40 .G Akshara kruthi

August 03, 2022

40 Akshara kruthi , 5th sem

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A 66 year old male patient with multiple painful blisters over the body

August 02, 2022

Patient is referred from Dermatology department.

A 66 year old male patient from Kakkereni, AP Lingotam, Shepherd by occupation came to the OPD with

C/o Multiple painful blisters all ove the body sparing palms and soles.

History of presenting illness

Patient was apparently asymptomatic 5 years ago then he started developing itching all over the body suddenly which subsides temporarily on applying Vaseline.

5 days ago he developed a blister on the dorsal surface of the middle distal phalynx of his left hand following which his body started itching and blisters started appearing on his body starting from the periphery spreading to the trunk which were painful. It was associated with fever but cured immediately on taking medication. The blisters are rupturing spontaneously and serosanguinous fluid is oozing out of the ruptured blister.

Past history

He had no similar complaints in the past.

K/c/o Diabetes mellitus since 5 years and Hypertension since 3 years and is on medication with Telmesartan and Metformin respectively.

Not a k/c/o Tuberculosis, Asthma, Epilepsy, CAD.

Has a history of allergy to few vegetables like Egg plant, potato.

Personal history

Diet - Mixed

Appetite - Normal

Sleep - Inadequate due to painful blisters

Bowel and bladder movements - Regular

Addictions - Occasional Alcoholic

Family history - No other family members have similar complaints.

Drug history - Metformin for Diabetes since 5 years and Telmesartan for Hypertension since 3 years.

General physical examination

Patient is conscious, coherent and cooperative

Moderately built and moderately nourished

No Pallor, Icterus, Cyanosis, Clubbing, Generalised lymphadenopathy, Pedal edema

Vitals

Temperature - Afebrile

Pulse rare - 76 bpm

Respiratory rate - 18 cpm

Blood pressure - 120/80 bpm

Skin - Multiple bullae and pustules over B/L upper and lower limbs, trunk, buttocks and one on distal phalynx with erosions, crusting and oozing blood and serous fluid.