RASHES ON THE CHEST

Dr. Aadil Chimthanawala, M.D.Prof & Head, Dept of Hom

Medicine & CardiologyTHE NATIONAL ACADEMY OF HOMOEOPATHY,INDIA

Shaad Homoeopathic HospitalNear Itwari Railway Station,

NAGPUR 440002INDIA

www.homeoacad.org1

RASH• A change of the skin, affecting its color,

appearance or texture. • May be localized to the chest or spread all

over. • Rashes may cause the skin to change

color, itch, become warm, bumpy, chapped, dry, cracked or blistered, swell and may be painful.

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COMMON CAUSESAnxietyAllergies to - food, dyes, drugs, insect stings, metals

(zinc, nickel) - hivesSkin contact with an irritant (chemical, clothes)Reaction to vaccinationEczema or acneSunburn or heat (photosensitivity)Friction due to chafing of the skin

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COMMON CAUSES

Menstruation, PregnancyInfections – Ringworm, Secondary syphilis, Lyme

Disease, Scarlet FeverPsoriasis; Repeated scratching on a particular spotLead poisoning

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HISTORYOnset, causation, spread, modalities, associated

symptoms (locally as itching or systemic as fever),

Medication taken, Occupation, Change of place, contact with animals and Complete physical examination.

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EXAMINATION

1. Appearance: Purpura (vasculitis & meningococcal disease), fine sandpaper like (scarlet fever); circular lesions with a central depression (molluscum contagiosum); plaques with silver scales (Psoriasis)

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EXAMINATION

2. Distribution: Scarlet fever rash becomes confluent & forms bright red lines in the skin creases of the neck, armpits & groins (Pastia's lines); Vesicles of chicken pox follow hollows of the body (along the spine and in hollows of shoulder blades); very few rashes affect the palms of the hands and soles of the feet (Sec Syphilis, Rickettsia, Guttate psoriasis, hand, foot & mouth disease)

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EXAMINATION

3. Symmetry: Herpes zoster (affects 1 side of the chest and does not cross the midline)

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AMMONIUM CARB

Erysipelas (Ac. Streptococcal inf of dermis & superficial lymphatics) in the elderly, infants or people with immune deficiency, DM, alcoholism, fungal infections & impaired lymphatic drainage (mastectomy, pelvic surgery, bypass grafting). Starts with red mottled rash + high fever, chills, fatigue, headache, vomit & general illness within 48 hours of the initial infection. Rash enlarges rapidly and has a sharply demarcated raised edge. It appears as a scarlet red, swollen, warm, hardened & painful- similar in consistency to an orange peel. AC: Drug of choice when the latter is associated with meningitis.. 9

AMMONIUM CARB

If infection persists, it results in vesicles, bullae & skin necrosis + lymphedema. Occ, a red streak extending to the lymph node can be seen (panaratia). Fat tissue is most susceptible.

Erysipelas can enter the skin through minor trauma, insect bites, dog bites, eczema, surgical incisions and originate from strep bacteria in pt’s own nasal passages. It does not affect subcut tissue. It does not release pus, only serum or serous fluid.

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Belladonna•Smooth, shining redness of skin•Imparts burning sensation to examining hand•Suddenly spreading •High grade fever

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APIS

Erysipelas – Rosy red, sensitive, sore, puffed up skin with Burning. After insect bites or stings. Rough eruptions or stinging like spots on skin. Large areas of urticaria

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KALI IOD

A grand indication as pointed out by Cooper & supported by Hartlaub & Trinks is a diffused sensitiveness over affected parts.

Hives or giant urticaria present as rough nodules <covering. Decidedly better in open air.Fever with violent sneezing + profuse hot, watery nasal catarrh.

It acts better in pale delicate subjects who are susceptible to damp and humid climates.

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Kali-sulph

Copious peeling of epithelium, leaves base moist & sticky

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RASH

Bryonia – Slow development and sudden receding of rash in eruptive fevers. Undeveloped measles.

Chelidonium - painful red pimples turning into pustules

Ledum Palustra – Rash only on covered parts. Rash after Puncture wounds or bites on chest with edematous rash. Carbuncles on the chest (Anthra, Tarentula Cubens)

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RASH

Ipecac: Miliary rash that itches accompanied with nausea. The patient is forced to scratch himself until relieved by vomiting. Such rash is seen after delivery or abortions >open air, < pork, rich food, candy, fruits, raisins, salads, lemon pill, berries.

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RASH

Caladium (American Arum): is the only drug for erysipelatous itching rash alternating with asthma. This occurs after the insect bite. There is profuse sweating with a sweet taste that attracts flies. The rash has a rough feeling + persistent mild burning compelling the patient to frequently touch the part but cannot scratch. It is also the remedy of choice for vaginal itching, impotency and craving for tobacco.

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RASH

Camphor – As a sequelae of measles rash the skin becomes hypersensitive to touch, dry, cold, and pale. Hates covering. (Pityriasis Rosea) starts with a single scaly, red & slightly itchy spot and in a few days, large numbers of smaller patches of the rash, some red and others tan.

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RASH

Merc Sol –Multiple type of rashes like vesicular, pustular, moist eczema, or irregular spreading shallow ulcers on a constantly moist skin. The patient has easy and smelly perspiration but is not relieved from it. Itching worst from warmth of bed and at night.

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RASHNatrum Sulph – Sycotic excrescences or wart like red lumps all over the body. Eczema which starts as itchy pimples. Itching < undressing. These pimples become moist and ooze profusely. The eczema is frequently accompanied with loose morning spluttering stools or humid asthma.

Natrum mur – Herpetic eruptions in flexural areas. Fever blisters on a greasy oily skin especially on hairy parts. Dry eruptions in the axilla. Rashes < at seashore, Eating salt. Seborrheic dermatitis: Bumps & swelling near the axillary glands

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RASH

Silicea- Rash in the form of coppery spots or rose coloured blotches as seen in lepromatous leprosy or as reaction after vaccination. The rash may end up in an ulcer that discharges offensive pus.

Manganum Aceticum- chronic eczema with amenorrhoea in diabetics. Red elevated spots. Itching > scratching. Deep cracks in bends of elbows, knees as a result of psoriasis.

Niccolum- Flea bites that cause vesicular eruptions with excess itching but not better by scratching. 21

NUPHAR LUTEUM

Psoriasis begin as red blotches with regular outline ovoid or circular, prominently covered with silvery white scales and violent itching. As eruption disappears the scales cease to be produced and skin at the place of each blotch becomes pale red or yellowish.

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URTICA URENS

Urtica urens- Sunburn with intense burning and itching. Hives with rheumatism after eating shellfish. Nettle rash -raised red blotches. Herpes labialis. Chickenpox

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VINCA MINORVinca Minor- Great sensitiveness redness and soreness of skin from slight rubbing. Chest hair matted together. Weeping eczema intermingle with foul thick crusts.

Viola tricolor- Eczema of childhood. Impetigo with intolerable itching. Thick scabs which crack and exude thick tenacious pus.

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RASH

Staph – Eczema : starts as rash then develops thick scabs that are dry and itch violently. Scratching changes location of rash and itching.

Linum usitatissimum (common Flax/ linseed) – crop of herpetic rash. One blotch from crown to toes with smarting and burning pain, Urticaria.

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CAJUPUTUM / CAJUPUT OIL

Small red dots on the skin, or larger, bruise-like spots (allergic purpura) that appear after taking drugs with flatulence+++, esophageal spasms, hiccoughs, excess salivation & sweating. Rash causes intense itching.

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Drug reactions due to Anti-hypertensive drugs:

1.Thiazides can cause vasculitis (phototoxic / allergic eruption), erythema multiforme or eczema. 2.Combination of Amiloride + Hydrochlorothiazide has the highest recorded ADR on skin. 3.Furosemide may cause eczema, purpura, bullous eruption or Steven-Johnson's syndrome. 4.Methyldopa = Eczema on hands and feet, a lichenoid eruption or purpura..

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Drug reactions due to Anti-hypertensive drugs: 5.Hydralazine may give lupus erythematosus-like eruptions, eczema, or urticaria. 6.Non-specific beta-blocking drugs can induce a morbilliform rash and may aggravate psoriasis. 7.Captopril may induce itching in up to 15% of patients. 8.The most serious dermatological side effect, exfoliative dermatitis is rarely seen following the use of anti-hypertensive drugs or diuretics.

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Graphitis•Skin- obstinate dry, perspiration–absent, unhealthy •Erysipelatous inflammation•Eruptions oozing out a sticky discharge-glutinous, thin

PsorinumDry/humid foetid eczemaScratches until it bleedsDisappear in summer and reappear in cold weatherFilthy smell from body

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SulphurItching < from any heat, warmthSpring timeDry, rough, scaly, voluptuous itchingFeels so good to scratchSkin cracks easily

MezeriumIntolerable itching < in bed, touch, nightconstant chilliness

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RHUS TOX

•Skin –inflamed, Erysipelatous, Purple, pitting upon pressure. Itching < after scratching, damp weather•Burning in the eruptions with Restlessness •Light colored patches (Tenia versicolor)

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THANK YOU

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