Concluded Case

31yr Male cement worker presenting with swelling and pain of both feet and DIP joints in hands since 2yr,pedal edema subside during night and gradually appear during day time, also have decreased temp. sensation on both hands and tingling sensation after cold bath. He also complains of having mild itching skin lesions on multiple sides and loss of wt...D/d, investigations, treatment.

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Concluded answer

Thanks for da Referral, @Dr. Vijaya Bhaskar Sir--- Yes, Agree with @Dr. Partha Sarathi Sahana Sir N @Dr. Saran Kumar Sir--- - It's a case of HANSEN'S DISEASE, along with da MUSCULOSKELETAL INVOLVEMENT, da 3rd Most Common feature (after 1. CUTANEOUS N 2.NEUROLOGICAL INVOLVEMENT)--- CHARCOT"S ARTHOPATHY, ie SYMMETRICAL POLYARTHRITIS or Swollen Hands N Feet Syndrome, during LEPRA REACTION--- CHRONIC SYMMETRICAL POLYARTHRITIS, Mimicking Rheumatoid Arthritis(RA)--- Thanks.

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Thanks for da Referral, @Dr. Vijaya Bhaskar Sir--- Yes, Agree with @Dr. Partha Sarathi Sahana Sir N @Dr. Saran Kumar Sir--- - It's a case of HANSEN'S DISEASE, along with da MUSCULOSKELETAL INVOLVEMENT, da 3rd Most Common feature (after 1. CUTANEOUS N 2.NEUROLOGICAL INVOLVEMENT)--- CHARCOT"S ARTHOPATHY, ie SYMMETRICAL POLYARTHRITIS or Swollen Hands N Feet Syndrome, during LEPRA REACTION--- CHRONIC SYMMETRICAL POLYARTHRITIS, Mimicking Rheumatoid Arthritis(RA)--- Thanks.

Thank you doctor
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Leprosy (??)

Presentation not completed ,since ear nodular lesion look like Hanson .Look for skin smear for leprae .

Wt loss:r/o dm, koch’s,connective tissue disorder(peripheral neuropathy,Raynauds phenominon) ear lesion suggest chondritis/ Hansens. Lesions on limbs need biopsy to R/o tuberculosis of skin, Hansens disease. Esr, hemogram, blood sugars, kft, ANA,skin biopsy cxr etc

? Leprosy

?HANSENS DISEASE..

Thanq sir
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Dystrophy of finger, loss of temp sensation, long duration, nodular pattern of earlobe itself suggest a case of hensen ds(leprosy). So better do SSS slit skin smear for AFB confirm it.. Do other routine investigation

Hansens disease

Very informative learn reaction or ra wysolone 10 mg tds will work for case by that time investigate

Hasens disease

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