Dr. Dhepe Snehal Madhav
Venereology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
This question is on behalf of my uncle. He is 93 years old. He is complaining of severe itching all over his body. He was previously treated for this condition but it has appeared again. He was prescribed Allegra M, Clindamycin cream for local application thrice daily, Momate cream for local application thrice daily. Crust has started forming on his lower legs and the skin is flaking. He applies moisturizer Aquasoft Max cream. Crusting goes but keeps coming back. He also has fungus in toenails. He takes medicines for hypertension, prostate, hip pain, and nerve pain. His current medications are Metolar 25, Cardace 5, Urimax, and Duloxetine 20 mg twice daily. He also has AMD of his eyes. We have pictures of his skin issue. Please help.
Hello,
Welcome to icliniq.com.
Take tablet Atarax 10 mg thrice daily for seven days (for itching) or Levocetirizine 5 mg twice daily for 15 days. Use Skin first moisturizing lotion after bath for 15 days, Tenovate cream at night for 15 days. Use Emoderm cream at daytime for 15 days, and Liquid Moyzen lotion or Liquid paraffin lotion in the evening for 15 days. 5 percent Amorolfine nail lacquer on fungal nail infection twice weekly for 16 weeks. Luliconazole lotion twice daily for 15 days (on fungal nail infection). Is he diabetic? Is there any fever, oozing, or excess scratching and rubbing of the lesion? Any history of psoriasis, atopy, or allergies?
Patient's Query
Hi doctor,
Thank you for your reply.
He is not diabetic nor does he have a fever or oozing. He scratches a lot. He does not have psoriasis. He had a scaly layer of skin in the past. My queries are, regarding tablet Atarax 10 mg thrice daily for seven days (for itching) or Levocetirizine 5 mg twice daily for 15 days. My uncle has taken the tablet Levocetirizine in the past and experienced excess drowsiness. He would like to try Atarax but is concerned about being drowsy. He is in a wheelchair for one week after a fall. He has been on Duloxetine 20 mg for the past four days for hip and nerve pain. This also makes him drowsy throughout the day. He recently started using Aquasoft Max Intensive moisturizing cream and has a few tubes left. Will this work? He also uses Moisturex liquid soap as well. Please advise.
Thank you.
Hello,
Welcome back to icliniq.com.
It is foot eczema or lichen simplex chronicus. The crust or thickened skin will require keratolytic treatment. Topisal 3 percent ointment at night at daytime for 15 days. (Do not apply it on oozing lesions, only on thickened skin). Use Liquid Moyzen lotion will help to reduce dryness and peeling. Emollient like Emoderm cream will make skin soft and smooth. Coconut oil can be used sometimes as home remedy. Tablet Widcet 5 mg once in a day (when itching) is fine, will not cause side effects. It is a low dose. Antihistamine which will help in reducing itching. I hope this helps.
Patient's Query
Hi doctor,
Thank you for your reply.
The pharmacy where my uncle orders his medicines does not have or has not heard of Tab Widget 5 mg prescribed for itching. Also, does he need to use Skin First moisturizing lotion after bath for 15 days and Tenovate cream at night for 15 days?
Look forward to your reply.
Thank you.
Hi,
Once more, thank you for allowing us to be of service to you.
We value the high level of confidence you have in us!
Widcet is Levocetrizine Tablet. He needs to continue Skinfirst moisturizing lotion after his bath. Also, continue to use Tenovate cream in the evening for 15 days.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
My uncle has started using the following as of the first week of this month, Topisal 3 percent ointment at night at daytime for 15 days (on the thickened skin), Emoderm cream in the daytime for 15 days (Emollient like Emoderm cream will make skin soft and smooth), Liquid Moyzen lotion o Liquid paraffin lotion in evening for 15 days (Liquid moyzen lotion will help to reduce scaling/dryness and peeling).
He uses the following for his toenail fungus: 5 percent Amorolfine nail lacquer on the fungal nail infection (twice weekly for 16 weeks) Luliconazole lotion twice daily for 15 days (on fungal nail infection) and Widcet or Levocetirizine 5 mg tablet once a day for itching. In addition, should he use Skinfirst moisturizing lotion after bath and Tenovate cream at night for 15 days?
Look forward to your reply.
Thank you.
Hi,
Welcome back to the icliniq.com family.
I appreciate the confidence you place in me for your healthcare consultation.
I suggest you to use the following:
1. Moyzen Light Liquid Paraffin Moisturising Liquid (Light Liquid Paraffin: 63.4 % w/w) during daytime for 15 days.
2. Topisal 3 percent ointment (Clobetasol 0.05% w/w and Salicylic Acid 3 percent w/w) on the thickened areas. If it is not available, you can use its alternative.
3. Tenovate cream at night for 15 days,
4. Skinfirst moisturizing lotion after bath for 20 days.
5 Both Emoderm cream and coconut oil are good emollients. You can use it according to your choice.
6. Tab Levocetirizine 5mg twice daily for 15 days.
7. 5 percent Amorolfine nail lacquer or 8 percent Ciclopirox nail lacquer twice a week for 16 weeks.
8. Luliconazole lotion twice daily for 15 days on the infected nail.
Consult your doctor and take the medicines accordingly.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hello doctor,
We were in contact with you around two months ago regarding my 94-year-old uncle's skin issues. You had said his skin issues were related to Foot eczema or Lichen simplex chronicus. He complied with your treatment for his skin condition since then. There was a vast improvement until the last week when the weather changed. Currently, he is complaining of severe itching all over his body. He has tried tablet Levocetirizine 5 mg twice daily for 15 days. Unfortunately, it did not work. So he tried the Tablet Atarax 10 mg thrice daily for seven days for itching. It did not work as well.
He also has a crust that has started forming on his lower legs, and the skin is flaking. The winter weather is severe and causes harsh skin issues for him.
He takes medicines for hypertension, prostate, hip pain, and nerve pain. His current medications include Metolar 25, Cardace 5, Urimax, and Duloxetine 20 mg twice daily. He also has AMD (age-related macular degeneration) in his eyes. Enclosing pictures of his skin problems, for review.
Please advise what to do to keep his skin in good condition during the winter months.
Thanks.
Hi,
Welcome back to icliniq.com.
I suggest you moisturize the skin very frequently during winter. Use Skinfirst moisturizing lotion or Cetaphil lotion to moisturize the skin three to four times in a day.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thanks for responding. Will those scaly and scabs or thickened skin that started forming fall off with the lotion? Also he has itching and the constant need to scratch. Please let us know what to do with it.
Thanks.
Hi,
Once more, thank you for allowing us to be of service to you.
We value the high level of confidence you have in us!
It is a chronic inflammatory condition of the skin with scaly plaques. There will be itching in 25 percent of the cases. I suggest you to:
1. Motium cream at night for 15 days.
2. Any moisturizer like Cetaphil moisturizing lotion or Skinfirst moisturizing lotion thrice daily for 20 days.
3. Use Cetaphil soap for bath.
4. Continue using Liquid paraffin in the daytime for 15 days.
5. Clindamycin lotion or Fucidin cream once daily on fissured lesions for seven days.
Consult your doctor and take the medicines accordingly. Do not scratch lesions, as it may cause secondary bacterial infection. Avoid trauma or injury to the skin. Painkillers may exacerbate lesions. Use moisturizers in the winter period to avoid exacerbation of lesions.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your response.
Hi,
We welcome you back to the icliniq.com family. I appreciate the confidence you place in me for your healthcare consultation.
You are welcome, I hope for a fast recovery.
Thank you.
Patient's Query
Hi doctor,
My uncle is complaining of severe itching all over his body, crust on his lower legs and the skin is flaking, fungus in his toenail, discoloration of nails on his right foot, and the skin issues are exacerbated during the winter months. He takes medicines for hypertension, prostate, hip pain, and nerve pain. His current medication includes Metolar 25, Cardace 5, Urimax, and Duloxetine 20 mg twice daily. He also has AMD in his eyes. I have attached pictures for reference.
Thank you.
Hi,
Welcome back to icliniq.com.
I suggest you use:
1. Topisal 3 percent ointment (Clobetasol 0.05% w/w and Salicylic Acid 3 percent w/w) at night for 15 days.
2. Skinfirst moisturizing lotion in the daytime for 15 days.
3. Tab Loratadine 10 mg at daytime after breakfast for 10 days.
4. Tab Levocetirizine 5 mg at night after dinner for 10 days.
Consult your doctor and take the medicines accordingly. Avoid scratching the lesions. Improvement will be seen soon.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your response.
There has been improvement in his skin issues. Is it alright to moisturize skin frequently because his skin tends to dry up quickly? Thank you.
Hi,
Once more, thank you for allowing us to be of service to you.
We value the high level of confidence you have in us!
You can moisturize three to four times a day.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
My uncle says that Topisal 3 percent ointment and Skinfirst moisturizing lotion are not available at the pharmacy where he lives. Are there other options for Topisal and Skinfirst ointment? He would need a strong moisturizer to manage his skin during the winter months.
What was your opinion when you saw his toenails? Does he need to continue with any treatment?
Look forward to your reply.
Thank you.
Hi,
Glad to have you back!
I am here to help you get the best medical advice.
I suggest you use:
1. Ciclopirox nail lacquer thrice weekly for 18 weeks.
2. Luliconazole lotion daily at night for 3 months.
3. Fucibet (Betamethasone 0.1% w/w and Fusidic Acid 2% w/w) cream twice daily for seven days.
4. Use a good Moisturizer like Aquasoft Max cream Olesoft Max cream or Venusia Max cream, two to three times a day.
5. Mix Topical Motium cream with Xerina cream(it is a moisturizer with urea) in a 1:1 ratio, and apply a thin layer only on the affected area at night for two weeks.
Consult your doctor and use the medicines accordingly.
It is very important to moisturize. Follow up after 10 days.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
I would like to reconfirm the following:
For nails you had suggested Ciclopirox nail lacquer thrice weekly for 18 weeks and Luliconazole lotion daily at night for three months. For skin, you had suggested Fucibet cream twice daily for seven days, a good Moisturizer like Aquasoft Max cream or Olesoft Max cream, or Venusia Max cream two to three times a day, and mixing Topical motium cream, with Xerina cream in equal amounts, and apply thin layer only on the affected area at night for two weeks.
Topical Motium is not available. Is there another option?
Thank you.
Hi,
Once more, thank you for allowing us to be of service to you.
We value the high level of confidence you have in us!
I suggest you use Fucibet cream twice daily for 10 days instead. Use the moisturizers separately.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
Hi,
We welcome you back to the icliniq.com family. I appreciate the confidence you place in me for your healthcare consultation.
You are welcome, I hope for a fast recovery.
Thank you.
Patient's Query
Hi doctor,
There is a noticeable improvement in my uncle’s skin. He is contacting you as a follow-up and is looking for some aggressive skin regimen during the winter months. He did mention that some of his skin treatment is sort of corrosive. The bed sheets have developed holes as a result of coming in contact with the ointments. Nevertheless, he is still looking to continue to combat the winter skin issues that he develops. Along with the topical treatment, is there any therapeutic way or oral skin-related vitamins, or health food for his age that you recommend?
Look forward to your reply.
Thank you.
Hi,
Welcome back to icliniq.com and thank you for choosing us as your provider for medical care.
I suggest you the following:
1. Tab Limcee 500 mg (Ascorbic acid) once a day after breakfast for 30 days will help in the healing of lesions.
2. Capsule Zitcare (multivitamin) once daily after dinner for 30 days.
Consult your doctor and take the medicines accordingly.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your quick response. He would like to know about continuing his skin regimen through the winter months. Does he need to continue with your previous prescription? He does not have enough of the ointment left. Do you recommend that he continue with the previous prescription? Thank you so much.
Dear,
Welcome back to icliniq.com.
With passion, commitment, and experience, I hope I will be able to provide you top-class medical opinion.
I suggest using Dermadew Bact soap (antibacterial soap) for taking a bath for one month. Continue with a good Moisturizer or cream (whichever suits him) three to four times daily for one month.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your response.
Hi,
Welcome back to icliniq.com.
My aim is to provide you a quality medical care that is easily accessible and responsive to you in your time of need.
I recommend cutting his nails short. Apply nail lacquer or lotion as mentioned previously.
I hope this information will help you. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your quick response.
Hi,
We welcome you back to the icliniq.com family. I appreciate the confidence you place in me for your healthcare consultation.
You are welcome, I hope for a fast recovery.
Thank you.
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