Age : 11 yr. Sex :F
P/C- Brownish hyperpigmentation of palms and soles and flexural areas since 3 months of age
HOPI-Patient is a product of nonconsanguinous marriage, was an FTNVD delivered at home. Patient was apparently well till 3 months of age when the parents noticed development of hyperpigmention over the knuckles and dorsum of I/P joints of hands and feet. By 7-8 yrs, hyperpigmentation gradually appeared bilaterally on the soles, palms , axillae, neck, periorbital area, groin, genitalia, cubital fossa and popliteal fossae b/l , oral mucosa and nails. The pigmentation progressively has increased in extent and intensity. H/o failure of hair to grow longer than the present length. H/o lightening of hair since 2 yrs of age .Three years back the patient also started developing crops of hyperpigmented, mildly itchy, pinhead sized papules on the extremities which heal in 2 to 3 weeks, with residual hyperpigmentation h/o hyperhidrosis of palms 3 yrs. Past history /Family history / Personal history - not significant
GPE and vitals
wnl Cutaneous examination
* Multiple discrete
hyperpigmented 0.3 - 0.5 mm sized macules primarily on
INVESTIGATIONS - NAD HISTOPATHOLOGY -
DIAGNOSIS : Generalised cutaneous melanosis.
Age : 22 years Sex: Male
1. Pain and swelling involving multiple
joints with fever off and on for
HISTORY OF PRESENT ILLNESS
* Low back pain followed by pain and swelling in right knee, left knee, right ankle, left ankle and left temporomandibular joint with stiffness for 6 months, associated with high grade fever.
* 2.5 months back he developed erythematous, scaly lesions with pustules on right knee and then on whole body.
* H/O burning micturition, redness and photophobia both eyes +
GENERAL PHYSICAL EXAMINATION - Mild pallor +
Bilateral axillary and inguinal lymph nodes +
1. Multiple, erythematous,
scaly, papules and plaques studded with pustules
MUSCULOSKELETAL SYSTEM EXAMINATION
B/L knee, ankles, left middle finger,
left TM joint - swelling, redness,
DIAGNOSIS - Reiter's disease
PURPOSE OF PRESENTATION : For demonstration.
CASE FOR DISCUSSION
20 Years Female
C/O : Raynaud's phenomenon in fingers - 1 1/2 years.
G.P.E. - Mild pallor
Mask -like facies with thickening of skin. Conjunctival
SYSTEMIC EXAMINATION- NAD
and Special investigations - WNL
Tab.Minocycline 50 mg. B.D.
27 Years male
C/O : Raynaud's phenomenon -4 years
Digital ulceration and scarrying -3 years
Reflux esophagitis -3 years
G.P.E. : W.N.L.
CUTANEOUS EXAMINATION :
* Thickened, indusrated skin over
face, distal digits of hands, forearms
* Raynaud's phenomenon -present.
* Digital pitted scarring
* Ragged cuticles , nail - fold telangiectasias.
* Reticulate pigmentation over upper, anterior chest.
SYSTEMIC EXAMINATION - NAD
Routine and special investigations -WNL
Chest X-ray : B/L prominence of bronchovascular markings.
Antibody profile -LE, RF, ANA-negative
PROGRESSIVE SYSTEMIC SCLEROSISSS
Age - 24 yrs
Sex -M Farmer
GENERAL EXAMINATION - wnl
CUTANEOUS Ex - Rt foot shows
diffuse swelling with hyperpigmentation with multiple draining sinuses some
active, which on manipulation extrude a serosanguinous discharge
with red granules. The interdigital spaces of Rt
foot show maceration and hemorrhagic crusted lesions. The sinus opening
hypertrophic granulation tissue. There is atrophy of calf muscles of Rt lower limb.
ROUTINE INVESTIGATION - wnl
septate hyphae seen.
Pus culture- .+ve for staph. aureus Culture for AFB- did not show any growth at
Treatment- Dapsone 100 mg 1 OD
Pateint : 9 yrs old girl.
P/C : asymptomatic,
hypopigmented, flat lesions with hyperpigmented spots clustered over them, involving Rt
upper chest, Rt axilla, Rt upper back noticed at 2 yrs of age.
H/o an episode of partial focal
seizures, involving the Lt side of body, preceeded by vomiting, controlled by iv diazepam
dislantin 4 yrs back. Pt was not on any maintainance anticonvulsants and seizures never recurred. No
h/o headache/ mental retardation/lower back pain / stopy / other skin
CUTANEOUS Ex : Nevus depigmentosus with
SKIN BIOPSY - Hyperpigmented spot
- consistent with lentigenes, hypopigmented macule - consistent
DIAGNOSIS : NEVUS DEPIGMENTOSUS with co- loclised LENTIGENES with SPINA BIFIDA.
PURPOSE : Demonstration.
10 years male
P/C: generalized peeling of skin since 2 years of age.
HOPI: Generalized peeling of
skin was noticed by the parents at 2 years
of age involving the shoulders, trunk, upper extremities, tips of fingers
and lower extremities with sparing
of scalp, fce, palms and soles. There was no
h/o erythema or pruritus. Since then there have been similar episodes occurring
periodically with h/o superficial versicles on both extermities in summers
which ruptured spontaneously, giving rise to peeling of skin without leaving
any moist skin surface.
G.P.E. - WNL
* Multiple discrete patches of peeling
skin without underlying
* Routine investigations : WNL
PEELING SKIN SYNDROME
PURPOSE OF PRESENTATION
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