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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Feet, Palms, Tongue, Dorsum Dark, Patches On Fingers, Decreased RBC Count. What Is The Reason?

hello doc,
I was visited by a patient 24/m who had blackish extremities(both palms and dorsum , both feet and dorsum, tongue and both axillae) which was noticed initially as a small patch on one of his fingers before 3 years.It has been aggravating for the past 3 months.Pt has a h/o poor appetite since last month.Routine examinations suggest 12% of haemoglobin and decreased rbc count .6-7 pus cells in urine and 4-6 epithelial cells. His vit b12 levels are less. What could be the possible diagnosis?
Regards,
Dr.anjali
Mon, 8 Apr 2013
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General & Family Physician,  's  Response
Hello Dr. Anjali, however h/o patient is not suggestive of many things but possible one diagnosis is "MELANOGENESIS". This is a type of melanoma ( nodular or pigmented), 2nd thing may be metastasis has stated in this patient. As far as concerned about pus cells in urine actually 5-6 are nearly normal ,loss of appetite, weakness are all indicator of melanoma so pl consider this thing also in your's diagnosis.
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Feet, Palms, Tongue, Dorsum Dark, Patches On Fingers, Decreased RBC Count. What Is The Reason?

Hello Dr. Anjali, however h/o patient is not suggestive of many things but possible one diagnosis is MELANOGENESIS . This is a type of melanoma ( nodular or pigmented), 2nd thing may be metastasis has stated in this patient. As far as concerned about pus cells in urine actually 5-6 are nearly normal ,loss of appetite, weakness are all indicator of melanoma so pl consider this thing also in your s diagnosis.