Allergic Contact Dermatitis

84yr male , with complaints of erythematous lesion over righ hip region. History of CVA 3month back , history of allergic Dermatitis - used to apply lotion and steroidal Ointment on and off. Patient uses sanitary diaper daily for past 3month. No other comorbidity. Lesion : initially erythematous lesion. No pustule. Mild ithching present. Patient was on tab Levocet for 15 days and Fucidin H ointment for 3 week. Following which size of lesion reduced , but not subsided completely. Kindly advice long term treatment (ointment/ lotion)

5 Likes

LikeAnswersShare

As per history the lesion was present before CVA for which she was using some Lotion and steroid ointment . Diaper which was in use is not mentioned to have contributed to the lesion .Hence diperdermatitis might not have role in a lesion that existed before its use. Antifungal treatment tried has said to have ineased it as per the clarificTion given . Response to Fucidin H is perhaps the benefit of Hydrocortisone in it than Fucidin as the lesion doesn't look inflammatory . The fact that she was using steroid b 4 and it's response to H shows that , it is steroid responsive . Then why it doesn't go ? Probably the Incitung cause is at work ie scratching again , once the response to steroid ie relief from the itch , the pt stops the medicine . ( uses off and on , in history ). But after sometime of stopping, the pt scratches and itch scratch cycle continues . So the lesion never dis appears . The reason for repeated scratch is the "urge" . The lesion does not fit into any k known dermatosis. Thickened patch with exaggerated skin markings and slight pigmentation. So my diagnosis is (Should you have to say after so much beating around the bush ! -Others may question ) Yes . My diagnosis is Nerodermatitis / L SC . The most important thing is to make the pt understand how it is perpetuated STONGLY ADVISED TO BREAK THE HABIT OF SCRATCHING . An enterobious Vermicularis infection , if present may also contribute to the personal itching . Hence treat it with a tablet of albendazole .

Clop gm oint locally Tab Medrol Tab Levocet

Contact dermatitis due to diaper

Sulphur 30 one dose

Thank you @Dr. Dinesh Gupta sir
0

THERE'S ALLERGIC CONTACT DERMATOLOGY ? Rx, Tab - Zindervit BD PC. Tab - Levocet-M BD PC. Tab - Roxid 150mg OD PC. OINT - MUPIROCIN / CLOBEX GM APPLY ON LESION. Use the coconut oil , Prevent from Dryness. AVOIDANCE OILY AND SPICY FOODS , E.g - NON VEG ( DON'T EAT THIS FOODS ). ANTISEPTIC SOAP USE FOR BATH.

Tinea incognito. Avoid steroids Consider optimum antifungal therapy.

I would treat it as tinea incognito and treat with clotrimazole creme.

Initially considered tinea as diagnosis and started with cotrimoxazole. No response to cotrimoxazole and size of lesion increase
0

STEROID ALTERED ALLERGIC CONTACT DERMATITIS. DIAPER DERMATITIS. RX, APPLY FUSIBACT OINTMENT OVER LESIONS TWICE DAILY. APPLY LULICONAZOLE LOTION AT NIGHT TAB BLISTON-20 MG OD FOR ITCHING. APPLY MOISTURIZER APPLY COCONUT OIL APPLY ALOEVERA GEL KEEP THE DIAPER AREA CLEAN, DRY AND CAN USE CANDID POWDER.

Diappers dermititis Flutibact oint twice daily Tab Levocetrizine bd Review every fortnightly

Thank you doctor
0

View 2 other replies

Management. Fucidin ointment used. Tab multivitamins antioxidants trace elements od. Tab levocetrizine 5 mg BD. Moisture lotion use. Coconut oil use. Alovira gel use. Keep the skin areas Sterile gauge. Clean skin regularly Alovira gel. Take healthy diet. Daily exercise. Daily meditation. Maintenance hygiene..

Thank you doctor
0

View 1 other reply

Load more answers