An 8-year-old boy presented with complain of pus-filled lesions over chest, arms and neck since 5 days. There was history of on and off reddish scaly lesions over body for 3-4 years which aggravated in winters. He was applying clobetasol propionate ointment for two weeks and had stopped suddenly 1 week back. What is the diagnosis and what can be expected in the histopathology?
A 65-year-old tailor with DM was admitted with multiple reddish, indurated lesions with silvery white scaling involving 60% BSA. He also complained of stiffness in small joints of fingers with difficulty in making a fist. He had a past history of treatment of tuberculosis 10 years back and is also an alcoholic. Which drug would be the best treatment option for him?
While methotrexate would be an ideal drug but the history of alcohol consumption makes an IL-17 biological a better drug. History of TB rules out use of TNF alpha biological drugs and cyclosporine is a rescue drug for acute flares.
A 6-year-old girl presented with sudden appearance of small reddish papules over back for 5 days. A history of sore throat 1 week back was elicited. The lesions were asymptomatic and gradually progressed to involve back, abdomen as well both extremities. Fine white scaling was seen over few lesions. What is the most probable diagnosis?
A male patient presents to you a scaly eruption with a flare in winters and on examination he had well-demarcated erythematous plaques with overlying thick adherent scale on the body, palm and soles, with a body surface area (BSA) of involvement around 10%. He also has developed arthritis. He has been given oral methotrexate on and off for the last 1 year. Which of the following drugs would you prescribe?
The ideal drug is a TNF alpha biological and adalimumab is better than other agents for this indication. The safest and fastest acting biological in India is secukinumab
A 26-year-old unmarried woman presents to the dermatology clinic for evaluation of itchy lesions all over the body for 4 months. There were Wickham striae in the mouth. She is desirous of a fast treatment, but she insists on not taking oral steroids. She has been applying a mid-potent steroid off and on with little relief. Which of the following will you consider?
The first two are slow acting though safe, the third has the highest evidence but is to be avoided in a unmarried female as it needs post-treatment contraception for 3 years. The fastest acting drug is cyclosporine and is the ideal choice here.
