My second patient for today was a 53 year old lady whom I saw about three weeks ago complaining of itchy rashes in her arms of about three weeks duration. She was not an asthmatic.
I remember she was quite distressed and was scratching away. And she said that, had she been fair, one could actually see the redness in her skin. She had an allergic dermatitis likely to be contact in nature. It was quite extensive and one would notice the thickening appearance of the skin with numerous scratch marks. She said she could hardly sleep due to the itchiness.
She had been to see three doctors and I was then the fourth. The first gave her antihistamines and calamine lotion, the second gave her an antihistamine injection as well and the third gave her a steroid cream which apparently worsened her itchiness so much so that she had to apply baby lotion to soothe the "burning skin". Obviously local treatment did not help neither were the usual oral and injectable anti-allergy agents. So I prescribed her a tapering oral dose of steroid and asked her to return after she had completed the therapy.
So she came today, smiling cheek to cheek and telling me that her condition had been "cured". In fact , according to her, the itchiness disappeared after two days of the medication. She thanked me profusely and showered me with praises and said she prayed for my good health and that of my nurse too! She apologised for not coming earlier as she had to travel outstation to see her sick old mother.
She also said she did go back to the first doctor for a cold medication and she told him that his medication did not cure her itchy condition such that she had to seek other doctors to get relief. Apparently the private doctor had inquired who was the doctor who "cured" her and also asked to look at the prescription.
She was indeed verbose with excitement and a kind of gratefulness. This patient made my day.
On a serious note, I advised her to keep away from the allergic agents/irritants as the condition will recur. Actually I do not fancy giving oral steroid on a regular basis as it is against my training and ethical practice.
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3 comments:
Marcella,
Congratulations! For solving a person's prolonged problem.
By the way, what are the good and bad things about steroid?
Hi AC,
Thanks for visiting. Done as per advice.
The good thing about steroid is that it stabilises cells thus reducing inflammatory reactions such as redness, swelling and itchiness on skin. It acts quite fast.
The bad thing is that its prolonged use can affect organs and cause weakened bone and muscles.
Its use must be monitored clinically. Steroid should not be freely available to the public due to the long term adverse effects.
Thanks for the info, otherwise I always relate steroid will cause cancer. :)
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