DefinePK

Abstract

CASE REPORT


A 20 years old male presented with a history of developing subcutaneous masses and fever 5 months back, which subsided in 15 days. Four days before admission he again developed fever along with fresh crops of subcutaneous masses, headache and fatigue. On admission the patient was toxic, temperature 39.2°C. Heart rate 120/mm., B.P. 110/80 and there were subcu­taneous nodules over the trunk, legs and ann, measuring 2-10 cm with overlying erythematous bluish hue, firm to hard in consistency and slightly tender (Figure 1).The systemic examination was unremarkable. Investigations showed a haemoglo­bin of 1 1.4G/dl, total leukocyte count was 8, 700/cumm with a normal differential. ESR was 48 mm/lst hour. Peripheral film for malarial parasites were repeatedly negative. His random blood sugar was 164 mg% and blood urea, creatinine and electrolytes were within normal limits. No growth was obtained on blood cultures. His liver function tests were marginally deranged and blood wasnegative for HBsAg. Serum amylase, ASO titre, C3, C4 and Immunogloblins A, E, G, and M, AMA, ASMA, anti DNA and skin tests for tuberculin and leprosy were negative or within normal limits. X-ray of chest and ultrasOnography of the abdomen were also normal.
Skin biopsy showed findings consistent with Weber-Christian disease or idiopathic panl­culitis (Figure 2).The patient was treated with prednisilone, and had 2 relapses in 3 months, with regression of nodules in second relapse.