young lady 30yr,no comorb,took some medication for itching from doctor outside.. developed this lesions,skin pilling, edema all over the body including face.... is it sjs?
This is a moderately serious case that should be admitted in a corporate hospital ( where all so rts of speacialists are available. Dont waste time!. It is a case of " exfoliative dermatitis with interstetial nephrites both cause by adverse drug reaction . The firmer explains the skin involvement- erythematous rash and peeling or exfoliation due to rapid turnover and sloughing if superficial epithelial cells - all a dry process. - unlike TEN Where sheats of skin sloughs off following rupture of bullae inxlding mucosa. The puffiness of face and almost ansarcaobviously is of kidney origin. The ost common ephritis an adverse drug can cause is " tubulo intetstitial nephritis." Low urine out put, raised RFT, anasarca and oesonophils in urine ( characteristic) Pt needs fluid and electrolyte management and monitaring of kidney function under care of a nephroligist. Wonder why the case is being discussed here. Dress syndomes is a serious delayed rea tion to a drug taken usually 2 to 3 b 4 but not within a week. Multisystom involvement like liver 80/ case, raise liver enzymes, heart - 30%:kidny,skinetc. Fever greatertha 100, lymphadenopathy, lucoctosisadatypicallymphocytes, raised lier ezyes etc. Peripheral high esonophilia.. Seious and had 10 % mortality. The presentatui mskes it unlikely. This is my opinion. " knowing what we can not treat is more important than what we can ".
Any bullous lesion..? Duration of gap between drug intake and lesions..? Any fever or rash..? Mucosal erosion.? Nikolsky sign..? Percentage of body surface area involved..? If any of these are present then thinks of sjs /ten.
Exfoliative dermatitis no doubt. Judicious use of steroids short course needed. Corporate hospital is not possible for all.. the problem is not immediately life threatening, too.
?Dress syndrome
Dr Abhishek, Dr prabhakar, and Dr umesh patnaik sirs.- I am overwhelmed by ur support to my answer. Thank u sir- now I am beginning to believe there is some truth in what I said.
I agree with Dr. Asv Prasad
Erythroderma. Or exfoliate dermatitis. Plz confirm from dermatologist
Can try lab-S.protin, S.creatanine, Hb, possibly drug reaction, Rx-Tab-Ivoral fort (1)+Tab-Montina L 1odx10, wysolone in tapping dose
I agree Dr. asv Prasad
I agree with Dr Asv Prasad
Cases that would interest you
- Login to View the image
61 y/o Male with rash starting on foot in summer. Initially responded to methylprednisone and PO steroid taper starting at 50mg and doxycycline. Rash recurred with the diffuse spread. Rash recurred with diffuse spread and improved some to repeat PO steroid taper and doxy. What is the diagnosis and treatment options?
Dr. Yugal Sachdev0 Like16 Answers - Login to View the image
A 50-year-old male patient . with dog bite on his only right leg. no systemic symptoms with ampicillin sulbactam treated Eczema-like itchy discharge lesions on hands and other leg. only crp high albumin low. What is the diagnosis and treatment recommendation?
Dr. Madhav Mishra2 Likes30 Answers - Login to View the image
13/yr old girl having this type of lesione since 15days Itching+ , no other compline Plz give your valuable Dx tx ....
Hiral Lathiya4 Likes88 Answers - Login to View the image
36 year old female pt. Came to IPD with such lesions on body. Relatives say this happened after taking carbamazepine. Bp is continuously high. Please help with diagnosis and treatment.?
Dr. Prakash Pandey2 Likes7 Answers - Login to View the image
patient have complaint about itching since 2 mont pl dx and treatment
Dr. Ashutosh Dubey3 Likes21 Answers
1 Like