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MEDICINE CASE DISCUSSION This is online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputsThis e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome 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 se