1601006027

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35 year old male patient, 

RESIDENT -ramchandrapuram,

OCCUPATION-works as a daily wage labourer, a chronic smoker (1 pack of beedi every 2 days) and chronic alcoholic (90ml daily) since 20 years presented with a 

3 month history of painless papules with erythema that started initially over the face then gradually extended to upper limb, low limbs and trunk 

~Patient got topical cream, soap and some oral drugs from nearby medical shop 

~He used them for 2 months, few lesions regressed but few persisted on nose, ear lobe, hands, legs and trunk.

~14 days ago patient developed blackish skin discolouration over hands and feet with skin peeling, cracking, ulcer formation associated with burning sensation and erythema all over the body.

~No new lesions were noted 

Since 4 days patient developed continuous high grade fever associated with chills and rigors.

Loss of appetite 

There is no history of similar complaints in the past 

EXAMINATION:

Face: loss of eyebrows,(madarosis) thickened earlobe

Oral cavity: dark erythematous lesions on the palate

Multiple papules with erythema all over the face, limbs and trunk 

Provisional Diagnosis:-

Based on the above findings my provisional diagnosis is 

  Leprosy