Arthrogryposis-renal dysfunction-cholestasis syndrome

A patient of 34 years complaining about having itching on the b/l palm region since 7-8 months and it has started from a small black patch . And it spreads in this condition. He has no history of DM and hypertension. N also No ho of smoking n alcohol.

Patient of Age 56 years came to the OPD with complaints of severe itching on the scalp since 2years and on plucking of hair he got some kind of relief.

Pharma standards body Indian Pharmacopoeia Commission (IPC) has issued an alert over some commonly used medicines as they trigger adverse reactions. Commonly-used painkiller "Nimesulide" & antibiotic "Cefuroxime" can lead to serious skin disorders. In your practice and observation, have you noticed any such adverse reactions in patients in recent times?

M37yrs. Pain neck referred to both hands. 6 months.

F.34yrs. Spot diagnosis please. No h/o Injury.