Good evening Curofians. This case is specially dedicated to "Dermatologists" and other specialists in general. A. Clinical diagnosis. B. Describe your findings, C. Differential diagnosis, D. Management. Kindly answer to the point. Thank you, Best regards. [Source: Internet]

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1 This is a case of cutaneous leishmaniasis of dorsum of left hand. 2 Looking like an ulcer with healed margins , granulomatous tissue and some glistening pearl like structures over the surface. 3 Differential diagnosis Fungal like chromo blastomycosis ,deep fungal infection, lobomycosis. Bacterial like cutaneous diptheria Rhino scleroma Tropical pyoderma Viral like ORF Inflammatory like pyogenic granuloma Nummular dermatitis Plaque psoriasis Malignant neoplasms like Psoriasis Metastasis Keloid Ulcers like Traumatic ulcer Stasis ulcer 4 Management It heals spontaneously over a few weeks some times healing is delayed leaving a permanent scar If not treated properly, it last many years. Usually no drugs needed for cutaneous leishmaniasis Drugs are Antimonials like Sodium stibogluconate Glucantine Amphotericin B Flucanazole Itrcanazole Ketocanozole paramomycin

Dr Kazi 1.Can it be Pyoderma gangrenosum as I don't have clinical history 2. Necrotic deep ulcers Painful violaceous borders 3. Antiphospholipid antibody syndrome, Blastomycosis, atypical mycobacteria infection, 4. No specific treatment, can use topical steroids, pimecrolimus, Oral Steroids, cyclosporine if severe and multiple. We might need to get Hematologist, gastroenterologist, rheumatologist opinion.

Pyoderma gangrenosum.

?orf

Madam Orf will have elevated borders swelling with central necrosis. It will look something like cherry plum from top.
1

Pyoderma gagrenosum D D cutaneos leshmaniasis. C/S and approprite A.B biopsy from the edge of the iesion will clinchthe diagnsis.

orf ?pyoderma

very rare site for venous stasis ulcer?

post burned ulcer dd. venous ulcer trophic ulcer

trophic ulcer- due to Hansen's Disease

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