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Q. I have itchy, fluid-filled sores on my hands, legs, back, chest, and arms. Please help.

Answered by
Dr. Dilip Meena
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 30, 2020

Hello doctor,

I am a 62-year-old male. I have worse skin conditions like hand sores, single sore on the legs, back, chest, and arms that itch. My hand sores tend to heal slowly but filled with fairly clear fluid. I have rash and lesions for approximately 6 months.

I am currently on Mendocin and Allopurinol.

#

Hello,

Welcome to icliniq.com.

I understand your concern. But there are no attached photographs in your message. Kindly send the pictures of the affected areas to assess the condition and suggest you the appropriate diagnosis and treatment.

Thank you doctor,

I have itchy spots on my arms, legs, and hands.

#

Hi,

Welcome back to icliniq.com.

Thanks for sharing the pictures (attachment removed to protect patient identity).

I can think of two differentials. The first one is dermatitis herpetiformis, which is characterized by intense itching and fluid-filled lesions. Fluid-filled lesions are mainly over extensor, and due to intense itching, blisters usually gets ruptured, so intact blisters are not so common.

Second is bullous pemphigoid, which is seen in the elderly and commonly over lower extremities, also has urticaria red patches and tense intact fluid-filled blisters.

Are you on any treatment? Can you send me the biopsy or any other reports?

Dapsone is the drug that can be effective in both conditions, though you will have to get a G6PD report for that.

Thank you doctor,

I use Mupirocin ointment 2% for open sores, Clobetasol Propionate cream USP 0.05%, Betamethasone dipropionate ointment USP 0.05%, Hydroxyzine HCl 25 mg tablet for itching. I hope the files I am uploading are helpful.

#

Hi,

Welcome back to icliniq.com.

I think dermatitis herpetiformis and bullous pemphigoid as two probable diagnoses. I would have started Dapsone, maybe with a short course of oral corticosteroids. If it is not possible, Dapsone 100 mg would be my first-line treatment, along with the treatment you are already taking.

Thank you doctor,

Should I give this information to my current dermatologist? Not sure what to do from here.

#

Hi,

Welcome back to icliniq.com.

A trial of Dapsone with topical Clobetasol and antihistamines should be the treatment plan.

You can take the following medicines:

1. Tablet Dapsone 100 mg once a day.

2. Clobetasol propionate 0.05% cream twice a day.

3. Cream Mupirocin twice a day.

4. Tablet Fexofenadine 180 mg twice a day for two weeks.

Dapsone needs to be started after the G6PD investigation is normal.


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