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MEDICINE CASE DISCUSSION

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FINAL PRACTICAL EXAM:SHORT CASE

A 35year old male patient resident of ramachandrapuram ,labourer by occupation came to OPD with chief complaint of painless lesions since 3 months.

History Of Presenting Illness:

Erythematous papules started initially at face then extended to Upper limb Lower limb,trunk.

No h/o discharge,no h/o loss of sensations

H/o blackish discoloration of  the skin of hands and feet associated with crusting and peeling of the skin, burning sensation and redness all over the body since 14 days.

He has a history of low grade fever since 4 days associated with chills and rigors.

PAST HISTORY:

No similar complaints in past.

PERSONAL HISTORY:

Diet:mixed

Appetite:loss of appetite 

Sleep:adequate 

Bladder &Bowel:regular

Addictions:present. 

DRUG HISTORY: Used topical medication for 2 months.

Examination: 

Inspection: Thickening and nodulation of ears and loss of lateral eyebrows are early manifestations. 

Trunk: multiple hypopigmented patches with ill-defined borders and with diffuse erythema on the front and back.

Limbs: dark pigmentation on the sides of the legs with peeling of skin. 

palpation:No loss of sensations. 

RESPIRATORY SYSTEM: Bilateral air entry,Normal vesicular breath sounds.trachea: midline.

CVS: S1,S2 heard,no murmurs. 

CNS:gait-normal ,cranial nerves-intact. 

INVESTIGATIONS 

 probable diagnosis: LEPROSY.