Transcript There - Ning

RASHES ON THE
CHEST
Dr. Aadil Chimthanawala, M.D.
Prof & Head, Dept of Hom
Medicine & Cardiology
THE NATIONAL ACADEMY
OF HOMOEOPATHY,INDIA
Shaad Homoeopathic Hospital
Near Itwari Railway Station,
NAGPUR 440002
INDIA
www.homeoacad.org
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RASH
• A change of the skin, affecting its color,
appearance or texture.
• May be localized to the chest or spread all over.
• Rashes may cause the skin to change
color, itch, become warm, bumpy, chapped,
dry, cracked or blistered, swell and may be
painful.
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COMMON CAUSES
Anxiety
Allergies to - food, dyes, drugs, insect stings, metals
(zinc, nickel) - hives
Skin contact with an irritant (chemical, clothes)
Reaction to vaccination
Eczema or acne
Sunburn or heat (photosensitivity)
Friction due to chafing of the skin
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COMMON CAUSES
Menstruation, Pregnancy
Infections – Ringworm, Secondary syphilis, Lyme
Disease, Scarlet Fever
Psoriasis; Repeated scratching on a particular spot
Lead poisoning
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HISTORY
Onset, causation, spread, modalities, associated
symptoms (locally as itching or systemic as
fever),
Medication taken,
Occupation,
Change of place,
contact with animals and
Complete physical examination.
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EXAMINATION
1. Appearance:
Purpura (vasculitis & meningococcal disease),
fine sandpaper like (scarlet fever); circular
lesions with a central depression (molluscum
contagiosum); plaques with silver scales
(Psoriasis)
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EXAMINATION
2. Distribution: Scarlet fever rash becomes
confluent & forms bright red lines in the
skin creases of the neck, armpits & groins
(Pastia's lines); Vesicles of chicken pox
follow hollows of the body (along the spine
and in hollows of shoulder blades); very few
rashes affect the palms of the hands and
soles of the feet
(Sec Syphilis, Rickettsia, Guttate
psoriasis, hand, foot & mouth disease)
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EXAMINATION
3. Symmetry: Herpes zoster (affects 1 side of the
chest and does not cross the midline)
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AMMONIUM CARB
Erysipelas (Ac. Streptococcal inf of dermis &
superficial lymphatics) in the elderly, infants or
people with immune deficiency, DM, alcoholism,
fungal infections & impaired lymphatic drainage
(mastectomy, pelvic surgery, bypass grafting).
Starts with red mottled rash +
high fever, chills, fatigue, headache, vomit &
general illness within 48 hours of the initial
infection. Rash enlarges rapidly and has a sharply
demarcated raised edge. It appears as a scarlet
red, swollen, warm, hardened & painful- similar in
consistency to an orange peel. AC: Drug of
choice when the latter is associated with
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meningitis..
AMMONIUM CARB
If infection persists, it results in vesicles, bullae &
skin necrosis + lymphedema. Occ, a red streak
extending to the lymph node can be seen
(panaratia). Fat tissue is most susceptible.
Erysipelas can enter the skin through minor
trauma, insect bites, dog bites, eczema, surgical
incisions and originate from strep bacteria in pt’s
own nasal passages. It does not affect subcut
tissue. It does not release pus, only serum or
serous fluid.
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Belladonna
•Smooth, shining redness of skin
•Imparts burning sensation to examining hand
•Suddenly spreading
•High grade fever
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APIS
Erysipelas – Rosy red, sensitive, sore,
puffed up skin with Burning.
After insect bites or stings.
Rough eruptions or stinging like spots
on skin. Large areas of urticaria
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KALI IOD
A grand indication as pointed out by Cooper &
supported by Hartlaub & Trinks is a diffused
sensitiveness over affected parts.
Hives or giant urticaria present as rough
nodules <covering. Decidedly better in open air.
Fever with violent sneezing + profuse hot,
watery nasal catarrh.
It acts better in pale delicate
subjects who are susceptible to
damp and humid climates.
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Kali-sulph
Copious peeling of epithelium,
leaves base moist & sticky
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RASH
Bryonia – Slow development and sudden
receding of rash in eruptive fevers.
Undeveloped measles.
Chelidonium - painful red pimples turning into
pustules
Ledum Palustra – Rash only on covered
parts. Rash after Puncture wounds or bites on
chest with edematous rash. Carbuncles on the
chest (Anthra, Tarentula Cubens)
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RASH
Ipecac: Miliary rash that itches accompanied
with nausea. The patient is forced to scratch
himself until relieved by vomiting. Such rash is
seen after delivery or abortions >open air, <
pork, rich food, candy, fruits, raisins, salads,
lemon pill, berries.
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RASH
Caladium (American Arum): is the only drug for
erysipelatous itching rash alternating with
asthma. This occurs after the insect bite. There is
profuse sweating with a sweet taste that attracts
flies. The rash has a rough feeling + persistent
mild burning compelling the patient to frequently
touch the part but cannot scratch. It is also the
remedy of choice for vaginal itching, impotency
and craving for tobacco.
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RASH
Camphor – As a sequelae of measles rash the
skin becomes hypersensitive to touch, dry,
cold, and pale. Hates covering. (Pityriasis
Rosea) starts with a single scaly, red & slightly
itchy spot and in a few days, large numbers of
smaller patches of the rash, some red and
others tan.
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RASH
Merc Sol –Multiple type of rashes like
vesicular, pustular, moist eczema, or irregular
spreading shallow ulcers on a constantly moist
skin. The patient has easy and smelly
perspiration but is not relieved from it. Itching
worst from warmth of bed and at night.
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RASH
Natrum Sulph – Sycotic excrescences or wart like
red lumps all over the body. Eczema which starts
as itchy pimples. Itching < undressing. These
pimples become moist and ooze profusely. The
eczema is frequently accompanied with loose
morning spluttering stools or humid asthma.
Natrum mur – Herpetic eruptions in flexural areas.
Fever blisters on a greasy oily skin especially on
hairy parts. Dry eruptions in the axilla.
Rashes < at seashore, Eating salt.
Seborrheic dermatitis:
Bumps & swelling near the
axillary glands
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RASH
Silicea- Rash in the form of coppery spots or rose
coloured blotches as seen in lepromatous leprosy
or as reaction after vaccination. The rash may end
up in an ulcer that discharges offensive pus.
Manganum Aceticum- chronic eczema with
amenorrhoea in diabetics. Red elevated spots.
Itching > scratching. Deep cracks in bends of
elbows, knees as a result of psoriasis.
Niccolum- Flea bites that cause vesicular
eruptions with excess itching but not better by
scratching.
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NUPHAR LUTEUM
Psoriasis begin as red blotches with regular
outline ovoid or circular, prominently covered with
silvery white scales and violent itching. As
eruption disappears the scales cease to be
produced and skin at the place of each blotch
becomes pale red or yellowish.
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URTICA URENS
Urtica urens- Sunburn with intense burning and
itching. Hives with rheumatism after eating
shellfish. Nettle rash -raised red blotches.
Herpes labialis. Chickenpox
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VINCA MINOR
Vinca Minor- Great sensitiveness redness and
soreness of skin from slight rubbing. Chest hair
matted together. Weeping eczema intermingle with
foul thick crusts.
Viola tricolor- Eczema of childhood. Impetigo with
intolerable itching. Thick scabs which crack and
exude thick tenacious pus.
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RASH
Staph – Eczema : starts as rash then
develops thick scabs that are dry and
itch violently. Scratching changes
location of rash and itching.
Linum usitatissimum
(common Flax/ linseed) – crop of
herpetic rash. One blotch from crown
to toes with smarting and burning
pain, Urticaria.
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CAJUPUTUM / CAJUPUT OIL
Small red dots on the skin, or larger,
bruise-like spots (allergic purpura) that
appear
after
taking
drugs
with
flatulence+++,
esophageal
spasms,
hiccoughs, excess salivation & sweating.
Rash causes intense itching.
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Drug reactions due to Anti-hypertensive drugs:
1. Thiazides can cause vasculitis (phototoxic /
allergic eruption), erythema multiforme or
eczema.
2. Combination of Amiloride + Hydrochlorothiazide
has the highest recorded ADR on skin.
3. Furosemide may cause eczema, purpura,
bullous
eruption
or
Steven-Johnson's
syndrome.
4. Methyldopa = Eczema on hands and feet, a
lichenoid eruption or purpura..
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Drug reactions due to Anti-hypertensive drugs:
5. Hydralazine may give lupus erythematosus-like
eruptions, eczema, or urticaria.
6. Non-specific beta-blocking drugs can induce a
morbilliform rash and may aggravate psoriasis.
7. Captopril may induce itching in up to 15% of
patients.
8. The most serious dermatological side effect,
exfoliative dermatitis is rarely seen following the
use of anti-hypertensive drugs or diuretics.
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Graphitis
•Skin- obstinate dry, perspiration–absent,
unhealthy
•Erysipelatous inflammation
•Eruptions oozing out a sticky
discharge-glutinous, thin
Psorinum
Dry/humid foetid eczema
Scratches until it bleeds
Disappear in summer
and reappear in cold weather
Filthy smell from body
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Mezerium
Intolerable itching
< in bed, touch, night
constant chilliness
Sulphur
Itching < from any heat, warmth
Spring time
Dry, rough, scaly,
voluptuous itching
Feels so good to scratch
Skin cracks easily
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RHUS TOX
•Skin –inflamed, Erysipelatous, Purple,
pitting upon pressure. Itching < after
scratching, damp weather
•Burning in the eruptions with
Restlessness
•Light colored patches (Tenia versicolor)
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THANK
YOU
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