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35 year old male patient who is resident of ramchandrapuram and a daily wage labourer by occupation came to the hospital with chief complaints of painless papules with erythema since 3 months and fever since 4 days.
History of presenting illness:
The patient was apparently asymptomatic 3 months ago then he developed papules which were painless and were associated with erythema that were initially present over the face but gradually extended to upper limb, lower limbs and trunk.
Patient got topical cream, soap and some oral drugs from nearby medical shop
He used them for 2 months, few lesions regressed but few persisted on nose, ear lobe, hands, legs and trunk.
14 days ago 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.
Since 4 days patient developed fever which was continuous high grade fever which was associated with chills and rigors.
Past history: No H/O similar complaints in the past.
Personal history:
- Loss of appetite
- Chronic smoker ( 1 pack of beedi every 2 day ) and chronic alcoholic ( 90mL daily ) since 20 years.
Examination:
Face: loss of eyebrows (madarosis), thickened earlobe
Oral cavity: dark erythematous lesions on the palate
Multiple papules with erythema all over the face, limbs and trunk
Provisional Diagnosis:
Based on the above findings my provisional diagnosis is leprosy
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