pt was admited on third day to the hospital with c/o of inability to eat or drink anything and vesicular lesion all over the face from day one and gradually developing since then, lesion ws present in eyes(continously watery) intraoral picuture shows white scrapable lesion giving an erythmatous base on scraping giv probable diagnoais or D/d and possible rx pt was on antidepressants taking valproic acid since 5 years pt is working as a metal welder in his own shop hiv hbsAg tests are negative cbc is normal absolute eosinophil count is highly raised

11 Likes

LikeAnswersShare

si feel its steven j syndrone. . but just wanted to know is body is involved. and if body is not involved do tzanck smear to rule out phempigus. and start deccirdron 1 cc iv in morning and night and taper it. add iv antibiotic for seven days. topical antibiotic. and antihistamine . abd oral kenocort orabase after fud and before fud sum oral lignocaine and chlorhexidine mouth wash .

High count of eosinophils is suggestive of some kind of allergic reaction. As he deals with metals, certain powders or chemicals can also be the cause. I agree with Dr. Mathew to go for biopsy to rule out vesicobulous lesion . Need to give him steroids with also protecting xerophthalmia .

Agree with Dr.Joe. Most likely its bullous/ cicatrical pemphigoid. Youll need 2 biopsies, one for histopathology second for immunofluorescence. Blepharitis is a serious issue can cause blindness. Opthalmic review mandatory. Steroids is first line of treatment.

it could be either occupational hazard... or may be any drug reaction as seen in erythamatous multiforme. as he has been taking valproic acid , type 3 hypersensitivity reactn can be suspected. biopsy can be additionally helpful.

biopsy and immunohistochemistry will differentiate this from other vesiculobulos lesions such as phempigus,phemphigoid

this is chicken pox...same history i faced...dont give steroids.it wil aggravate..check out for sj syndrome too

looks like steven johnson syndrome check for target lesions on palm. course of steroid tx with taper advised

Vesiculobullous disorder. Biopsy advised

pemphigus???

Allergic.

Load more answers