A 38/M with psoriasis vulgaris CBBLE UDHC similar cases

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE - IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS / HER /GUARDIAN'S SIGNED INFORMED CONSENT .HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS WITH AN AIM TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT 

Patient complains of itchy scaly lesions all over the body since 2 months

C/O CHOUGH with sputum since 10 days

History of presenting illness

Patient was apparently asymptomatic 2 months ago later developed is itchy lesions all over the body

CHOUGH with white sputum since 10 days aggravating on exposure to cold weather, associated with rhinorrhoea

No history of SOB, ORTHOPNEA, FEVER

Past history

History of similar complaints over the past 7 years for witch patient was taking regular treatment (unknown) for two years following which he got admitted and started on acitretin 25 MG OD for 2 weeks and discontinued.

PERSONAL HISTORY

DIET - MIXED,

APPETITE -NORMAL ,

BOWEL MOVEMENT - REGULAR , 

BLADDER MOVEMENTS - REGULAR,

Regular alcohol intake 

Occational cigar smoker since 10 yrs

Treatment history

Oint. Halobetasol + Salycilic acid L/A OD (SCALP) 1 year

Oint. Clobetasol + Salycilic acid L/A OD HS 1 year 

Liquid paraffin L/A BD since 1 year

T. Levoceterezine 5mg PO OD since 1 year

VITALS - 

TEMPERATURE - 97' F

PULSE RATE - 70 BPM

BLOOD PRESSURE - 110/70 MM OF HG 

RESPIRATORY RATE - 26

SPO2 - 99 % AT ROOM AIR

SYSTEMIC EXAMINATION - 

CARDIOVASCULAR SYSTEM : S1 AND S2 HEARD , NO MURMURS, no JVP

RESPIRATORY SYSTEM : BILATERAL AIR ENTRY PRESENT, end expiratory wheeze in B/L ISA RT>LT

CENTRAL NERVOUS SYSTEM : NAD

P/A - non tender, no organomegaly

Skin

Multiple scaly plaques noted over trunk, and all four limbs

Workup

ECG

CBP

CUE

UREA -19

S. CREATININE -1.0

Uric acid -7.0

Na -140

K -3.2

Cl -97

LFT

FBS -119

Treatment

Nebulization with asthlin 6th hrly

T. Montelukast 10mg PO OD 

SYP. Grilinctus - P TID

Oint. Halobetasol + Salycilic acid L/A OD (SCALP)

Oint. Clobetasol + Salycilic acid L/A OD HS

Liquid paraffin L/A BD

T. Levocetirizine 10 mg OD HS

Protienex powder with milk PO BD