A 55 year old female presented with itching all over the body

A 55 year old female, resident of Miryalaguda housewife by occupation came to hospital on 15/9/22 with 

CHIEF COMPLAINTS

       Itchy lesions all over of the body since 15 years . She complains of fever with pain with appearance of blisters .

HISTORY OF PRESENT ILLNESS 

     The patient was apparently assymptomatic 15 years ago. Then she complains of itching all over her body associated with pain and fever and appearance of blisters.

PAST HISTORY

      No history of DM

      No history of HTN 

      No history of CAD , Asthma , epilepsy, TB

FAMILY HISTORY 

        A history of DM ,HTN

        No History of CAD , TB , Asthma 

PERSONAL HISTORY

       Married

       Farmer by occupation

       Mixed diet 

       Normal appetite

       Normal bowel movement

       Normal micturition

       Non alcoholic

       Non smoker

       No known allergies 

 

GENERAL EXAMINATION 

       Conscious and coherent

       Moderately built

       Moderately nourished 

       No pallor

       No icterus

       No cyanosis, clubbing of fingers ,           lymphadenopathy, pedal oedema  

VITALS 

 Temperature - 98.8F

  Pulse rate - 73beats /minute

  Respiratory rate - 16/min

  BP  -120/80 mm of Hg

 

SYSTEMIC EXAMINATION

 CVS 

 No thrills 

 S1 S2 + 

 No cardiac murmurs

RESPIRATORY SYSTEM

Centrally located trachea 

Vesicular breath sounds 

No dyspnea

No wheezing 

ABDOMEN

Scaphoid shaped abdomen

 No tenderness

No palpable mass

 

CNS 

Conscious and coherent

Normal speech

 

SKIN

Multiple hyperpigmentated scaly plaques all over the body. 

INVESTIGATIONS 

ECG

TREATMENT 

  1.Liquid paraffin BD

  2.Tab. Atarax 25mg OD

 3.Tab. ZONCOVIT OD

 4.Tab . SHELCAL 500mg OD

 5.MgSO4 dressing (left ear)

PROVISIONAL DIAGNOSIS 

Psoriasis