This patient presented with epistaxis. Please examine the hands.What is shown in the picture above ?
What else would you examine ?
What are the associated clinical manifestations ?
What is the diagnosis ?
What is the most likely cause for the epistaxis ?
What are the investigations ?
Outline the management.
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3 comments:
1) Gottron's sign/papules > erythema on the joints
2)myositis?speech/swallowing? cardiomypathy?raynaud?joints?malignancies?
3)dermatomyositis
4)drug induce. patient on warfarin?
5)INR. workup to rule out maligancies
6)maintain INR 2-3
1) Gottron papules
2) Helitrope rash
telengiectases
proximal myopathy
shawl sign
raynaud
3)Dermatomyositis
4)NPC
5)CK EMG muscle biopsy
6)steroid,steroid sparing ,IVIG,physio,treat U/L cause
Yes ! Excellent Anonymous !
Look hard always for associated malignancies....
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