Derm round 3

Case 1

A 13-year-old boy, presented with Dengue encephallitis and later developed Dengue Shock Syndrome, was ventilated in ICU for two weeks. He developed nosocomial infection and his blood C&S grew Acinetobacter species. He completed two weeks of IV Sulperazon and later transferred out to the general ward for further management. In the ward, he developed spikes of temperature again, which he was covered with IV Meropenem and IV Vancomycin. He had developed the above rashes over the body for few days, even before his spiking temperature and the introduction of IV antibiotics. The managing team was worried about the rashes, as they thought it might be the source of the sepsis, and thus referral to dermatologist.

Diagnosis?
Miliaria crystalina.
More:
Wikipedia.
eMedicine.
Dermnet.
Merck manuals.


Case 2


46 years old lady, presented with the above mild pruritic plague over her left shin of three years duration. Her blood sugar was normal.

Diagnosis:
Necrobiosis lipoidica (diabeticurom).

*Note:
Relationship to DM- 1/3 have clinical DM, 1/3 have abnormal glucose tolerance, 1/3 have normal glucose tolerance.

The above patient was found to be diabetic after 3 years on follow-up.

More:
eMedicine.


Case 3

Nail changes:
Sandwich of red and white longitudinal bands, with a V-shaped nick at the free margin of the nail.

Diagnosis:
Darier's disease.

More:
eMedicine.