DERMA


C/O painful transient skin lessions all over the body associated  with Fever since 1 month was diagnosed with histoid Hansen's from 26/1/2021(on irregularfollow up)
H/o medication taken
  Tab thalidomide 100mg TID 
Tab prednisalone 35 mg
Tab Pantop 40mg
On MB-MDT since 11 months
H/o erythematous lessions over the abdomen and buttocks 1 year back 
HOPI:
   patient was apparently alright 1 month back. C/o painful transient skin lessions all over the body associated with Fever since 1 month. 
H/o facial puffiness since 1 month 
H/o diarrhea since 15 days(5-6 episodes)
H/o joint pain since 15 days .
Patient gives h/o excessive sweating on taking medication. 
H/o similar complaints in the past  since 1 year 
No family history 
K/c/o left arytenoid growth - excisional biopsy with tracheasotomy done 10/2/2021
No other comorbidities
On examination  
Skin - erythematous nodules over the rt side of neck ,axilla,both thighs palms and lft foot .
Uinar nerve thickening on both the sides
Radial nerve thickening on the right side.

Provisional diagnosis:HISTOID HANSENS WITH TYPE 2 REACTION (ENL) with no deformities on MB-MDT 
biopsy report suggests features of Borderline tuberculoid leprosy.
Slit skin smear on 20/1/21
BI:3.66
MI:70%

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