Inflamed lesions on hands and arms

A 48-year-old farmer, with a history of type 2 diabetes, hypertension and hypercholesterolemia, presented to the local hospital with fever, malaise and inflamed lesions on his hands and arms. What can be the differential diagnosis?

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Infected insect bites. Cellulitis. Clavam cl 625mg bd. Diclo PCM TDS. Chymoral forte TDS. Multivitamin and antioxidants orally. Clean area with diluted betadine lotion apply mupriocin oint locally. Levocet if itching present. Keep area clean and covered with sterile gauge.

Thanks Dr Sandeep S
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IT'S A..CASE OF.. UNCONTROLLED DIABETES WITH.. ? PYODERMA GANGREOSUM.. ? ECTHYMA GANGREOSUM.. ? CELLULITIS.. * STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. * ANTIBIOTICS WITH NSAIDS AS PER REQUIREMENT.. * WOUND MANAGEMENT WITH SURGEONS OPINION.. NEED'S.. * HEMOGRAM.. * BSR..HBA1C.. * SWAB C AND S EXAMINATION..

Tnx Dr Shivraj Agarwal sir
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DD 1 Ecthyma (Pseudomonas aeruginosa and staphylococcal infections) 2 Glanders (Pseudomonas pseudomallei) 3 Histoplasmosis 4 Orf (Rickettsia akari) 5 Rat-bite fever (Streptococcus moniliformis, Spirillum minus) 6 Lymphocutaneous Tularemia 7 Cutaneous Anthrax 8 ?

Ecthyma gangrenosum. Ecthyma gangrenosum is a cutaneous infection most commonly associated with Pseudomonas bacteraemia. Ecthyma gangrenosum usually occurs in patients who are critically ill and immunocompromised. The characteristic lesions of ecthyma gangrenosum are haemorrhagic (bloody) pustules that evolve into necrotic (black) ulcers. ecthyma gangrenosum. ... produces punched-out shallow ulcers with a purulent necrotic crust and surrounding erythema Ecthyma gangrenosum, a Pseudomonas aeruginosa infection characterized by bacterial invasion of the media and adventitia  DD.Cellulitis..

Multiple lesions on forearm with necrosis Suggestive of bacterial infection However considering farmer by profession - sporotrichosis need to be considered as one of the differential diagnosis Please send biopsy for fungal culture to confirm the same

D/D Pyoderma Gangreosum Cellulitis Cutaneous anthrax Infected insects bites Ecythema gangrenosum

Uncontrolled Diabetes On Wrist Looks like "Infected Insect bites." Other lessions r Possiblity of "Ecthyma gangrenosum" with Cellulitis.

Tnx "Dr.Ashok leel Sir"
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Ddx: cellulitis, ecthyma gangrenosum,infected insect bites, cutaneous anthrax.

Bullous pemphigus Uncontrolled diabetic pt flaredup cellulitis With multiple bullaes and necrotising epidermis

Thanx dr Pushkar ji Bhomia
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Insects bite,Cellulitis caused by abrasions from plant’s Use of insecticide ( during farm work) Pyoderma gangrenosum

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