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A patient developed pain and severe loss of vision 36 hours after cataract surgery. On examination the following was seen. Which of the following is the least useful for treatment tre given pathology? (Image above)
Anonymous Quiz
27%
Topical Antibiotics
27%
Intravitreal antibiotics
26%
Systemic antibiotics
20%
Pars plana vitrectomy
A 60 year old male , known case of diabetes underwent a cataract surgery. 36 hours atier surgery the patient presents with the following picture. What is the first line of management?
Anonymous Quiz
39%
Intravitreal antibiotics
20%
Pad and bandage
21%
High dose steroids
20%
Topical Antibiotics
Case 47 || Solution || Last Part


The answer to the given question is “Peutz–Jeghers syndrome”

Seen in pediatric patient (Average age: 11yrs)

Pathogenesis: Mutation in LKB-1 / STK-11 gene

Gross Findings:

Bosselated Surface [Single mass having multiple small nodules]

Microscopic Examination:

Arborisation of smooth muscles within glandur epithelium

Smooth muscles intersecting within hyperplastic glandular epithelium
Identify the disease based on the symptoms and examination reports 🧐

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Case 48 || Solution ||

The answer to the given question is “Oral Lichen Planus (LP)"

LICHEN PLANUS:

Lichen Planus word is derived from leichen (tree moss) & planus (flat)

Tree moss is purple; hence purple lesions

Also lesions are flat

Autoimmune, inflammatory disease of skin, mucosa and hair follicles

5P's:

Purple (violaceous),
Polygonal
Pruritic
Plane topped (flat),
Papules

On the surface, white criss-cross streaks (Wickham striae) are seen especially, if a thin layer of oil is applied to the surface [Classical feature]

Flexural predisposition

Even though itching is prominent, patients will rub (not scratch) the lesions. Hence, excoriation (scratch marks) not seen

Association with liver disorders:

HCV
HBV
Primary biliary cirrhosis

Koebner's phenomenon

Usually self-limiting within 1 or 2 years & heals leaving hyperpigmentation

Types of LP:

Acute widespread LP
Nail LP
Hypertrophic LP
Oral LP
Follicular LP
Actinic LP
LP pigmentosus (LPP)

ORAL LICHEN PLANUS:

Seen upto 30-70% patients with cutaneous LP

Triggering Factor:

Dental Filling (Dental amalgam) can be causative

Mercury in this amalgam can cause oral LP at the area of contact onto the buccal mucosa

Commenest form: Reticulate / Lacy pattern [M/C site - Buccal Mucosa]

Rare form: Ulcerative / Erosive [Premalignant]
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Identify the disease based on the symptoms and examination reports 🧐

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Case 49 || Solution ||

The answer to the given question is "Pityriasis Rubra Pilaris (PRP)"

Rubra = red, pila = hair follicle

Red follicular hyperkeratotic papules occur

Soon they coalesce to form large orange-red plaques. [Appearance has been compared to a "Nutmeg-grater"] (Fig. 1)

Characteristic "islands of sparing" in between the follicular papules

Keratoderma of the palms and soles

Keratoderma on sole is so thick that it appears like a sandal [Keratotic sandal] (Fig. 2)

Follicular papules can fuse together to affect > 90% body surface [erythroderma]

Keywords in an MCQ

Keratotic sandal
Palmoplantar thick skin
Islands of sparing
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2025/06/28 18:21:03
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