A 25 year old male who is a resident of Choutuppal and a driver by occupation came with CC of 

Pain and Redspots on the tips, pulp and nailbed of fingers (Rt hand) since 4 days

✓HOPI-

The patient was apparently asymptomatic one and a half month back then he had burning sensation in the epigastric region aggravated on having heavy and spicy food.

Associated with bloating after intake of food and abdominal tightness.

For which he got treated by a local doctor ( Pantop-D for 6 days)

Then 4 days back he had dragging type of pain which was sudden in onset and aggravated on doing work and relieved on rest. No H/o trauma.

There are Redspots on the tips,pulp,nailbed of fingers of Right UL.

✓Past History -

N/k/c/o DM, HTN, TB, Asthma, Epilepsy

✓Personal History-

Appetite - Reduced

Diet- Mixed

Bowel and Bladder-Regular

Sleep- Adequate

Addictions - Nil

✓Family History - Not Significant

✓On Examination-

Patient is conscious and coherent.

Thin built and well nourished.

Vitals

Temp- Afebrile 

PR- 95 bpm

RR- 16 

BP- 100/80 mm Hg

Generalised Lymphaedenopathy + (Enlarged and palpable cervical, axillary, Inguinal LN)

No pallor, icterus, cyanosis, clubbing, No b/l pedal edema.

✓Systemic Examination:

CVS-S1, S2 heard,no murmurs

Respiratory System:-

Petechiae over chest.

 BAE- present 

NVBS- heard

PER ABDOMEN:-

 soft , non tender.

Liver- Palpable (Hepatomegaly)

Spleen- Palpable (Splenomegaly)

CNS- NAD

✓Clinical Images -

Investigations

Provisional Diagnosis -

DRESS SYNDROME

Treatment -