1601006153: Short case Final practical

GM FINAL PRATICAL SHORT CASE 
This is an online E log book to discuss our patients de identified data shared after taking his /her/guardians signed consent form 

Mbbs final short case 
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35 year old male patient , resident of ramachandrapuram works as a daily wage labourer, since 20 years he is a chronic smoker (1 pack of beedi every 2 days ) and a chronic alcoholic(90 ml daily ) .
He presented with a 3 month history of painless papules with erythema that started initially over the face ,then it gradually extended to upper limb ,lower limb and trunk 

No hypodense lesions 
No fever 
No pus 
No loss of sensations 
No genital lesions 

He had soap and topical cream available and some oral drugs taken from the nearby medical shop 

He used this remedy for 2 months , some lesions regressed over time ,but few persistent lesions were noticed on hands ,leg ,trunk ,earlobe ,nose 

Then the patient developed blackish skin discoloration 14 days  ago over hands and feet with skin peeling, cracking, ulcer formation associated with burning sensation and erythema present all over the body 

Associated with Loss of appetite 

Since 4 days patient developed continuous high grade fever associated with chills and rigors

There is no history of similar complaints in the past 

EXAMINATION:

  • Face: loss of eyebrows, thickened earlobe
  • Scaly hyperpigmented plaques with fissures noted involving the feet Extending  from the sole to the dorsal aspect of the foot
  • Oral cavity: dark erythematous lesions on the palate
  • Multiple lesions of different sizes with ill defined erythematous borders and pale hypopigmented centre with peeling and raw areas are seen on trunk, limbs and face
DIAGNOSIS : HANSEN'S DISEASE

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