RASHES  ON  THE  CHEST  

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

Medicine & Cardiology THE NATIONAL ACADEMY OF HOMOEOPATHY,INDIA

Shaad Homoeopathic Hospital Near Itwari Railway Station,

NAGPUR 440002 INDIA

www.homeoacad.org      

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RASH  •  A  change  of  the  skin,  affecBng  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  CAUSES  Anxiety  Allergies    to  -­‐  food,  dyes,  drugs,  insect  sBngs,  metals  (zinc,  nickel)  -­‐  hives  

Skin  contact  with  an  irritant  (chemical,  clothes)  ReacBon  to  vaccinaBon  Eczema  or  acne  Sunburn  or  heat  (photosensiBvity)  FricBon  due  to  chafing  of  the  skin  

 

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COMMON  CAUSES  

MenstruaBon,  Pregnancy  InfecBons  –  Ringworm,  Secondary  syphilis,  Lyme  Disease,  Scarlet  Fever  

Psoriasis;  Repeated  scratching  on  a  parBcular  spot  Lead  poisoning  

 

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HISTORY  Onset,  causaBon,  spread,  modaliBes,  associated  symptoms  (locally  as  itching  or  systemic  as  fever),    

MedicaBon  taken,      OccupaBon,    Change  of  place,    contact  with  animals  and    Complete  physical  examinaBon.  

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EXAMINATION  

1.  Appearance:    Purpura  (vasculiBs  &  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.  DistribuBon:  Scarlet  fever  rash  becomes  confluent  &  forms  bright  red  lines  in  the  skin  creases  of  the  neck,  armpits  &  groins  (PasBa'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,  Ricke`sia,  Gu`ate  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..

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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  sensaBon  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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RASH

Natrum 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 20  

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 MINOR Vinca 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, bu l lous erupt ion 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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GraphiBs  • Skin-­‐  obsBnate  dry,  perspiraBon–absent,  unhealthy    • Erysipelatous  inflammaBon  • ErupBons  oozing  out  a  sBcky    discharge-­‐gluBnous,  thin      Psorinum  Dry/humid  foeBd  eczema  Scratches  unBl  it  bleeds  Disappear  in  summer    and  reappear  in  cold  weather  Filthy  smell  from  body      

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Sulphur  Itching  <  from  any  heat,  warmth  Spring  Bme  Dry,  rough,  scaly,    voluptuous  itching  Feels  so  good  to  scratch  Skin  cracks  easily  

Mezerium  Intolerable  itching    <  in  bed,  touch,  night  constant  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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