Suppurative otitis media

A 40 year male having multiple joint involvement, PIP ,wrist , right shoulder, knee joint He has presentation of migratory arthritis. On physical examination he has subcutaneous nodules (painless & non tender) on both forearm since 3 years. *On asking he said his R.A FACTOR was Negative* What should be the next line of investigations. & DDx ? *Chief Complaints* He is suffering from pain & tenderness in joints. Assymetric joint involvement. From last 3 years *History* No family history of arthritis *Physical Examination* Subcutaneous nodules painless non tender on forearms

F.55yrs. Diagnosis please.

12 year old boy c/o these lesions from past 3 months (appeared in winter 1st time) As per parents, these are not active lesions, earlier they were more erythematous and dry, when child scratches bleeding+ *History* On Elbow he has LICHEN NITIDIS I was suspecting him to be ATOPIC , on taking history, his brother's father (chacha) has ASTHAMA & his Maternal side also has ASTHAMA.

Findings and diagnosis please. HSG

Findings and diagnosis please.