a lady of 60 years came to my opd with these skin lesions on her back .whats the diagnosis n treatment.

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PN / Kyrle disease (??)

Clusters of swollen reddish bumps- MALASSEZIA (PITYROSPORUM) FOLLICULITIS, would be a Differential diagnosis, except STEROIDAL ACNE.

I feel these are pustular acnes Rx express the pus or sebum with expellor may require frequently Orally tab azithromycin250mg 1od for 5days or clindamycin 300mg 1bd for 7days thereafter continue azithromycin100mg on alternate days Pt is 60yrs old you can put on isotrentoin 20mg 1od Locally clindamycin oint twice daily Benzyl benzoate 5%oint at bed time and to be washed after half an hour and moisturisers to be be used

Thanx dr Abdul Majeed
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? Stroid induced trucal acne.

A. C. D DD ... STEROIDAL. AGGRAVATED TRUNCAL. ACNE ... FOLLICULAR DERMATOSIS

Pityrosporum follicutitis: erythemetous, Multiple pustules plaques seen ,need some investigation of blood nd Management as per dd with maintained her catering

AGREE
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IT'S A CASE OF.. * PERFORATING DERMATOSIS.. * PN..

Tnx a lot Dr Wun Teng Quek
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Any symptoms ? PL do mention a few more details henceforth. DD.. Pustular psoriasis vulgaris, drug rash, steroid acne, generalized lichen planus, neurofibromatosis, histoid leprosy.,bipsy for Hpe. Then decide the TT accordingly.

sir except this she has no chief complaints n since two months she is having this lesion
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Malassezia folliculitis Oral Itraconazole, Topical Ketokonazole or Selenium Sulphide. Ketokonazole soap bath. Continue topical treatment for few days after rashes vanish to prevent relapse.

Perforating dermatosis , usualy associated with diabetes and kidney failure .Also associated with liver disease, hypothyroidism , melagnancy and HIV infection .

Thank you doctor
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