WEL COME TO. SEMINAR ON. BULLOUS DISEASES OF SKIN. CASE HISTORY. NAME : MARJINA BEGUM Age : About 25 year Sex : Female Marital Status: Married Occupation : House wife.
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BULLOUS DISEASES OF SKIN
NAME : MARJINA BEGUM
Age : About 25 year
Sex : Female
Marital Status: Married
Occupation : House wife.
Address : Vill : Kujghar, Post : Kujghar,P.S.: Sadar, Dist : Jamalpur. Date of Admission: 08-11-2005 Date of Examination: 09-11-2005
Diffuse painful blisters & crusted lesions over scalp, face, trunk, upper extrimities & groin.For about 1½ month. A few small blisters in mouth cavity For 7 days.
The patient states that she was all right about six months back. Then she developed a few blisters with itching at lower part of back of Lt painful blisters
side. Subsequently after 4 months she developed various sizedassociated with itching at her chest, back, upper extrimities, scalp, face, groin & a few painful lesions is oral mucous membrane which became crusted,
With above complaints she was admitted in Mymensingh Medical College Hospital for proper management. exfoliative, reddened with moist surface
Menstruation : Regular.
Habitchewing of battle
Medical College Hospital for proper management. exfoliative, reddened with moist surface Family History: No any of her
suffered from any
such notable disease.
Medical College Hospital for proper management. exfoliative, reddened with moist surface Treatment History: Patient was admitted with complaint mentioned in MMCH on 20-10-2005 & was treated with long acting steroid triamcinolone acetonide parenterally & was improved.
Appearance : Ill looking.
Body build : Average.
Medical College Hospital for proper management. exfoliative, reddened with moist surface Oedema
Medical College Hospital for proper management. exfoliative, reddened with moist surface Pulse : 86/min/reg/mod.
B.P : 120/35mm of Hg.
Temp : Normal
Respiration : 14/min.
Neck veins : Not engorged.
Lymph Node : Not palpable.
Inspection Vesicles & bulla on
scalp, face, chest, back, upper extrimities, groin, some on normal skin & some are erythomatous based.
Crust & erosions with scaling in some areas & superfical ulceration in oral cavity.
superfical ulceration in oral cavity. Palpation : Vesicles & bullae are flacid, tenderness present
NIKOLSKY Sign - Present.Bulla – spread plenomenon (The Asboe- Hansen sign) – Present.
NAD except a few oral mucosal
Marjina Begum, Age about 25 years of vill Kujghar, Jamalpur was admitted in MMCH on 08-11-05 with complaints of progressive development of painful blisters. Crust, erosions & exfoliative lesions associated with itching
over scalp, face, trunk, upper arms, groin & a few small painful blisters in oral cavity. Examination shows flaccid & vesicles, Bullae, crusted & exfoliative lesions with erythomatous base at the mentioned sites. The lesions are
tender, moist with malodourous condition & a few superficial erosions in oral mucous membrane.
Nikolsky sign – Present
Bulla – Spread Phenomenon – Present.
D/D. : Pemphigus Vulguris.
Stevens johnson syndorme & TEN.
Skin biopsy for Histopathology & IF test.
Blood for TC DC Hb% ESR - 6600/cmm. N-62%, L-32%,
M-02%, E-0%, Hb%- 80%,ESR- 10mm/1st hour.
erosions in oral mucous membrane. Random blood suger.- 103mg/100 ml.
Urine for R/E. - NAD
Blood Urea. - 18mg/100ml.
Serum creatinine. - 1.0mg/100ml.
BIOPSY FOR HISTOPATHOLOGY : erosions in oral mucous membrane.
Finding : Pemphigus compatible with pemphigus foliaceous.
Inj. - TRIAMCINOLONE ACETONID 1AMP I/M stat and 1amp on 3rd day & 1 amp on 7th day.
Tab. - Prednisolon -80mg/day.
Tab. - Neotack (150mg) 1+0+1 daily.
Cap. - Sefradine (500mg)1+1+1+1 daily.
Tab. - Alatrol 0+0+1 daily.
Potash wash - daily.1% Silver sulphadiazine ointment -
Mr. Sumon Das, son of Dr. Kanu Das, aged 29 years hailing form Jamalpur was admitted in MMCH, Cabin-7 on 28th November,2005. He was referred to skin & VD OPD on 30th Nov. 05 with the complaints of exfoliation of
skin with generalized mild itching for 20 days, a known case of hypothyroidism due to thyroidectomy 3 months back & bronchial asthma from childhood. On examination we found extensive scaling all over the skin with erythema
and itching, mild leg oedema & puffy face. Pt’s pulse was 96/min, BP= 120/65 mm of Hg, temp. = 101.40F, lungs, heart & urinary output – normal. There was no mucous membrane and nail changes. Pt. also complaints of
chilling & gave H/O taking tab. Ibuprofen 20 days back and also paracetamol & azithromycin. With these above features our diagnosis is drug induced exfoliative dermatitis.