What can be done??
A 23 year old male patient is a farmer by occupation, residing in karave and hailing from Maharashtra presented with the chief complaints of dark coloured lesions with peeling of skin on body predominantly the face since 7days , with fever since 9 days and yellowish discoloration of eyes and nails since 7 days. The peeling of skin is associated with itching and a burning sensation. There is a history of watery discharge from the eyes and photophobia. The patient is a known case of Hansen’s disease and was diagnosed 1 month ago for the same. He took 18 days of MB-MDT, before the development of the present lesions. The history of contact of leprosy in child and neighbor on MB-MDT is present. H/O treatment by a local doctor was taken which included cefadroxil, ciprofloxacin eye drop but it showed no improvement. There is history of alcohol consumption everyday 7months back. There is history of joint pain, abdominal pain, diarrhoea, tingling numbness B/L in hands and legs. On examination, the patient is positive for pallor, icterus and bilateral pitting edema on lower leg upto ankle. Sensations are intact and nerves show, B/L radial nerve, posterior tibial nerve enlarged and tender. On further investigations, serum creatinine, serum uric acid were raised.CBC reveals, a lowered Hb level of 9.2g/dl, and increased wbc count, eosinophilia and ESR is raised. LFT revealed raised bilirubin, SGOT,SGPT, alk phosphatase levels and a decreased serum albumin level. What can be done to treat the patient??