History of condition since last night . Most likely a case of fracture penis Points in favour 1.Typicsl egg plant deformity also called Aubergine sign 2.Dark coloured bruising of penis typically seen in fracture penis 3.Loss of erection 4.Haemorrhage can extend to scrotum as in this, case which may progress to Fournier 's gangrene 5.Since history is specifically of last night , may be having sex as it occurs only in an erect penis . It is a Surgical emergency. Get a MRI scan and urethrogram done to confirm the diagnosis. Start parenteral 3rd generation cephalosporins. Shift to O.T for emergency surgery after catheterisation with Foley's catheter. A debridement with evacuation of clot. followed by repair of tunica albuginea is indicated
It's a case of.. ? FOURNIER'S GANGRENE.. Symptoms of Fournier's gangrene usually start's with vague abdominal pain..or.. severe itching.. Better to go for .. USG STUDY.. Tissue histopathological study..
Fournier's gangrene May be any trauma penis Need some pathology MRI Nd Management as per dd with personal hygiene maintained
DD. Pyrenie's disease due septum in the mid penile tissue sepating the two corpora spongiosa.vitE, Antioxidants
Allergic contact dermatitis Contact dermatitis Treatment consists of antihistamines antiseptic and Topical cream and lotion. Keep clean usable clothes and inner ware.
It is a case of chronic paraphimosis. Management -reduce the eden by multiple puncture and sqezzing.Antibiotics and Anti inflamatory analgesics.
DD.... SEEMS. TO. BE.... THE. AFTER. EFFECT OF... ...... SOME....... .......... ALLERGIC. REACTION... OR..... ........ SOME. INSECT. BITE
Allergic reaction to some ointt. applied or spider bite
FOURNIER'S GANGRENE USG SCROTUM CBC RFT LFT BLOOD SUGAR FASTING PP HIV PUS FOR C /S ANTIBIOTICS AS PER CULTURE REPORT SURGEON OPINION
FOURNIER'S GANGRENE ADVISABLE... USG BIOPSY
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Dx? Rx? . A newly married boy came to me for this type of lesions on Scrotum since yesterday. burning++itching++. h/o applying veet cream for hair removal on the occasion of his First night..! . no DM.Dr. Akshay Ingole11 Likes92 Answers
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patient presented with this lesion over the hand since morning. patient was doing normal kitchen work. when she removed the gloves she noticed small blisters over the hand. as day passes area become sloughy. very mild pain is present. no itching. what is the diagnosis and treatment for this case.Dr. Kamal Singh7 Likes49 Answers
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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. It is attended with marked burning and intense itching. The discharge is highly offensive in nature. The hair gets matted together due to the sticky discharge. 6. Vinca Minor – For Eczema of Scalp In addition to Mezereum, another wonderful medicine for eczema where it appears on the scalp is Vinca Minor. The person needing Vinca Minor has eruptions in spots on the scalp. The eruptions ooze discharge that may result in matting of the hair. Excessive itching with an irresistible desire to scratch predominate. 7. Arsenic Album – For Eczema with Asthma Arsenic Album is a top grade medicine for eczema where it is accompanied by asthma. The symptoms include dry, rough itchy skin. Burning sensation in eruptions may be marked. Cold may worsen the itching and burning. Along with eczema, asthmatic symptoms with marked dyspnoea, suffocative attacks, cough, constriction in air passages are present. Arsenic Album is also an excellent medicine for cases of eczema with hay fever. 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. Few common allergens are poison ivy, nickel, cosmetics, and antibiotic creams. 9. Can eczema spread from skin contact? No, eczema is not contagious. It does not spread from one person to another via the skin. 10. My 2-year-old has eczema. Will it cure itself as he grows? Yes, there are chances that your child’s eczema will go away as he gets older. However, the age at which a child will start to show improvement varies though most children do start to get better by the age of three years. 11. Does stress cause eczema? Stress does not cause eczema, but yes it can cause eczema symptoms to flare up or intensify. 12. Is eczema related to weather? Eczema can arise irrespective of the weather conditions though it usually gets triggered in cold weather. 13. Will applying topical steroids/ointment help cure eczema? Ointment application offers relief from the itching, burning sensation in eczema. However, this relief is short term and ends up suppressing eczema. Treatment of eczema needs to work inside out to show results. 14. I have had eczema for years. Does Homeopathy have a permanent solution? Yes, eczema can be permanently cured with medicines though the results vary from person to person. Factors such as the severity of eczema, the spread of eczema and the duration decide the extent to which medicines will help. Also, each body responds differently to homeopathy, which decides how well an individual feels. 15. Can lifestyle changes bring relief from eczema? Yes, a few basic lifestyle measures, when adopted, can help manage eczema. These measures are as follows: Avoid bathing with water that is too cold or too hot Use a very mild soap while bathing Avoid using cosmetics and perfumes Wear cotton clothes preferably. Avoid synthetic and woolens Do yoga, meditation or breathing exercises to manage stress Avoid excessive scratching of the skin. Use a moisturizer in dry eczema to reduce itching Avoid exposure to extremely cold environments.Dr. Rajesh Gupta8 Likes13 Answers
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A 46 year old male patient with a history of hypertension and diabetes mellitus type 2, presented with 5 days history of pruriginous and slightly tender rash on his left lower arm and hand (picture no. 1, 3 & 4), right arm (picture no. 5) and right feet (picture no. 2). He was using some creams but without improvement except on the right foot where skin changes started to disappear. He was referred to me because of od suspicion of herpes zoster. Patient stated that he started to use the anti-alcoholic drug on its own, 10-days before the current presentation, which is called acamprosate. I discarded HZ as diagnosis and referred the patient to the dermatologist. What this could be? Is it drug related or it is something else?Dr. Rajesh Kumar2 Likes9 Answers
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Friends today I am discussing about a skin problem known as Contact Dermatitis. Contact Dermatitis Have you ever used a new type of skin care product or detergent, only to have your skin become red and irritated? If so, you may have experienced contact dermatitis. This condition occurs when chemicals you come into contact with cause a reaction. Most contact dermatitis reactions aren’t severe, but they can be unpleasant until the itching goes away. What are the symptoms of contact dermatitis? Contact dermatitis symptoms depend on the cause and how sensitive you are to the substance. Allergic contact dermatitis Symptoms associated with allergic contact dermatitis include: dry, scaly, flaky skin hives oozing blisters skin redness skin that appears darkened or leathery skin that burns extreme itching sun sensitivity swelling, especially in the eyes, face, or groin areas Irritant contact dermatitis Irritant contact dermatitis may cause slightly different symptoms, such as: blistering cracking skin due to extreme dryness swelling skin that feels stiff or tight ulcerations open sores that form crusts What causes contact dermatitis? There are three types of contact dermatitis: allergic contact dermatitis irritant contact dermatitis photocontact dermatitis Photocontact dermatitis is less common. It’s a reaction that can occur when the active ingredients in a skin product are exposed to the sun and result in irritation. Allergic contact dermatitis Allergic contact dermatitis occurs when the skin develops an allergic reaction after being exposed to a foreign substance. This causes the body to release inflammatory chemicals that can make the skin feel itchy and irritated. Common causes of allergic contact dermatitis include contact with: jewelry made from nickel or gold latex gloves perfumes or chemicals in cosmetics and skin care products poison oak or poison ivy Irritant contact dermatitis Irritant contact dermatitis is the most common type of contact dermatitis. It happens when the skin comes in contact with a toxic material. Toxic substances that can cause irritant contact dermatitis include: battery acid bleach drain cleaners kerosene detergents pepper spray Irritant contact dermatitis can also occur when the skin comes in contact with less irritating materials — like soap or even water — too often. People whose hands are frequently exposed to water, such as hairdressers, bartenders, and healthcare workers, often experience irritant contact dermatitis of the hands, for example. How is contact dermatitis treated? Most cases of contact dermatitis go away on their own once the substance is no longer in contact with the skin. Here are some tips you can try at home: Avoid scratching your irritated skin. Scratching can make the irritation worse or even cause a skin infection that requires antibiotics. Clean your skin with mild soap and lukewarm water to remove any irritants. Stop using any products you think might be causing the problem. Apply bland petroleum jelly like Vaseline to soothe the area. Try using anti-itch treatments such as calamine lotion or hydrocortisone cream (Cortisone-10). If needed, take an antihistamine drug such as diphenhydramine to cut down on itching and to reduce your allergic response. You can purchase these items at most drugstores or online. Most times, contact dermatitis isn’t cause for concern. However, you should seek medical attention if your rash is close to your eyes or mouth, covers a large area of your body, or doesn’t improve with home treatment. Your doctor can prescribe a more potent steroid cream if home treatments don’t soothe your skin. How is contact dermatitis diagnosed? Contact your doctor if your symptoms are severe or don’t improve with time. Your doctor will take a thorough medical history and examine your skin. Questions they may ask you include: When did you first notice your symptoms? What makes your symptoms better or worse? Did you go hiking just before the rash started? What products do you use on your skin every day? What chemicals do you come in contact with on a daily basis? What do you do for a living? Your doctor may refer you to an allergy specialist or dermatologist to pinpoint the cause of your contact dermatitis. This specialist can perform allergy testing called a patch test. It involves exposing a small patch of your skin to an allergen. If your skin reacts, the allergy specialist can determine the likely cause of your contact dermatitis. How can I prevent contact dermatitis? Avoiding initial exposure to irritants can help prevent contact dermatitis. Try these tips: Purchase products labeled “hypoallergenic” or “unscented.” Refrain from wearing latex gloves if you have a latex allergy. Opt for vinyl gloves instead. Wear long-sleeved shirts and pants when hiking in the wilderness. If you notice irritation from a new product, stop using it immediately. If you know you have sensitive skin, do a spot test with any new products. You can apply the new product to one place on your forearm. Cover the area, and don’t expose it to water or soap. Check for any reaction at 48 and 96 hours after application. If there’s any redness or irritation, don’t use the product. Homeopathic Medicines used for treatment of Dermatitis 1- Anacardium orientale – These kinds of patient have weak memory, has depression and very irritable. Patient has fear of examination. There is weakness of all senses, like sight, and hearing. They do not want to work, they lack self confidence. There is empty feeling in the stomach which is relieved by eating. Eating relieves all discomfort. Patient has anxiety when walking. He feels as if pursued. Patient is also absent minded. He is very revengeful, has suspicion on other. Patient has intense itching. Complaints of eczema. Swelling is seen in body. It is good remedy for urticaria, Lichen planus and neurotic eczema. Ulcers are seen on forearm. Patient has sickly face, with hollow eyes. He has dark rings around eyes. He looks wild, childish. Has expression less face. Eczema is seen of face and neck. Worse- application of hot water. Better-from eating, from rubbing. Dosage-200 potency, given 3 times a day for 10 days. 2- Arsenicum album-Patient is very weak. He cannot do slightest work. Pains are burning type. The feeling of burning is relieved by heat. Patient’s condition is worse when he eats watery fruits. He has gradual loss of weight from impaired nutrition. Patient is very angry and restless. He has fear of death. He has fear of being left alone. He has great despair, which drives him from place to place. He lacks courage. Skin is itching and burning. There are various eruptions which are dry, rough, scaly. This is worse from cold and from scratching. Pus filled eruptions are also seen. It can be given for urticaria, with burning and restlessness. It is very good remedy for psoriasis. Worse- wet weather, after midnight, from cold , from cold drinks or foods. Better- from heat, from warm drinks. Dosage- 1M potency, 2 times a day for 10 days. Best result is obtained when the medicine is taken in any part of the day, except midday and midnight. 3- Borax Veneta- Patient has fear of downward motion. He has extreme anxiety, from going downstairs. Patient is excessively nervous and easily frightened. He is sensitive to sudden noises. He has fear of thunder. It can be given for psoriasis . Itching is seen on the finger joints. Patient has unhealthy skin. It can be given for herpes. Eruptions are seen on fingers and hands with itching and stinging. The face of the patient is pale and swollen and has earth like expression. Patient is obese with light weight. Skin of the patient is wrinkled. Patient has herpetic eruptions on face. Worse- from downward motion, noise, smoking, warm weather, after menses. Dosage- 200 potency, 3 times a day, for 10 days. 4- Cantharis vesicatoria- Skin complaint of this remedy is often associated with urinary complaints, as this remedy often acts on gastric and urinary system. There is intolerable, constant urging to urinate. Patient is very anxious. He has restlessness, which ends in rage. He has constant attempts to do something, but accomplishes nothing. It is given for Dermatitis with bleb formation. It can be given when patient has secondary eczema around scrotum and genitals, followed by excessive perspiration. There are various vesicles with burning and itching. It can be given for Sunburn. Burning with rawness can be better by cold applications. It can cure burning in soles of feet at night. Worse- from touch, urination, drinking cold water or coffee. Better- rubbing. Dosage-30 potency, 3 times a day, for 20 days. 5- Flouric acid-It is remedy for bed sores, ulcerations, varicose veins and ulcers. It is suited for old age people, or those people who are prematurely aged. Patient lacks any emotions towards thos eloved most. They are unable to realise their responsible. They are very happy persons. It can be given when patient has itching especially in the various openings of body and this is worse by warmth. There is profuse sour, offensive perspiration. Worse- warmth, morning, warm drinks. Better- cold, while walking. Dosage- 30 potency, 2 times a day for 10 days. 6- Lycopodium- It is suited for people who develop disease gradually. They are very weak. Patient has difficulty in digestion. This remedy suited to old people, with earth like complexion, having difficulty in uric acid synthesis. All symptoms which begins from right goes to left. All conditions are worse from about 4 to 8 p.m. Patient wants everything warm. These people are intellectually very intelligent, but physically are very weak. They have weakness especially in morning. Skin is very unhealthy and ulcers are form very easily. There are various kinds of abscesses beneath the skin. These abscess are worse from warm applications. There is violent itching along with fissured eruptions. Patient has chronic eczema associated with urinary, gastric and liver disorders. Skin becomes thick because of the this condition. Patient has brown spots and freckles which is worse on left side of face and nose. There is offensive secretions, especially of feet. Worse- on right side, from right to left, from above downward, from 4 to 8 p.m., from heat, in warm room, from hot air, from warm applications. Better- by motion, after midnight, from warm food and drink, on getting cold, from uncovering. Dosage-30 potency 3 times a day, for 20 days. 7- Nux- vomica-It is suited to people who are thin, quick, active, nervous and irritable. He does a good deal of mental work. Because of this mental strains he lives a sedentary life. He do prolong office work and do over work. He is habitual of taking drugs like coffee, wine, excess of tobacco, opium. He is very irritable and sensitive to all impressions. He cannot bear noises, odours, light. He does not want to be touched. Even the least ailment affects him greatly. His body burning hot, especially the face. He is very sensitive to cold. His skin is very red and unhealthy. Worse- morning, from mental exertion, after eating, from touch, from taking spices, from stimulants, from taking narcotics, from dry weather, from cold. Better- from taking a nap, in the evening, while resting in damp, wet weather. Dosage-200 potency , 3 times a day for 15 days.Dr. Rajesh Gupta7 Likes7 Answers