A 30 year old Asian female presented with white patches and ulcers on the lips since two months. She has been trying over-the-counter drugs, but it is still present. I put her on Daktarin (Miconazole) ointment and a thick emollient cream. She came after three weeks and it is still not gone. I now gave her systemic antifungal medication also. What can be given next to this patient?
Any medical history? kindly upload pic and are the ulcers painful? please give details about ulcer and patches (scarapable or not, etc). Two months is quite a long time. Should be taken seriously and further evaluation must be done.
Please check labs, cbc, Iron panel, kidney function, vitamin b level.and if possible vitamin A levels. And thyroid function
This is not fungal so antifungal will not help.
In food stop any citrus fruit. Lemon or grape fruit.
Examine the diet.
Start vitamin B Complex 1000 units daily.
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