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Sorry to hear about your father
What exactly is your question?
What investigations were carried out for his problem?
What about the results of nerve conduction study and skin biopsy?
Is he on Humira and Xeralto since the start or something else has been given as well?
What about his kidney function?
So he never received steroids or cyclophosphamide at any stage?
And he didn,t feel any better since being on Humira?
Thanks for the information
Let me explain it all one by one
First of all it seems his problem does not fit into any specific category of vasculitis
It seems like an undifferentiated vasculitis
Now in my opinion he needs to be on steroids in a high dose and as Humira is not working well for him so I would suggest a switch to Cyclophosphamide or Rituximab
For pain relief he should be on Opioids for a short period of time as pain of vasculitis is generally a severe one
I would look for any fresh lesion for biopsy or even biopsy from the edge of that gangrene to be more certain about evidence of vasculitis
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