female 28 yrs.... presented with both leg swelling, with multiple lesion, oozing fluid, and pain in both legs... over a short span of 10 days. There is h/o steroid intake(oral prednisolone), oral antibiotics, analgesics. She had mild dyspnoea and facial puffiness Rx and Dx please
Cause of swelling must be ruled out E.g Thyroid dysfunction, varicose vein, filarias, Renal disorder, Anemia,, Excessive steroid use, Heart failure than decide about Rx
My entery is late but expressing my views There are two contradictory points 1 facial puffiness well understood can be steroid induced 2 swelling with oozing lesions in lower limbs So if pt has recieved steroid specificaly for which indication if swelling with lesions are already there it may have aggravated bcz of water retention There is h/o dysponea is it a primary complaint or induced after steroids So far lesions with swelling are concerned need to know whether pt has varicose earlier or dvt Is pt is obese over wt or diabetic I feel before answering for lesions we need to work out and investigate completely. Thanx
Bilateral filarial lymphadenitis leading to elephantiasis, Diethylcarbamazapine 100 mg tid for a month or so, test microfilaria at 4 am if fever exists, antiinflammatories, antihistomonics, antoxidants avoid mosquitoes ,use mosquito nets, chemical vapours etc., Antibiotic, foot end kept elevated supine position
Cause of swelling must be ruled out E.g Thyroid dysfunction, varicose vein, filarias, Renal disorder, Anemia,, Excessive steroid use, Heart failure than decide about Rx
1.Facial puffiness well understood can be steroid induced. 2. Swelling with oozing lesions in lower limbs. If patient has received steroid specifically for which indication if swelling with lesions are already there it may have aggravated because of water retention. To know the lesions are concern need to know whether patient has varicose earlier or dvt. Lesions need to know and investigate completely.
STASIS DERMATITIS ..WITH.. BILATERAL OEDEMA FEET.. NERDS CLINICOPATHOLOGICAL EVALUATION..WITH.. BLOOD CBC CT BT PR.. URINE ROUTINE.. BSR , Hba1c.. LFT , KFT.. COLOUR DOPLER STUDY.. MEANWHILE TREAT WITH.. SYMPTOMATICALLY.. LIMB ELEVATION..
Even though history is short, she has evidence of chronic eczema of the feet. Secondary infection is a possibility. Diabetes, anaemia, varicose veins should be ruled out. Advised RFT.
Chronic eczematous dermatitis Adv CBC RFT LFT BLOOD SUGAR FASTING PP Lipid profile ECG, thyroid profile x-ray chest, USG full abdomen SOS Colour Doppler Nadoxin plus cream Moiste lotion Tab Atarax 10 mg BD Tab cefadroxyl cv 500 Multivitamins & antioxidant Further management as per report
Stop wysolone slowly puffiness dyspnoea due to steriod pta of lichen planus with cellulitis dd cellulitis eczema Aug 625 tds oint halox bd fucidin bd
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