A 67-year-old patient with uncontrolled type 2 diabetes mellitus with peripheral artery disease, neuropathy and a history of foot ulcer presented with complaints of interminable pruritus that began six months ago. His previous visit to dermatologist did not lead to a diagnosis and the use of hydrocortisone cream provided short relief. Medications The patient’s diabetic medications include insulin glargine, insulin aspart, metformin and liraglutide.
Physical examination Lower extremities exhibit with 4/8 sense of vibration bilaterally Impaired response to monofilament testing in both feet A callus under the first toe of the left foot Multiple scratch marks on his extremities and trunk Lab tests Urinalysis: Normal liver function: Normal HbA1c: 8.2% Mild anemia with a hematocrit of 37% Which of the following is NOT advised in the workup and management for the patient’s pruritus? Optimize…
