Concluded Case

What is the differential diagnosis & treatment

A 35 yr female pt with Nodular swellings over both hands , feets and face since 5-6 months with B/L foot swelling, no itching , no burning sensation

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Concluded answer

The linear arrangement of subcutaneous (nodules,on the upper limb ( fore srm),starting from finger tips suggest the possibility of ZSPOROTRYCHOSIS WHICH SPREADS BY LYMPHATICS. BILATERAL AND FACE INVOVEMENT ARE RARE ,BUT REPORTED IN THE LITERATURE. BIOPSY& HpE and fungal culture might decide. Nodular leprosy(LL) has much closer and larger sized and esr lobe involvement and leaning face are common. EAR SCRAPPINGS FOR AFB and morphological and Bacteriological indexes might help.

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The linear arrangement of subcutaneous (nodules,on the upper limb ( fore srm),starting from finger tips suggest the possibility of ZSPOROTRYCHOSIS WHICH SPREADS BY LYMPHATICS. BILATERAL AND FACE INVOVEMENT ARE RARE ,BUT REPORTED IN THE LITERATURE. BIOPSY& HpE and fungal culture might decide. Nodular leprosy(LL) has much closer and larger sized and esr lobe involvement and leaning face are common. EAR SCRAPPINGS FOR AFB and morphological and Bacteriological indexes might help.

Thank you doctor
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Hansen's disease. Go for biopsy of the lesion.

Thank you doctor
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Cold pressed coconut oil massage and in naval lime juice pineapple with black pepper orange juice sproutskalijeeri walnuts blue berries ginger.pomegranates muskmelon under strict supervision of Doctor

? Leprosy

Neurofibromatosis Dermatitis? Hansen's disease.. HPE study.. Biopsy..

Thanks doctor Wagish Mishra
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Looks like NEUROFIBROMATOSIS Needs clinicopathological evaluation.

Thank you Sir@Dr. Rakesh Kayasth (pt) .
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? LEPROSY ADV HPE

?.Hansen's disease.. More history required. Biopsy...

Thank you doctor
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LOOKS LIKE LEPROSY,,, HENSEN'S DISEASE. AS BUMPS ARE PAINLESS WITH SWELLING. D/D:- CAN BE RHEUMATOID NODULES. GRANULOMA ANNULARE DERMOID CYST/SEBACEOUS CYST. DO,,, BIOPSY AND HPE OF NODULES TO ARRIVE AT A DIAGNOSIS. CHECK OUT THE SENSORY LOSS.

Thanks @Dr. Rakesh Kayasth (pt) boss
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If refractory lesions, may consider biopsy HPE . See for sensory loss if any.

Thank you doctor
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