Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Cause | Diagnostic Tests | Management |
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Atopic Dermatitis (Eczema) |
- Primarily clinical diagnosis based on history and physical exam
- Skin biopsy (rarely needed, only in atypical cases) |
- Topical corticosteroids: To reduce inflammation
- Emollients: To maintain skin hydration - Antihistamines: For itch relief - Immunomodulators: For severe cases (e.g., tacrolimus) |
Allergic Contact Dermatitis |
- Clinical diagnosis
- Patch testing: To identify specific allergens |
- Topical corticosteroids: To reduce inflammation
- Avoidance of allergens: Identified through patch testing - Emollients: To restore skin barrier |
Psoriasis |
- Clinical diagnosis based on characteristic plaques
- Skin biopsy if uncertain - Psoriasis Area and Severity Index (PASI): To assess severity |
- Topical treatments: Corticosteroids, vitamin D analogs
- Phototherapy: For moderate to severe cases - Systemic therapy: Methotrexate, biologics for severe cases |
Scabies |
- Skin scrapings: To identify mites, eggs, or fecal matter
- Clinical diagnosis based on itching, especially at night, and presence of burrows |
- Topical permethrin: Apply to the entire body
- Oral ivermectin: In more severe cases or outbreaks - Antihistamines: For pruritus relief - Environmental cleaning: Wash clothes, bedding |
Urticaria (Hives) |
- Clinical diagnosis based on appearance of wheals and history of triggers
- Allergy testing: May be indicated if a specific allergen is suspected |
- Antihistamines: H1-blockers (e.g., cetirizine, loratadine)
- Corticosteroids: For severe or chronic cases - Avoidance of triggers: If an allergen is identified |
Liver Disease (Cholestasis) |
- Liver function tests (LFTs): To assess for elevated bilirubin and liver enzymes
- Ultrasound/CT: To identify biliary obstruction |
- Ursodeoxycholic acid: For cholestasis-related itching
- Cholestyramine: Bile acid sequestrant for symptomatic relief - Liver transplantation: In severe cases of liver failure |
Chronic Kidney Disease (Uraemia) |
- Serum creatinine and BUN: To assess renal function
- Dialysis adequacy testing: To ensure proper dialysis |
- Improved dialysis: Adjust dialysis regimen
- Topical emollients: To alleviate dry skin - Antihistamines: For itch relief - Gabapentin: For refractory pruritus |
Iron Deficiency Anaemia |
- Complete blood count (CBC): Low haemoglobin, low iron levels
- Serum ferritin: To confirm iron deficiency |
- Iron supplementation: Oral or IV iron
- Treat underlying cause: Manage source of bleeding or nutritional deficiency |
Diabetes (Peripheral Neuropathy) |
- Fasting glucose/HbA1c: To assess glucose control
- Nerve conduction studies: To evaluate neuropathy |
- Glycaemic control: Optimize blood sugar levels
- Topical capsaicin or menthol: For neuropathic itch relief - Gabapentin or pregabalin: For neuropathic pain or pruritus |
Drug-Induced Pruritus |
- Clinical diagnosis based on temporal relationship with medication
- Discontinuation of suspected drug: Improvement confirms diagnosis |
- Discontinue offending drug: If identified
- Antihistamines: For symptom relief - Corticosteroids: For severe reactions |