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this pt is 55 years old and he is chronic smoker .the pt is having this kind of legions since 2 years having pain in the leg and no other comorbidies kindly give the diagnosis and management of this ? thank u in advance

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@Dr. Mohd Zishaan thanks sir for tagging. It's a case of GRAVITATIONAL ECZEMA (aka STASIS DERMATITIS) with DD being DIABETIC DERMOPATHY. Advice.... 1. Conservative management : Pressure stockings. Topical application of potent steroid. Topical emollient. Quiting smoking / Tobacco in any form. Heel raising exercise. 2. Investigations : Fasting blood sugar, HbA1C Colour doppler study of lower limb vessels.

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1 patient is chronic smoker, due to nicotine and other toxic components in smoke, which are directly going into lungs and then to circulation, cause injury to blood vessels due to which, Venus stasis occur and veins are unable to pump blood antigravity as the viscosity of blood is increased... This in turn stays accumulated in lower limbs only. Now poor circulation means poor oxygen supply.. this causes such stasis dermatitis. Due to extracellular fluid accumulation, there is swelling on foot. Now if in case any ulcer occurs, it will slowly heal or remain unhealed due to poor oxygen and blood supply, if any infection settles, then it will turn in cellulitis and will become very difficult to treat.. Smoking also cause high risk of heart disease, so that may also be the underlying cause, SMOKING TOXINS MAY CAUSE FAT DEPOSITION AND DEVELOPMENT OF PLAQUE IN THE BLOOD VESSELS DAMAGING THEM Stasis dermatitis is caused by poor circulation in the legs and can happen in people with varicose veins, congestive heart failure, or other conditions that cause chronic leg swelling. Veins in the lower legs fail to return blood efficiently, causing pooling of blood and fluid buildup and swelling. This swelling leads to skin irritation, especially around the ankles. To treat the disease, ask him to stop smoking first Ask to sleep in foot raised position Tab enzoheal.. Walk. Usg color Doppler of the limb Pressure stocking. Locally aloe Vera based emmolient and depiwhite cream R/o DVT to be on safe side Adv ECG 2D ECHO FBS/PPBS HbA1C

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@Dr. Mohd Zishaan thanks sir for tagging. It's a case of GRAVITATIONAL ECZEMA (aka STASIS DERMATITIS) with DD being DIABETIC DERMOPATHY. Advice.... 1. Conservative management : Pressure stockings. Topical application of potent steroid. Topical emollient. Quiting smoking / Tobacco in any form. Heel raising exercise. 2. Investigations : Fasting blood sugar, HbA1C Colour doppler study of lower limb vessels.

Fantastic approach sir v good sir
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? VASCULOPATHY.. ? STASIS DERMATITIS..ECZEMATOUS DERMATITIS.. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. BLOOD CBC CT BT PT.. URINE ROUTINE.. BSR HBA1C.. ECG STUDY.. COLOUR DOPLAR STUDY..

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Pt is aged and chr smoker with h/o leg pains suggest he has peripheral as well as deep vasculopathy He should be investigated for dvt Black discoloration with secondary infection is probably hemosedirosis due to varicosity Rx first investigate in detail Treatment rules round the varicose veins

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As the age and chronic smoker the lesion with blackish colouration may be due to vasculopathy with venous stasis either due to varicose veins or DVT Quit smoking Compressive stocking Color Doppler to see the cause of venous stasis Steroid ontment to apply locally Treatment if varicose veins

Nicely sweetly explained sir
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Eczematous Dermatitis, stasis dermatitis DM to be ruled out, peripheral arterial occlusive vascular disease should be ruled out

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Stasis Dermatitis

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Stasis dermatitis

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Stasis dermatitis. Rule out DVT BY DOPPLER STUDY

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Stasis Dermatitis

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