CASE PRESENTATION DR KRITIKA JOSHI Assistant professor HAMCH

Patient’s information �Opd No. 1919/52485 �Date Of Registration- 21/8/17 �Patient’s Name- Rubeena �Age- 8

Chief complaints �Rashes (papulovesicular ) with itching on hands and feet since 10 days.

History Of Present Illness �According to mother pt. was well 10 days back. Papulovesicular

Treatment history �Patient didn’t take any treatment for present complaint. �No history of any

Family history �Her elder sister and her mother are having same rashes on hands

General examination �GCFair wt. – 21 kg �P/R – 86/Min �R/R – 18/Min �Temp.

Local Examination �Skin- Erythematous papular & vesicular rashes with bleeding and crusting (due to

Systemic Examination �No abnormality is seen in �CNS, �CVS, �RS, �GIT and other systems.

Provisional diagnosis Scabies (with secondary bacterial infection) �Pruritic papular vesicular rashes � 1 st

Differential Diagnosis �Atopic dermatitis In older childern rashes are dry , pruritic & maculopapular.

Management �Nimbadi churna- 1 gm Suddh gandhak- 150 mg Vidang churna- 500 mg 1

Instructions for patient �Apply lotion all over the body below neck at bed time

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CASE PRESENTATION DR KRITIKA JOSHI Assistant professor HAMCH

Patient’s information �Opd No. 1919/52485 �Date Of Registration- 21/8/17 �Patient’s Name- Rubeena �Age- 8 yrs �Sex- Female �Religion- Hindu �Fathers Name- Mr. Ajay �Address- ABC �Informant- Mother

Chief complaints �Rashes (papulovesicular ) with itching on hands and feet since 10 days.

History Of Present Illness �According to mother pt. was well 10 days back. Papulovesicular rashes started appearing on and between fingers and toes with itching which then starts spreading to whole hand, wrist , feet and ankle. �No history of insect bite.

Treatment history �Patient didn’t take any treatment for present complaint. �No history of any other drug intake.

Family history �Her elder sister and her mother are having same rashes on hands and feet with itching since 10 -15 days. �No history any other illness in the family.

General examination �GCFair wt. – 21 kg �P/R – 86/Min �R/R – 18/Min �Temp. – 98. 6 Deg. F �Pallor- Mild �Icterus- Absent �L. N – Not Palpable.

Local Examination �Skin- Erythematous papular & vesicular rashes with bleeding and crusting (due to intense itching ) on hands and feet.

Systemic Examination �No abnormality is seen in �CNS, �CVS, �RS, �GIT and other systems.

Provisional diagnosis Scabies (with secondary bacterial infection) �Pruritic papular vesicular rashes � 1 st appeared between the fingers and toe. �Intense itching at night. �Other family members are also affected. �No history of drug intake or insect bite.

Differential Diagnosis �Atopic dermatitis In older childern rashes are dry , pruritic & maculopapular. Commonly involve flexor surface of extremities wrist ankle and neck. �Papular urticaria Intensly pruritic disorder caused by an allergic response to insect bite on exposed skin surface. Lesions are papular with punctum on erythematous base. �Drug reactions No history of any drug intake.

Management �Nimbadi churna- 1 gm Suddh gandhak- 150 mg Vidang churna- 500 mg 1 x 3 with honey �Ascabiol lotion – L/A below neck at bed time x 3 successive night �Tb. Moxikind CV (375) - 1 BD x 5 days.

Instructions for patient �Apply lotion all over the body below neck at bed time and take bath next morning. �Wash all clothes, beddings, towel etc properly in hot water , dry in sun light and iron. �Keep skin dry and clean �Do not share clothes, bedding, towel etc with others.

Thank you Have a good day