About six weeks ago a 26 year-old, thin and depressed-looking man came in with a complaint of being itchy all over his body including his face. When asked how long had he had the condition, he replied that it had been there for years! He volunteered the information about applying all sort of cream bought over the counter. The itch was relieved temporarily on occasions and came on again and again and now had affected his face.
I took his social history and found out that he worked as a security guard with night shifts and his meals were irregular and appeared to be not nutritious. He seldom changed his work uniform and had poor personal hygiene like irregular showers or bathing. He also kept many cats in his house.
There were numerous small flat lesions with central clearings and scaly borders indicating a fungal infection in his face, trunk, arms and thighs. It was quite formidable and I had a good mind to give him a course of oral anti-fungal medication for two weeks which could be toxic to his liver.
On second thought, I would try a simpler treatment first, so I prescribed an anti-fungal cream to be applied twice a day after a shower and a daily dose of vitamin C and advised him to improve his personal hygiene, eat nutritious foods which I listed for him and to get rid of those cats which are known to carry fungal agents if not properly looked after.
If these measures did not work after six weeks, I would definitely start him on medication by mouth. His liver status was assessed by a blood test as a pre-therapy requirement. I was sure he would need the oral treatment.
He finally returned to the clinic today and what a surprise it was! He looked clean and cheerful and his skin! Where were the lesions noted six weeks ago? All I could see were very light and small and clear depigmented areas and he said the itch had almost gone then.
He actually followed the advice to the letter and it had paid off. It is such a relief for me as I do not really like to institute a therapy which would cause harmful side effects for my patients.
A condition which has existed for "years" is now coming to an end with simultaneous improvement of his quality of life.
I recommended that he apply the anti-fungal cream for the next 10 days and always have regular nutritious meals and to forever practice good personal hygiene. And to watch out for those cats!
I took his social history and found out that he worked as a security guard with night shifts and his meals were irregular and appeared to be not nutritious. He seldom changed his work uniform and had poor personal hygiene like irregular showers or bathing. He also kept many cats in his house.
There were numerous small flat lesions with central clearings and scaly borders indicating a fungal infection in his face, trunk, arms and thighs. It was quite formidable and I had a good mind to give him a course of oral anti-fungal medication for two weeks which could be toxic to his liver.
On second thought, I would try a simpler treatment first, so I prescribed an anti-fungal cream to be applied twice a day after a shower and a daily dose of vitamin C and advised him to improve his personal hygiene, eat nutritious foods which I listed for him and to get rid of those cats which are known to carry fungal agents if not properly looked after.
If these measures did not work after six weeks, I would definitely start him on medication by mouth. His liver status was assessed by a blood test as a pre-therapy requirement. I was sure he would need the oral treatment.
He finally returned to the clinic today and what a surprise it was! He looked clean and cheerful and his skin! Where were the lesions noted six weeks ago? All I could see were very light and small and clear depigmented areas and he said the itch had almost gone then.
He actually followed the advice to the letter and it had paid off. It is such a relief for me as I do not really like to institute a therapy which would cause harmful side effects for my patients.
A condition which has existed for "years" is now coming to an end with simultaneous improvement of his quality of life.
I recommended that he apply the anti-fungal cream for the next 10 days and always have regular nutritious meals and to forever practice good personal hygiene. And to watch out for those cats!
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