A 55 year old female 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


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