Lesions on the dorsum of foot

An 11-year-old female.diabetic on insulin for 9 years. Had this lesion on the dorsum of both feet. It's painful with no itching, present for 2 years. It started as small papule than increased in size. Also complaint of mild fever. What is DDX & management.

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? DIABETIC DERMOPATHY/VSD STRICT GLYCEMIC CONTROL WITH INSULIN AS WELL AS ORAL ANTIDIABETIC DEBRIDEMENT AND DRESSING AT LEAST TWICE DAILY TAB. CLINDAMYCIN TAB. ENZOMAC PLUS Oint. MUPIROCIN+ METRONIDAZOLE TAB METHYL COBALAMIN+ PREGABALIN VIT-C SUPPLIMENT ANTIOXIDANTS CBC,ESR, HBA1C,LFT,RFT, X-RAY, COLOR DOPPLER STUDY,PUS OR SCRAP SWAB FOR C/S AVOID FREQUENT MOVEMENT....
Thanks Dr. Kute Ankush
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??? Chromoblastomycosis
Diabetic Dermopathy Strict control by diet medicine and change of life style. Clean areas with diluted betadine lotion and debridement under LA and antibiotics cover dressing with betadine lotion covered by sofra tullu gauge bd. Clavam CL 625 mg bd. Metrgyl 400mg TDS. Multivitamin and antioxidant orally. Diclo PCM TDS. Rest the area and maintain blood circulation. Needs further investigation into evaluation to conclude and treatment plan.
Thanks Dr Kute Ankush
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Chronic eczematous dermititis with secondary infection Since pt is diabetic and doesn't look after hence the present status As pt is insulin dependent needs to review her diabetic status and revise the doses or add OHA with insulin Local lesions are to be attended Broadspectrum antibiotics like lenazolinid or clindamycin Locally application of fucibact or flutibact oint Once infection resolved than shift on Rx of eczema
Thanx dr Pushkar ji Bhomia
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This may be a case of juvenile insulin dependant diabetic dermopathy with vasculopathy. Go for a colour Doppler to see the vascularity of loweler limb Strict diabetic control with inj insulin Care of the wound The may be infected culture sensitivity of the wound and give appropriate antibiotic. Dressing after removal of unhealthy tissue and regular dressing.
IT'S A..CASE OF.. DIABETES WITH..LESIONS ON FEET.. ? VENOUS STASIS DERMATITIS.. ? DIABETIC DERMOPATHY.. ? MYCETOMA.. NEED'S.. * STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. * ANTIBIOTICS WITH NSAIDS AS PER REQUIREMENT.. * WOUND MANAGEMENT WITH SURGEONS OPINION.. * HPE STUDY.. * COLOUR DOPLAR STUDY.. * X-RAY STUDY..
Tnx Dr Gyanendranath Tripathy
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Diabetic dermopathy strict control of diabetes antibiotics orally antibiotics locally tab Gabapentine 150 mg bd
Agree@Dr. Gyanendranath Tripathy
Diabetic foot ulcer
Diabetic foot. Adv: Detailed investigation. Dermatology, vascular surgeon, endocrinology opinion needed for proper management.
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