DOI: 10.36347/sjmcr.2017.v05i03.015

Pages: 177-180

A 50-year-old man, old case of Type 2 diabetes mellitus with peripheral neuropathy with chronic pancreatitis, presented with a 20 days history of inflamed tongue and angles of mouth, oral ulcers, irritated, edematous and itchy genital skin, and dry burning eyes. He had a history of fever with chills, loss of appetite, painful defecation and weight loss. On physical examination, he had mainly mild Erythema over inner canthus and medial sclera, a bright red and smooth tongue, and edematous dermatitis of the genitals. Other findings included pallor (++), pitting type pedal edema, multiple painful erosions of variable sizes with well defined margins present bilaterally over buccal mucosa. The patient had been consuming large quantities of alcohol daily since the past 25 years but hardly any cereals or vegetables. On routine laboratory testing, the hemoglobin level was 10.2 g perdeciliter, the white-cell count was 16000 per cubic millimeter with an abnormal differential count (86.0 percent neutrophils, 1 percent eosinophils, 1 percent basophils, 0 percent monocytes, and 12 percent lymphocytes). Mean corpuscular volume was 92 Units and Mean corpuscular hemoglobin concentration was 32 Units. Sr Alkaline phosphatase was mildly raised (197 units/liter) and Sr Proteins were low (Total proteins 4 g/deciliter, Albumin 1.9 g/deciliter, Globulin 2.1 g/deciliter) as were Sr Sodium levels (124 mEq/liter). On the basis of clinical findings and investigations, diagnosis of Oculo-Orogenital Syndrome was made. The patient was treated with 2 cc of Vitamin B complex injections per day intravenously and an oral multivitamin once per day. All lesions responded within 7 days. Nutritional instructions were given, but the patient refused treatment for his alcoholism.