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PSORIASIS VULGARIS PATIENT DEMOGRAPHICS:-

PSORIASIS VULGARIS PATIENT DEMOGRAPHICS:- NAME:- mahadevappa naik AGE:- 60 yrs SEX:- male CHIEF COMPLAINTS:- c/o, exacerbations of skin lesions since one and half month. HISTORY OF PRESENT ILLNESS:-

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PSORIASIS VULGARIS PATIENT DEMOGRAPHICS:-

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  1. PSORIASIS VULGARIS PATIENT DEMOGRAPHICS:- NAME:- mahadevappa naik AGE:- 60 yrs SEX:- male CHIEF COMPLAINTS:- c/o, exacerbations of skin lesions since one and half month. HISTORY OF PRESENT ILLNESS:- The exacerbation of skin lesions was insidious in onset, progressive gradually. Initially the lesions were red colored. The lesions are present on forearm , lower legs progressed to trunk, and associated with scaling and itching of grade-II. PAST MEDICAL HISTORY:- k/c/o:- psoriasis vulgaris . PERSONAL HISTORY:- alcoholic since 30 years.

  2. LABORATORY INVESTIGATIONS:- COMPLETE BLOOD COUNT:- ESR:- 65mm/hr URINE:-

  3. GENERAL PHYSICAL EXAMINATION:- • Itching – grade 2 • Sleep- disturbed • b/l pedal edema present • Cutaneous exacerbation:- multiple, well defined, extending from lower one third of leg to ankle joint. • Erythematous hyper pigmented plaques with silvery white colour loosely adherent scales present. • Scalp scaling present • Subungual hyperkeratosis present on toe nails SOAP FORMAT SUBJECTIVE DATA:- here is a 60 yrs old male patient hospitalized with complaints of exacerbations of skin lesions since one and a half month.

  4. OBJECTIVE DATA:- • The ESR values are increased- it indicates infection • The total bilurubin and conjugated bilurubin values are increased – this indicates biliary flow obstruction. • The SGOT and ALP values are increased – this indicates biliary obstruction. • USG abdomen:- • Presence of gall bladder stones. • Skin biopsy is also done. • DIAGNOSIS:- • By observing all the subjective and objective evidences the patient was diagnosed with psoriasis vulgaris.

  5. ASSESSMENT:- • Problem list:- • 1. skin lesions:- the activated T cells secrete various cytokines, interferon Alfa and interleukin-2. this stimulates the local keratinocytes and neutrophils to produce TNF- Alfa and interleukin-8, as a result there will be T cell production and activation and the psoriatic epidermal cells proliferate. • 2. psoriasis:- it is a chronic inflammatory skin disorder characterized by recurrent exacerbations and remissions of thickened erythematous and scaling plaques.

  6. THERAPY:-

  7. DRUGS AND THEIR MECHANISM OF ACTION:- • 1. hydroxyzine- they are H-1 blockers. They block histamine induced itching, wheal and flare ( triple response ). • 2. clobetasol- they suppress allergic phenomenon. They block accumulation of inflammatory mediators. • 3. liquid paraffin- they hydrate stratum corneum and minimize water evaporation. They prevent scaling and itching. • 4. mupirocin:- they inhibit bacterial protein synthesis by blocking production of t- RNA.

  8. DISCHARGE DRUGS:- • 1. tab. Atarax 25 mg 0-0-1 • 2. tenovate ointment 1-1-1 • 3. liquid paraffin • Follow up after 7 days • DRUG INTERACTIONS:- • No drug interactions found. • SUSPECTED ADR:- • Dizziness- it may be due to the drug Atarax.

  9. Thank you

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