35F ?allergic dermatitis METHOTREXATE TOXICITY

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Here we discuss our individual patient problems through series of inputs from available Global online community of experts with n aim to solve those patient clinical problem with collect current best evidence based input

This Elog also reflects my patient centered online learning portfolio.

I have been given this case to solve in an attempt to understand the topic of " Patient clinical data analysis" to develop my competancy in reading and comprehending clinical data including history, clinical finding, investigations and come up with a diagnosis and treatment plan

35 year old female, farmer by occupation resident of aakaram. wakes up at 5 am does household chores till 9am goes to farm and comes back by evening 5pm, cooks food, have dinner and go to bed by 9pm.

The patient is apparently asymptomatic until 5 days ago then she had sudden onset of low grade fever without chills at night time . Not associated with sweating, dizziness, fatigue and body pains.

Second day after onset of fever she went to farm for work and injured her left toe with ?sand while spraying fertilizers. From third day she noticed progressive painful lesions appearing on both lower limbs and upper limbs chest and neck associated with local rise in temperature and swelling . Not associated with loss of sensation, itching, joint pains.

No complaints of headache, burning micturition, giddiness, chest pain, shortness of breath, palpitations, cough ,insomnia, loose stools, loss of appetite.

History of usage of semecarpus anacardium for one day. Tab deflazocort 6mg for five days itraconazole tofloxacin, orividazole, clobetalol propionate, and megaheal ointment for five days

History of psoriasis vulgaris? From 2 years for which she used tab methotrexate 7.5mg OD for one month and capsule itraconazole 100mg OD for one month which she stopped 15 days back

Day 1

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