CASE OF BURNING SENSATION AND ITCHING ALL OVER BODY

This is a case of 58 year old Male came to dermatology opd with chief complaints of itching and burning sensation all over body since 1 month on 12/05/22

HOPI :
 Patient was apparently asymptomatic  1 month back  then presented with complaints of itching and burning sensation all over body 
H/o fever and shivering since 1 month  
H/o unknown skin lesions over right lower leg subsided on its own 1 month back .

Past history :
H/o snake bite ( non specific).
H/o weight loss present 
H/o Pedal edema (on and off)
No other comorbidities 
No h/o exposure 
No h/o plant or sun exposure 

Family history:
No significant family history 

Personal history:
Bowel and bladder normal 
Thin built 
Moderately nourished 

General examination :
patient is conscious ,coherrent, co operative and well oriented to her surroundings.
Built: Thin 
Nourishment: good
no pallor ,no cyanosis, no icterus, no clubbing.
Right inguinal node palpable 
Pedal edema: not present 
Vitals :
 Temp : afebrile
BP : 120/70 mm hg 
Pr :88 BPM
RR: 17 CPM
spo2 :98 %on RA

systemic examination:
CVS : S1 S2 HEARD
RS : BAE + , NVBS HEARD 
P/A :SOFT NON TENDER
CNS :INTACT 

Local examination :
Skin :
Generalised scaling seen all over body prominent over hands and foot .
Scalp :scaly plaques all over scalp 
Nails :normal 
Nose :spared


Referral to general medicine department done in view of low bp recording on 14/05/22
 BP:90/60 mm hg recording seen 
Rx:
Iv fluids @ 100ml /hr is advised as treatment 
BP monitoring 4th hourly 

Provisional diagnosis :

ERYTHRODERMA secondary to 
? ALERGIC CONTACT DERMATITIS 
? PSORIASIS VULGARIS 
? MYCOSIS FUNGOIDES


Investigations:

Serology :

Hbsag  Non reactive 
HIV  Non reactive
RPR Non reactive 
HCV Non reactive 

Serum electrolytes : with in normal limits 
Serum urea: normal range 
LFT : with in normal limits 
Hb:11.2%
RBS : 110 mg/dl
Serum creatinine :1.6 mg/dl


Lipid profile :
TOTAL CHOLESTEROL:150 mg/dl
TRIGLYCERIDES:185   normal less than 150
HDL:37   normal 40-60 
LDL : 101 normla less than 100
VLDL :37.2 

ECG:

2D ECHO:
TREATMENT :

1.LIQUID  PARAFFIN PLUS GLYCERIN local application TID 
2.TAB B COMPLEX PO OD
3.TAB ATARAX 10 MG OD
4.MOISTUREX CREAM local application OD
5.FUDIC CREAM L/A BD
6. Drink plenty of fluids 
7.High protein diet 
8.Barrier nursing
9.TAB PCM PO BD SOS




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