INVOLUNTARY MOVEMENTS OF HAND AND ITCHING OVER THE LESIONS IN A 52 YEAR OLD MALE

October 23, 2021

INVOLUNTARY MOVEMENTS OF HAND AND ITCHING OVER THE LESIONS IN A 52 YEAR OLD MALE

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Case:

A 52year old male resident of bhogramguri of westbengal came to the casualty with chief complaints of involuntary movement of fingers since 6months(during resting),gradual onset,non progressive.

Itching over the scalp,brows,armpits since 12yrs.

Discoloration over the neck and shoulder since 12yrs ,

Decreased vision in both eyes since 6months(gradually progressive),

ringing sensation in the ear since 3years(on/off)

No h/o. Giddiness

PAST HISTORY:

Not a K/c/o hypertension, DM, CAD, asthma, TB, epilepsy,CVA

PERSONAL HISTORY:

Mixed diet with normal appetite and disturbed sleep since 6 months ( only 1 1/2 - 2 hours per day).

he has normal bowel movements and bladder filling.

addictions: takes alcohol since 10 years, 80ml per day. Stopped taking 6 months back

Tobacoo chewing.

No significant family history

GENERAL EXAMNATION:

Icterus+

No pallor, cyanosis, clubbing, lymphadenopathy, pedal edema.

VITALS:

BP: 120/60 MMHG,

PR: 78bpm

Temp: afebrile

SPO2: 98%

Rr:18/min

Grbs:122mg%

RS: BAE+,NVBS heard

CVS: S1 ans S2 heard. No murmurs.

P/A: soft and non-tender

CNS: No focal deformities.

PROVISIONAL DIAGNOSIS:

Dermatology referral in view of itching of all over body and scaly lesions:

C/o itchy,scaly skin lesions on both groins, buttock, abdomen, axillae, behind the ears, scalp on and off since 12 years

O/E:

Multiple, well defined, scaly plaques noted on BL axillae, groin, periumbilical are, buttocks, retroauricular areas, nape of neck extending to scalp. Generalised xerosis +

Diagnosis: INVERSE PSORIASIS+ SCALP PSORIASIS

Treatment suggested:

1. T. ATARAX 10 MG AT NIGHT FOR 7 DAYS

2. LIQUID PARAFFIN L/A ALL OVER THE BODY BD FOR 2 WEEKS

3. MOMATE CREAM L/A AT NIGHT ON ITCHY LESIONS FOR 7 DAYS

REVIEW IN DVL OPD AFTER 1 WEEK

SOAP NOTES: 25/10/2021

S-

Itching+

Complaints of disturbed sleep

Invountary finger movements +

O-