Upload
sita-anindita
View
235
Download
0
Embed Size (px)
Citation preview
8/12/2019 Morning Report Eritema Multiforme
1/21
Novianti Rizky Reza
8/12/2019 Morning Report Eritema Multiforme
2/21
Chief Complain :Red Patches on face, neck and both arms
History :Redness patches on her face, neck and shoulder3days before admission. First patch appeared onthe face then spread on neck and arm. She complain about pain swallowing and blackcrust in her lower lips and sariawan in hermouth She had no fever, no pain micture,She take some medicine for diabetes melitussince april 8 th 2010 and also take jamu.There were no previous same complain beforePatient went to local clinic and reffered to RSSA
8/12/2019 Morning Report Eritema Multiforme
3/21
Past Ilness history :There were no history of the same diseasebefore
No history of another skin disease beforeDiabetes mellitus since a month before and shegot Gludepatic , Glimepiride and Carbamazepinform dept, int medicine
There were no history of hipertensionNo history of drug allergyAtopic was denied
8/12/2019 Morning Report Eritema Multiforme
4/21
L : faceD : ScateredE : Erithematous macule,
well define, irregular
shape and various in size
L : LipsD : Scattered
R : erithematous macules,well define, irregularshape, vesicle, erosionand black crust in lowerlips
8/12/2019 Morning Report Eritema Multiforme
5/21
L : both upper armsD : ScatteredE : Erithematous macules,
well defined, round shape,
some of themconfluences, there areerithematous papule inthe center of the macules(target lesion)
8/12/2019 Morning Report Eritema Multiforme
6/21
L : Upper trunkD : ScateredE : Erithematous
macule, well define,irregular shape andvarious in size
8/12/2019 Morning Report Eritema Multiforme
7/21
L : BackD : ScatteredE : Erithematous macules,
well defined, roundshape, some of themconfluences, there areerithematous papule inthe center of themacules (target lesion)
8/12/2019 Morning Report Eritema Multiforme
8/21
L : both feetD : ScatteredE : Erithematous macules,
well defined, irregularshape
8/12/2019 Morning Report Eritema Multiforme
9/21
L : Palms and soles
D : ScatteredE : Erithematous macules, well defined, round shape, some of themconfluences, there are erithematous papule in the center of themacules (target lesion)
8/12/2019 Morning Report Eritema Multiforme
10/21
Compos mentis, GCS 4-5-6Vital Sign :
P: 120/80 mmHgPR: 100x/m
BT: 36,9 CRR: 18x/m
Eyes : anemia -/-,ict -/- secrete -/-Neck : no enlargement of lymphHeart : wnlLungs : wnlAbdomen : wnlExtremities : edema -/-
8/12/2019 Morning Report Eritema Multiforme
11/21
Erythema MultiformeStevens Johnson Syndrome
8/12/2019 Morning Report Eritema Multiforme
12/21
Red patches on face, lips, upper trunk, botharms and feetsPain on swallowing
Diabetes Mellitus
8/12/2019 Morning Report Eritema Multiforme
13/21
Erithema Multiforme
8/12/2019 Morning Report Eritema Multiforme
14/21
PDx:Blood, LFT, RFT,electrolyteConsult to internal med dept
Ptx :Stop the suspected drug -- carbamazepin
IUFD normal saline 20 drop/minMetyl Prednisolon inj 25mg-0-0
Ranitidin inj 2x1 ampWet dressing with NS
8/12/2019 Morning Report Eritema Multiforme
15/21
Hb 11.5 gr/dl
Hematocrite 36.5/mm
Leukocyte 8200 /mm
Trombocyte 153800/mm
RBG 208
Ur/Cr 24.3/0.61
SGOT/SGPT 58/55
Na/K/Cl 132/3.5/101
8/12/2019 Morning Report Eritema Multiforme
16/21
DDS : ODS dry eyes syndromeTherapy :Eyefresh 6x1 drop ODS
8/12/2019 Morning Report Eritema Multiforme
17/21
DD :1. Erithema multiforme2. Hyperglicemic state
1. Reactive2. DM type IIPDx : BG I/II, Check lipid profile
Ptx :- Gludepatic 1x500mg- Glimepiride 2x5mg
8/12/2019 Morning Report Eritema Multiforme
18/21
April 27 th 2010 (2 nd day)
S Pain in swallowingFell itchy in her eyes
O L : faceD : ScateredE : More numerous erithematous macule, well
define, irregular shape and various in size
A Erithema MultiformeHyperglicemic State
P IUFD normal saline 20 drop/min
Metyl Prednisolon inj 25mg-12.5 mg-0 Ranitidin inj 2x1 amp Wet dressing with NS Consult opthamology dept
A il 28 th 2010 (3 d A il 29 th 2010 (4 th A il 30 th 2010 (5 th d )
8/12/2019 Morning Report Eritema Multiforme
19/21
April 28 th 2010 (3 rd day)
April 29 th 2010 (4 th day)
April 30 th 2010 (5 th day)
Pain in swallowing Less pain inswallowing, patienteat well
No pain in swallowing
L : Face, neck andboth armD : ScatteredR : Deskumation
Erithema Multiforme
Hyperglicemic State
Erithema Multiforme
Hyperglicemic State
Erithema Multiforme
Hyperglicemic State IUFD normal saline20 drop/min Metyl Prednisolon inj25mg-12.5mg-0 Ranitidin inj 2x1
amp Wet dressing with NS
IUFD normal saline20 drop/min Metyl Prednisolon inj25mg-12.5 mg-0 Ranitidin inj 2x1
amp Wet dressing with NS
IUFD normal saline 20drop/min Metyl Prednisolon inj25mg-0-0 Ranitidin inj 2x1 amp
Wet dressing with NS
8/12/2019 Morning Report Eritema Multiforme
20/21
8/12/2019 Morning Report Eritema Multiforme
21/21