A fifty-year-old clerk from West Bengal presented with gradually progressive ulceration and excoriation of skin over the penile shaft and anterior surface of the scrotum for 1 month He also has reddish, non-pruritic, raised skin rash over the abdomen, thighs, axillae, arms, feet, and left eyelid. There is no history of fever, cough, dyspnoea, chest pain, oral ulcers, abdominal complaints, headache, seizures, or focal symptoms.
He underwent renal transplant (1996); Native kidney disease- details unknown; currently on Tab Prednisolone (10mg) and Tab Azoran (100mg) once a day; Diabetic for 4 years - uncontrolled.
Left eyelid: nodular erythematous rash
Skin: Erythematous, raised, palpable indurated papulo-nodular rash over abdomen, axillae, thighs, arms, and legs
Systemic examination: Right iliac fossa kidney palpable, nontender
External Genitalia: Excoriation of skin over penile shaft and ant surface of the scrotum. Forming an ulcer- with well-defined margins, sloping edge, base- slough
What is the most likely diagnosis? View Answer