1601006171 SHORT CASE

 MBBS FINAL SHORT CASE

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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 limb, low 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 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 continuous 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:

Hansen’s disease 




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