61Y Male suffering from Psoriasis

May 03, 2023

3rd May 2023

NOTE: THIS IS AN ONLINE E LOGBOOK 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 A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT.

This is the case of a 61-year-old male, resident of West Bengal, and retired Engineer by occupation. The following history was taken through a telephone conversation. The patient was explained about confidentiality and written consent was taken to create the following case report.

This case report aims to record the patient's journey.

CHIEF COMPLAINTS:-

- Patient complains spreading of rash since last forty years.

History of present illness:-

According to the patient, the onset of rash was gradual and nature of the rash is progressive over the last forty years. It started off as a itchy, red lesion at the base of the penis, which gradually spread through out the body (as shown in the clinical images given below). It was painful upon touch and the pain was consistently there, however it would transfer to other parts of the body as described by the patient. The intensity of pain in the rashes would increase if the patient is exposed to the sun. The intensity of pain would be relieved (especially at the back) if the patient uses a blow drier on the lesion. The nature of pain at that time, as described by the patient, would be similar to that of burning. Another characteristic feature as reported by the patient is that if the pain decreases, then the colour of the lesion would change from red to black and the size of the lesion would also increase. Currently, the patient reports that the pain is not as intense as it used to be previously but the itchiness is still present.

The patient also reports having kidney stones of size 4mm for the past 12-13 years. According to the patient, there is no abdominal pain. However, the patient reports experiencing polyuria, micturating 3-4 times in the night. No surgical intervention nor medication has been done.

History of past illness:-

The patient has no history of TB, Asthma or Epilepsy.

The patient has a history of having DM and HTN.

10-11 years ago, the patient has undergone surgery for the removal of a tumor in the Axillary region. 2-3 years ago, the tumor has reappeared just above the same location where the tumor was earlier removed. It is painless and there has been no surgical intervention done since.

Personal history:-

Water intake:- normal (2L max.)

Appetite:-normal

Diet:- mixed

Bowel movement:- Constipation. Patient is only able to excrete once after two-three days.

bladder movement:-Polyuria

Addictions:- Consumes supari.

Alcohol:- none

Smoking:- doesn't smoke

Allergies:- none.

Exercise status:- Patient used to do pranayam in the morning for 30 minutes. For the last 2-3 months, the patient doesn't do pranayam anymore.

Family History:- Patient's mother had a rash on her left leg, just below the knee.