the elbows. The eczema eruptions in the bends of limbs are dry, chapped, raw, inflamed and crusty in nature. In addition to this, Natrum Mur is a well-indicated medicine for eczema eruptions arising around the margin of the hairline. 3. Sulphur and Psorinum – For Dry Eczema with Excessive Itching Sulphur is a prominent medicine for eczema with excessive itching and eczema rash. This is attended with intense scratching. Burning sensation follows scratching of the rash. The itching worsens in the evening and night time. Warmth also worsens the itching. In some cases, washing may increase the itching in eczema rash. The skin looks very dirty and unhealthy. Another guiding feature for use of Sulphur is eczema that worsens in the spring season. Sulphur is also the most appropriate choice of medicine for eczema cases that have been treated with ointments in the past. Psorinum is helpful for dry, itchy eczema where a person scratches until it bleeds. Another indication for using Psorinum is worsening of eczema in winter and relief during summer. Psorinum is also a well-indicated medicine for eczema behind the ears. 4. Petroleum – For Eczema that Worsens in Winter In cases where eczema gets worse during the winter, medicine Petroleum is prescribed. The person who needs Petroleum has skin that is very rough, hard and thick. Deep cracks appear on the affected skin. The cracks may bleed in some cases. Burning and itching are present on the skin which is highly sensitive to the touch. Petroleum also works very well in cases of eczema with deep cracks on the fingertips. 5. Mezereum – For Eczema with Thick, Crusty Eruptions Mezereum is the most suited for eczema with thick, crusty eruptions. There is a discharge of glutinous character from these eruptions. In some cases, pus discharge may be observed along with blood. The discharge is acrid in nature with intolerable itching. On scratching, the itching changes place very often. Mezereum works wonders in treating eczema of the scalp as well. The key features here are thick, leather-like crusty eruptions on the scalp with sticky or pus-like discharge. 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Both these conditions may coexist or may alternate with one another. Frequently Asked Questions 1. What is Eczema? Eczema, also known as dermatitis, is a common skin complaint. It is characterized by inflamed skin with dry rash, erythema, papules, vesicles or pustules. Erythema is red skin discoloration; papules refer to eruptions of less than 1cm without any fluid; vesicles refer to fluid filled eruptions; pustules refer to pus-filled eruptions. In the long run, it results in thickening of the skin. Itching and scratching – varying from mild to severe intensity – may be present. With scratching, the skin may even bleed. Eczema may cover a small area of the body or may be widespread, covering the entire body. 2. What causes eczema? The exact cause of eczema is not yet known. A combination of genetic and environmental factors play a role. Persons with a family history of eczema or any other allergy such as hay fever, urticaria, asthma stand a high risk of developing eczema. 3. How can I tell I have eczema? Eczema can be broadly divided into two types – dry and moist. Dry eczema appears as itchy rash while moist eczema will show up as skin eruptions oozing discharge which varies in consistency from watery to sticky or pus-like. If you see any of these signs, there are chances that you may have eczema. There are no specific lab investigations for eczema. Eczema is diagnosed based on the clinical presentation of skin eruptions. A family history of eczema adds to the likelihood that the symptoms are those of eczema. 4. At what age is eczema likely to appear? In a majority of the cases, eczema starts early, before 5 years of age. However, eczema can show up in the teenage years and in adults as well. 5. Which part of the skin is more vulnerable to eczema? Eczema can develop in any part of the skin, but the location may vary with the age group. In children, common areas are the face, scalp, and chest. Adults are more likely to get eczema in the bends of elbow and hollow of the knees. 6. Why does my child have eczema? The answer could lie in his genes. If a child has eczema, there are chances he has atopic dermatitis. Atopy is a term applied to a genetic predisposition towards developing allergic diseases like hay fever, dermatitis, and asthma. 7. What are the various types of eczema? The various types of eczema include atopic dermatitis, seborrhoeic dermatitis, contact dermatitis, dyshidrotic eczema, venous/stasis eczema. Atopic dermatitis runs in families and starts in childhood. It is characterized by skin inflammation with a dry, itchy rash. Atopy is a genetic tendency to develop allergic diseases. Asthma and hay fever often arise in addition to eczema in atopic dermatitis Seborrhoeic dermatitis mainly affects the scalp, face, and eyelids. It will show up as scaly, greasy or crusty lesions. In infants, thick, crusty eruptions appearing on the scalp is referred to as cradle cap Contact dermatitis is mainly of two types – allergic contact dermatitis and irritant contact dermatitis. In allergic contact dermatitis, the allergic reaction appears on the skin when exposed to a foreign substance like nikel, gold and cosmetics. Irritant contact dermatitis arises when the skin comes in contact with a toxic or irritating substance such as detergent, bleach or battery acid. Dyshidrotic eczema is mainly visible on the soles and palms. It is characterized by the presence of vesicles (fluid filled bumps) Venous/stasis eczema mainly develops on the lower limbs from poor blood circulation and varicose veins. There remains a tendency to develop leg ulcer in such cases 8. Is eczema an allergy? There are cases of eczema that are allergic in origin, but not every case is an allergy. In allergic eczema, the skin reacts on coming into contact with an allergen. 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Use a moisturizer in dry eczema to reduce itching Avoid exposure to extremely cold environments.Dr. Rajesh Gupta8 Likes12 Answers