1601006056 SHORT CASE

 

FINAL PRACTICAL EXAM SHORT CASE.

 This is an online E log book to discuss our patient’s de-identified data shared after taking his/her/guardian’s signed informed consent. 

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

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

Patient got over the counter topical cream, soap and some oral drugs from a nearby medical shop.  

He used them for 2 months, few lesions regressed but a few persisted on his nose, ear lobe, hands, legs and trunk.

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

No new lesions were noted. 

Since 4 days, the patient developed high grade fever associated with chills and rigors.

Associated with Loss of appetite.  

There is no history of similar complaints in the past.


EXAMINATION:

  • Face: loss of eyebrows, thickened earlobe
  • 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
  • Scaly hyperpigmented plaques with fissures noted involving the feet Extending  from the sole to the dorsal aspect of the foot
DIAGNOSIS:

Leprosy (Hansen's Disease.)







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