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A 60 years old women with skin lesions who can not afford to see any doctor


This is a HIPAA de-identified open-online-patient-record with initial information in patient's voice, posted here after collecting informed patient consent (form downloadable Click Here)  by BMJ Elective Student. 


This is 60 years old women, housemaid by occupation, presented with this painful, itchy and discharging lesions (image attached) over the chest and naval area. She first noticed this lesion 15 days back and since then it has progressively spread. She is hypertensive on medication and has IHD (?she vaguely mentioned about it). She is a very poor housemaid and can not afford to visit any skin specialist.

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drugs to avoid or use in terms of their pregnancy category

The optimal AEDs therapy of women with epilepsy who are of childbearing age is unclear because of a lack of conclusive data on the comparative teratogenicity of different antiseizure drugs and no antiepileptic drug has proven safe in pregnancy in terms of teratogenesis. Data on the comparative efficacy of various antiseizure drugs for controlling seizures during pregnancy are also quite limited, and there are no randomized trials in this setting. Treatment must be individualized for all patients. Women with epilepsy are classified as high risk during pregnancy and as there are no clear data indicating that any drug is without risk in pregnancy therefore, the antiseizure drug regimen should be optimized six months prior to planned conception.  Choice of antiepileptic drugs in women of childbearing age and  pregnant women with epilepsy:  1. T he antiseizure drug that stops seizures in a given patient is the one that should be used with an exception of valproate. 2.