som
Forum Guru
Topics: 59
Posts: 308
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overwt 48 yr pt who has had multiple incidences of vaginitis, presents with global darkening of skin color. pt is previuosly on atkins but denies any abnormal eating habits now. u recomend:
insulin
steroids
hydroquinone cream
sunlight exposure
phlebotomy
full disclosure of diet
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| GDS2008
Forum Elite
Topics: 9
Posts: 144
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will probably try to explore further in the history and PE
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| frank100
Forum Guru
Topics: 48
Posts: 586
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atkins is low carbs and high proteins, she is middle aged and overweight, associated maybe to some kind of immunosupresive state (chronic vaginitis) unleashed by diet requirements...whatīs that some sort of hemochromatosis..or suprarrenal stuff, maybe steroids, or phlebotomy.
but GDS2008 in right, question stem lacks a lot of info.
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| cbenitesch
Forum Senior
Topics: 10
Posts: 141
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what about this: overweight, repeated vaginitis, darkening of skin, on diet but still overweight... Diabetes repeated vaginitis is not uncommon on diabetic people, overweight that you canīt manage with diet... and darkening can go with Acanthosis Nigricans (but question says global!!! and we find AN mostly on flexures) I go for INSULINE... but we need more information.
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| jvo_md
Forum Senior
Topics: 22
Posts: 189
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frequents vaginitis (p/b DM) + Darked skin = could be hemocromatosis...We need mor History....but ill go with phlebotomy
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| shumaila
Forum Elite
Topics: 58
Posts: 347
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hmm could it be addisons?? steroids???
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| juanma0
Forum Senior
Topics: 10
Posts: 146
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I agree with u cbenistech. Overweight, presumed imunosupressed state (from chronic vaginits) and acanthosis nigricans points to DM. So...treat w/ Insulin. Could be other answers, but this is the MOST likely answer.
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| tolito
Forum Fanatic
Topics: 119
Posts: 2,174
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the global darkening of skin suggests hemochromatosis which may be responsible for the diabetes. treatment for hemochromatosis will be phlebotomy.
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| fox
Forum Guru
Topics: 70
Posts: 727
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yeah bronze diabetes
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| som
Forum Guru
Topics: 59
Posts: 308
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yes, this is a case of bronze diabetes or primary hemochraomatosis and pt needs early phlebotomy to improve survival.
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| cbenitesch
Forum Senior
Topics: 10
Posts: 141
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Ouch! you are right! bronze diabetes!!!!!.... 
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