35 YR OLD FEMALE PATIENT WITH ITCHY AND PAINFUL SKIN LESIONS

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 A 35 year old female patient , farmer by occupation came from Nalgonda to OPD with Chief Complaints of

           Itchy and painful skin lesions since 1week

HISTORY OF PRESENTING ILLNESS

Patient was apparently alright 1week back . Then she complained of itching over the trunk and eyes and later progressed to other areas hands and legs . She first noticed itchy lesion on lateral side of right ankle which later progressed to blister . On scratching , there is pus exudate .  Later she noticed similar lesions behind her right ear , face , trunk and lastly extremities . Associated with low grade fever , chills , rigor . 

PAST HISTORY 

Not a known case of DM , HTN , TB , Asthma , Epilepsy , CAD 

PERSONAL HISTORY

Patient takes mixed diet.She has good appetite.Her sleep is adequate.Her bowel Nad bladder movements are regular.She has no known allergies.She has no addictions.

FAMILY HISTORY 

No member of family has similar complaints 

DRUG HISTORY 

She took TAB.DOLO at home for fever

GENERAL EXAMINATION 

I EXAMINED THE PATIENT AFTER TAKING HER CONSENT IN A WELL LIT ROOM.

Patient is conscious , coherent , cooperative . Moderately built and nourished .

VITALS : Temperature - Afebrile

                  Pulse rate - 80 bpm

                  Respiration rate - 19 cpm

                  Blood pressure - 120/80 mm Hg

                  GRBS - 154 mg/do

Pallor - Absent

Icterus - Absent

Cyanosis - Absent

Clubbing - Absent 

Generalised lymphadenopathy - Absent 

Pedal Edema - Absent 

SYSTEMIC EXAMINATION 

RESPIRATORY SYSTEM - B/L air entry present and equal . Normal vesicular breath sounds heard all over chest . 

CARDIOVASCULAR SYSTEM - S1 S2 heard . No murmurs

CENTRAL NERVOUS SYSTEM - No focal neurological deficits elicited . All cranial nerves are are intact . 

PER ABDOMEN - Soft , non tender . Liver not enlarged . Spleen not palpable . No evidence of free fluid . Bowel sounds present .

SKIN

PROVISIONAL DIAGNOSIS 

1. Pyoderma

2. Varicella zoster 

MANAGEMENT 

INVESTIGATIONS : 

TREATMENT 

1. CAP.AMOXICLAV 625mg TID

2. TAB.PCM 650mg SOS

3.  FUDIC CREAM L/A BD

4. TAB.ATARAX 25mg BD

5. KMNO4 compress TID