Conversation: The conversation between human and AI assistant.
[|Human|] Age 60 years ,diabetic since 2003 but usually keep it under control with medicines and exercise except some short duration jump in glucose level. HbAIc level remains between 6.5 to 8.2.  Since 2009 I have developed B.P and am taking Amdepin 5 for it.For the last 3 years I have developed cracks under the sole of my feet with hardening of skin around the cracks like rashes which are difficult to heal. There is no peeling of the skin.Some Doctors diagnosed it as dry eczema ,others fungus and some other as psoriasis. I took treatment for all these but with no permanent relief.  I have used salicylic acid ointments but the cracks do not heal fully and re-appear after very short duration.I have noticed one particular phenomena. When the cracks are about to heal say around 90 % and if suddenly I have tension due to any reason even for a moment I feel as if my blood is boiling and feel strange and acute itching under the sole my feet and within few minutes there are cracks again. within next one or two days skin thickens around the cracks. Suppose I have arguments with any body for a minute, immediately there is itching under my feet and cracks appear thereafter. Cracks also aggravate whenever I have allergic cold .  I am taking following tablets now a days for diabetes and H.T:-Morning dosages:1. Amdepin 52. Glimisave M 13. Aspisol 754. Nuromark5. Evion LCAt dinner:6. Piglit MF 15Note: For H.T I have tried Telmistar tab but that does not suit me and causes sudden unsteady gait for a second while taking morning walk. My father suffered from Psoriasis/lichen planus. He took treatment from different Hospitals and doctors like A.I.I.M.S, Irwin Hospital, Dr Ram Manohar Lohia Hospital, Behal Skin Institute and other Private practiotioners but with every treatment his condition deteriorated and ultimately he died of Skin Cancer in the year 1986 at the age of 57.                                                                                                                                    Therefore I  do not want to take any oral medicine especially averse to taking any Steroids.At present I am applying Xerina foot cream in the morning and at night.  My diabetic physician has now prescribed the following drugs:1.To stop Evion LC and take Bio D3 Fem once daily and Tayo 60 K once in a week for 4 months2. Instead of Amdepin 5 to take Ramihart-53. To take Telekast-L once daily in the night.4. To stop Nuromark for one month and restart after that.Please advise.
[|AI|]  Hi, welcome to Chat Doctor,first you need to be diagnosed properly, as different physician has diagnosed differently, fungal infection, psoriasis and Chat Doctor. Although clinical diagnosis is straight forward, but some times need diagnostic help to diagnose. Skin smear under KOH will show fungal hype in fungal infection. Psoriasis needs dermatopathological examination. If you can send us clinical photograph then it will be helpful. Psoriasis has no cure, it can only be controlled. Thanks