Kasu ajay reddy

Short case final exam   This is an online e log book to discuss about patients de identified data shared after taking his /her /guardians signed informed consent  35 year old male patient, Resident oframchandrapuram ,HYD,works as daily wage labourer . Who is a chronic smoker(1 pack of beedi every 2 days )  and taking alcoholic (90 ml daily ) since 20 years  Presented with 3 months history of painless lesions - papules with erythema  that started initially over face then extended to upper limb and lower limb ,trunk . No hypodense lesions ,no fever ,no pus discharge ,no loss of sensation ,no genital lesions . Patient got topical cream ,soap and some oral drugs from medical shop - OTC  He used for 2 months ,few lesions regressed ,but few persisted on nose ,earlobe and on trunk ,hands ,legs . 14 days back patient developed blackish  skin discoloration over hands and feet with skin peeling ,cracking ,ulcer formation - associated with burning sensation and  erythema all over the body. No new

E log medicine  “ This is an online e log book to discuss our patients deidentified data shared after taking his /  her /guardians consent ”  A 50 year old female with joint pains  A 50 year old female came to the OPD with chief complaints of pain and stiffness in several joints since 1 year. History of present illness : She was apparently asymptomatic 10 years ago, then she developed a dulling aching type of pain and stiffness in her finger joints(MCP joints) of right hand with limitations of movements at the joints.  Then within 6 months of onset the disease progressed to involve other joints of the right hand and left hand as well( wrist joint and elbow joint)  Within 4 years of onset she started feeling pain in the joints of the feet and ankle joint.  Since 3 months the pain became unbearable limiting  her activities The pain was insidious in onset, slowly progressive dull aching type of pain, non radiating, associated with swelling, stiffness and limitations of movements in the in