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




Comments

Post a Comment

Popular posts from this blog

60 YEAR OLD MALE WITH COMPLAINTS OF GIDDINESS

Image
This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box" This is case of 60 year old male came to casualty with chief complaints : Patient c/o giddiness since 6days C/o headache since 6days Hopi: Patient was apparently sympatomatic 10 years back then he had stomach ache for which he was referred to our hospital. Then he was diagnosed with intestinal perforation and he was operated and discharged after 6 days.  4yrs back he fell in drainage pit and got ankle fracture. And he got nail plate operated and removed after 1 month 6 days bac...
Read more
Image
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...
Read more