Internal examination
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A 18yr old male with multiple hyperpigmented patches
A 18yr old male patient presented to the Opd with chief complaints of purple stretch marks all over abdomen, lower back, b/l lower limbs, b/l upper limbs since 2 years No itching, burning sensation, pain History of presenting illness Patient was apparently asymptomatic 2 and 1/2 years ago then he developed round annular itchy lesions on lower back which spread all over the abdomen, groin, b/l upper limbs, b/l lower limbs for which he visited local doctor where he prescribed ayurvedic medication, ointment and tablets (unknown composition). Patient used the medication for 2 months the lesions reduced a bit Later 2 months the patient got multiple hyperpigmented plaques all over abdomen,lower back, b/l upper limbs, b/l lower limbs associated with dizziness, tiredness, inadequate sleep, increased weight of 30kgs for which he again visited the same doctor who prescribed ayurvedic oil and CLOBETASOL ointment for the lesions for 1yr History of past illness N/c/o DM HTN CAD AST...
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