Good Afternoon Dear Curofians, Elderly Male, Non Diabetic, presented with these lesions over Trunk, chest n abdomen regions. Had Rt side Great toe trophic ulcer. Sensory loss in lower leg n feet region. ESR 125. Hiv Non reactive. Give your differential diagnosis. Share your management n investigation plan. Regards.

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It's academy of rheumatoid arthritis.hydrocortisone will do along with NSAIDs

Boutonniere deformity of 3rd digit of rt hand, arthritis of mtp, pip joints of both hands likely due to RA, onychomycosis, dermal neurofibromas of neurofibromatosis type 1, to rule out malignant peripheral nerve sheath tumor on back, neurofibromatous neuropathy is a possibility suggesten in history.

Psoriatic arthritis with skin lesion or Rheumatoid arthritis with tinea infection of skin Confirm by sending skin scraping to KOH preparation

Tinea unguim with bouteniere deformity rule out vasculitis by doing ANA profile

Twenty Nail dystrophy RA- Swan neck deformity Guttate Psoriasis Nail Psoriasis Neurofibromatosis

Hansens dieases

Henson biopsy HP

On nail its tinea aenguinum +rheumatoid arthritis.

Boutonniere deformity withonyhomycosis likrly Rheumatoid Arthritis

Nat mur 200 Anagaallis arvensis 200

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