1. Dermatology ward case presentation

2. Id : the patient is a 59 years old man who came here with cc of painful scrotal ulcers since one month ago. First lesions were started since 10 years ago and this duration patient received treatment with improvement periods. The pt have cc of Weakness and urinary incontinency sine 1 month ago.

3. PM HX: negative
DRUG HX: negative
Smoking: negative
Family HX: negative
Allergy: negative

4. p/e :
Bp:130/80
Pr:73/min
RR:15/min
T:37.3

5. skin examination : 3 punchout scrotal ulcers in 1. 2 & 2
skin examination : 3 punchout scrotal ulcers in 1*2 & 2*2 size with erythematous basis & pusy discharge & tenderness & Malodor And hypopigment & erythematous scar. Mouth Exam : Normal EYE Exam: mild redness

6. nail: normal
hair: normal
Lymphadenopathy: negative
heart exam: normal
lung exam: normal breathing
organomegaly: negative
Muscle force of limbs: normal

9. lab data :
FBS:90
BS:117
VDRL : negative
TG:52
cholestrol:113
HDL:33
LDL:69.6

10. Cr:0. 7 WBC:9. 3 AST:15 RBC:4. 04 ALT:14 HB:8
Cr:0.7 WBC:9.3 AST:15 RBC:4.04 ALT:14 HB:8.9 ALKP:235 MCV:74 BILI D:0.2 PLT:241 BILI T:0.7 Na:141 K:3.6

11. kidney and urinary tract sonography: Normal Prostat volume: 13 cc PVR: 230cc

12. norology consult : Brian MRI & PAN Spinal MRI Requested
norology consult : Brian MRI & PAN Spinal MRI Requested. Ophtalmology consult: PT wasn’t retin & vitrus involvement.

13. DDX:
Behjat
Vasculitis
Chanchroid
Lichen simplex atrophiticus
Lupus vulgaris
Syphylis
Donovanosis
SCC