Delusion disorder (secondary)

The syndrome is associated with abdominal pain, nausea, vomiting, Obstruction and peritonitis, which depends on the size of this structure. Identify the structure and this extremely rare condition

A 15 yr old boy presented with multiple crusted/scarred lesions on the trunk, back and upper limbs of 1 week duration. History of a preceding red rash which occurs spontaneously and heal with such lesions, present.Systemic examination was normal and he was not using any medicines. Diagnosis?? Management?? I m posting this case, because it is one of the rare cases I have seen and was taken aback by its presentation. Hope this case would lead to a healthy discussion among dermats and friends from other specialities...;)

13 yrs girl having this kind of rash on back.. with burning pain, mild itching since 6 days no fever, no any other complain... What is D/D & Rx? @

A 45 yrs old married women came to opd with complaints of ,her lower end of vagina has teared and has sever stress duty to same , because of that she would not like to go anywhere, Had took multile consultancy with gynaecologist.But she didn't satisfied and her Symptoms increase over time ,lead to familial conflict, social withdrawal sleep impaired started Olanzapine 5mg to 20mg with BZD sos,And confrontation of her delusion also done. later add on TFP has tried but after 15 days,no improvement.(Not able to tolerate clozapine)Finally pt post for ECT 6 given and seen better for week and then again start asking about her somatic delusion but distress was not present .Then we plan to replace TFT with T.Pimozide 2mg and go upt T.pimozide 4 mg.and 3 session of behavioral therapy. Patient discharge after a week on Olanzapine 20mg and Pimozide 4mg with significant improvement atleast Her insight 4/6.Kindly give your valuable opinion Thanks

ECG from a 25- year-old man with palpitations, breathlessness with crepitations and dizziness