morning report eritema multiforme

8/12/2019 Morning Report Eritema Multiforme

1/21

Novianti Rizky Reza


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


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


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


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)


6/21

L : Upper trunkD : ScateredE : Erithematous

macule, well define,irregular shape andvarious in size


7/21

L : BackD : ScatteredE : Erithematous macules,

well defined, roundshape, some of themconfluences, there areerithematous papule inthe center of themacules (target lesion)


8/21

L : both feetD : ScatteredE : Erithematous macules,

well defined, irregularshape


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)


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 -/-


11/21

Erythema MultiformeStevens Johnson Syndrome


12/21

Red patches on face, lips, upper trunk, botharms and feetsPain on swallowing

Diabetes Mellitus


13/21

Erithema 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


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


16/21

DDS : ODS dry eyes syndromeTherapy :Eyefresh 6x1 drop ODS


17/21

DD :1. Erithema multiforme2. Hyperglicemic state

1. Reactive2. DM type IIPDx : BG I/II, Check lipid profile

Ptx :- Gludepatic 1x500mg- Glimepiride 2x5mg


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 )


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


20/21


21/21

morning report eritema multiforme

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