Diabetic Dermatitis Case Study: Itchy Skin Lesions in Type 2 Diabetes Patient
This case study presents a female patient with itchy skin lesions on both lower limbs due to diabetic dermatitis accompanied by Type 2 Diabetes and Essential Hypertension. Details include patient history, past medical records, laboratory investigations, dermatological findings, and assessments highlighting the relationship between diabetes and skin issues.
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Presentation Transcript
Therapeutics I III Sessional practicals Major practical Diabetic dermatitis Presented to : Mr. Zia Inamdarsir Presented by : Manoj Kumar
Patient profile form Patient name: Neelamma patil I.P No : 5632 Unit : Unit VI Age : 60yrs Dept : Medicine Sex : Female DOA : 28/02/2013 DOD :06/03/2013 Present complaints :C/O, itchy skin lesions our both lower limbs since 1 month
Past medical history : DM,HTN -2years on prescription Past medication history: Tab metosartan, Tab Dianorm 80 ,Tab PiozMFG2 , Tab Anxit. Personal history: Diet :Veg Apeptite : Good Bladder and Bowel: Normal Sleep :adequate
Laboratory Investigations: RBC : 4.34 WBC : 4900 HB : 11.7 PLATELET COUNT : 1.53 ESR : 80 POLYMORPHS : 65 LYMPOCYTES : 33 BASOPHILS :00 MONOCYTES :00 ESINOPHILS :02 PCV : 36.5 MCV :84.5 MCH :27.0 MCHC :32.1
SOAP NOTE: SUBJECTIVE: C/O, itchy skin lesions our both lower limbs since 1 month OBJECTIVE: DATE 28/2 1/3 2/3 3/3 4/3 5/3 6/3 BP 150/90 160/100 150/84 160/84 164/94 160/108 130/80 Pulse 82 86 80 82 84 82 80 ESR 80 (M<10,F<20) Due to infections Polymorphs 65 (40-60) Due to infections MCH 27( 32-36) Due to hypochromic anaemia
URINE EXAMINATION : Albumin : Absent Pus cells : 2-3 Sugar : Absent Epithelial cells : 3-4 DERMATOLOGY : O/E ,Multiple erythromatous papules seen over both extensor aspect of both legs & knee . ECOCARDIOGRAPHY: Valves :- mitral valve : mild annular calcification Aortic,tricuspid,pulmonary Normal
Chambers :- LV :Mild concentric LVH RV Normal RA-Normal LA-Normal Conclusion : Mild concentric LVH Normal resting Lvsystolic functions with LVE of 60% Type 1 diastolic dysfunction
ASSESSMENT:- PROBLEM LIST: 1) Itchy skin lesions 2) Type 2 DM 3) Essential HTN 1) Itchy skin lesions : It occured due to diabetes i.e type 2 DM (Diabetic dermopathy). 2) Type 2 DM : It occcured due to insulin resistance & may be due to increased glucose levels.
3) Essential HTN : It may be age related or asympatomatic. PLAN : 1) DM : 1)Inj H.Actrapid all the days (Human insulin) 1-1-1 MOA: It acts by reducing the glucose levels. 2)Tab PiozMFG2 Pioglitazone HCL +Metformin+ glimepiride -1-0-1- last day only MOA : It acts by reducing the blood glucose levels & enhancing the insulin receptor sensitivity.
2)HTN : 1)Tab. Metosartan 50 metoprolol + telmisartan -50 1-0- 0 all the days MOA: It is a beta blocker, it blocks the adrenergic receptors present in the smooth muscles. 3)Dermatis (itchy skin lesions): 1)Elovera lotion Vit E & Aloevera M-0-0- except 1stday 2)Tenovate cream clobestol-0-0-N-except 1st day MOA:-Clobestol is a corticosteriod ,it reduces pruritic manifestations & inhibits prostaglandins & leukotrienes synthesis
3)Tab.Atarax 25 Hydroxyzine-1-0-1-25mg-all days MOA:- It act as antihistamine,it can be used for treatment of severe cases of itching. 4)Others: Inj.Augumentin-Amoxcillin+clavunicacid-1.2gm-1-0-1-all the days. MOA:-These are the betelactamase inhibitors & used for prophylaxis purpose. 2)Inj.Pan-pantoprazole-40mg-1-0-0-all the days MOA: It s a proton pump inhibitor ,it reduces gastric acid secreation.
DISCHARGE DRUGS: 1)Tab pan 40 40mg-7 days-1-0-1 2)Tab Augumentin -625mg-7 days-1-0-1 3)Tab PiozMFGz-7 days-1-0-1 CLINICAL PHARAMACIST INTERVENTIONS & SERVICES PROVIDED : DDI s : 1)Insulin + metoprolol moderate hypoglycemia or hypertension
PATIENT COUNSELLING FOR : DISEASE : 1) Monitor BP regularly 2) Kidney assement 3) Foot care 4) Eye care 2)MEDICATION :- 1)PAN 40 : Should be taken BEFORE meal 2)Metfomin : Should be always taken along with meals & avoid alcohol consumption. 3)LIFE STYLE: 1)Exercise regularly 2)Reduce or avoid the sugar content in food 3)Monitor your blood glucose regularly 1)
