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Diabetic, suffering from chicken pox, has crust all over legs and itching. Prescribed with acyclovir. Suggest?

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is there any special ways of managing chicken pox in adult diabetics,my mom is a chronic diabetic,suffering from chicken pox,she has crusts all over her legs and she has generalised itching all over the body,and offensive smell is coming from her wounds.,doctors prescribed acyclovir 400 mg bd and herpex oint for topical use,intermittently her sugars values were raising,she has occasional vomiting,how to manage these things kindly explain...
Posted Sun, 26 May 2013 in Diabetes
Answered by Dr. Kalpana Pathak 2 hours later
Thanks for writing to us.
From the description provided your mother has crusted or scabbed lesions of chicken pox which have secondarily developed bacterial infection( offensive smell signifies the same). Itching is common in lesions of chicken pox. Diabetes as you know impairs wound healing and is a cause of decreased immunity too. In such cases a person can have severe or extensive involvement.
Stress or any illness can lead to elevated levels of blood sugar. Firstly ask her to take her anti diabetic medicines properly and remain stress free. Just let her know that though her lesions have got infected the phase of viral infection or chicken pox is over( scabbing in chicken pox signifies the same). She should take multiple small non spicy meals in a day including kichdi, daliya, daal etc. She should take juices like XXXXXXX litchi, guava etc. Coconut water, curd would help a lot. Ask her to avoid spicy food, citrus juice or fruits as sometimes patients have erosions in mouth and such foods cause more irritation. The idea is basically to improve her diet and hydration level as it would better her immunity and help wound healing and would prevent any weakness post illness from developing.

Now coming specifically to her chicken pox lesions.
1)Firstly ask her to take acyclovir in doses of 800 mg five times in a day for seven days. This is the standard dosing for chicken pox in adults and should usually be commenced within 72 hours of developing infection.
2) she should take tablet cetirizine twice in a day. This would help in treating the itch
3) to help with vomiting and gastric upset a combination of pantoprazole with domperidone like pantocid d one tablet in morning 30 minutes before breakfast would help
4) as the lesions are secondarily infected. She should take bath daily with antibacterial soap or by adding dettol in bathing water. Ask her not to rub the towel vigorously to dry herself after bathing as this could lead to erosions instead she should just dab herself dry. Also a course of oral antibiotic like amoxyclav in adult doses of 625mg twice to thrice in a day for five days should be taken. Also topical antibiotic like mupirocin cream should be applied twice in a day over lesions.
Ask her to stop applying calamine and acyclovir cream.

As the above mentioned drugs are prescription drugs, these should be taken under a qualified dermatologist's guidance. For the same please consult a dermatologist nearby.
Hope that helped. Extend my best wishes to your mother and tell her she would recover soon. So she has no reason to be depressed. Should there be any other doubt, please write back.
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