Suggest treatment for exfoliation
Patient: An 68 year old female, diagnosed to have gouty arthritis 3 months ago came to the OPD with history of dry scales all over the body since 3 weeks. There was history of fever with chills. She started exfoliating profusely, initially trunk and buttocks, gradually progressed and involved face, back and lower extremities. There was no history of evanescent skin lesions, weakness, joint pains or history of red eyes. There was no history of jaundice vomiting or abdominal pain. Systemic review of symptoms was within normal limits. On examination patient was ill looking. There was no pallor, jaundice, clubbing or lymphadenopathy. Systemic examination was normal. On skin examination, there were dry scales involving trunk, buttocks, face, back and lower extremities involving more than 90% body surface area. Skin was shiny, thickened and erythematous. Scalp skin also showed exfoliation. Hair and mucous membranes were normal.What is the most probable diagnosis on her? Doctor: Hello,I can understand your concern for exfoliation of skin. Kindly check for the exact reason for exfoliation as it can be due to varied reasons. In my patients I combine Petroleum and other oils as emollients and urea as keratolytic cream.Petrolatum and other oils are available over the counter easily. I suggest my patients to apply any of these just after bathing when the skin is still wet. It preserves the moisture in the body and therefore reduces flaking. On applying any of the creams later you should first give compressions of mildly warm water of can take a shower and then apply it. Do not use any strong soap or detergents over skin. Wear simple lose cotton clothes and avoid synthetic clothes.All the best.