35 years male with itchy skin lesions
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Chief complaints:-
Itchy skin lesions all over the body since 8 months
History of present illness:-
Patient was apparently alright 8 months back then he developed small papules over the cheek after which it transformed into erythematous scaly plaques first on the nose and cheek then over the entire face,neck,back,hands and legs.
H/o itching over the plaques
H/o photosensitivity
C/o Tenderness in wrist joint, metacarpophalangeal joint,interphalangeal joint
H/o fever 4 episodes in last 8 months,last episode 20 days back.fever lasts for one day releived after taking medication.
H/o oral ulcers on hard palate since 10days
No chest pain,sob, palpitations
No abdominal pain,nausea vomiting
No increased or decreased output
PAST HISTORY:
H/o cva, left UL ,LL weakness and slurred speech 10 years back
H/o apendectomy 8 years back
Used ayurvedic medicine 1 month back for 15 days.
Not a known case of diabetes mellitus, hypertension, tuberculosis, asthma, epilepsy
Family history:-
not significant
Personal history:-
Appetite:- decreased since 3 days
Diet:- mixed
Sleep :- adequate
B& B :- regular
Addictions :- toddy drinker since 20 years
Bedi smoker since 25 years(15 per day)
General examination:-
Patient is conscious, coherent, cooperative well oriented to time place and person .
Moderately built, moderately nourished
Pallor:- absent
Icterus:- absent
Cyanosis:- absent
Clubbing:- absent
Generalized lymphadenopathy:- absent
Bilateral pedal edema :- absent
Vitals:-
Bp:100/70 mmhg
Pulse rate:-80 bpm
RR:- 18 cycles per min
Temp :- afebrile
Systemic examination:-
Cvs :- s1,s2 heard no murmurs
Cns :- no focal neurological deficits
Abdomen :- soft ,non tender
Rs:- BAE present
Investigations:-
5/4/2023
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