DERMATOLOGIC DISORDERS CASE STUDY

DERMATOLOGIC DISORDERS
DERMATOLOGIC DISORDERS

DERMATOLOGIC DISORDERS

DERMATOLOGIC DISORDERS CASE STUDY

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Dermatologic disorders can present due to an actual skin problem or as the result of a systemic problem that manifests in the skin. Depending on the type of disorder, the presentation might be unique, making a quick diagnosis possible. However, some disorders have similar presentations in terms of symptoms and appearance, making diagnosis more difficult. Skin color and tone can also contribute to difficulty in diagnosis, making it important to consider cultural variations during assessments. In this Discussion, you examine the following case study of skin disorders.

Case Study:
An adolescent presents to your office with a complaint of an itchy, red rash that first appeared on his lower legs 1 week ago after he returned from a camping trip. The rash has since spread to the upper legs, trunk, and groin. He denies fever or other systemic symptoms.

Review these two links – these resources were provided to us this week.

http://www.meddean.luc.edu/ lumen/MedEd/medicine/ dermatology/melton/atlas.htm

http://www.telemedicine.org/ stamford.htm

Write an explanation of the skin disorder in the case study. Include in your explanation the lesion type, lesion distribution, color, and any ancillary findings. Then, present a differential diagnosis and explain which is the most likely diagnosis for the patient and why. Finally, explain a treatment and management plan for the patient’s skin disorder, including appropriate dosages for any recommended treatments.

Use APA format for references and citations that are 5 years and newer.

SAMPLE ANSWER

DERMATOLOGIC DISORDERS

Case Study:

An adolescent presents to your office with a complaint of an itchy, red rash that first appeared on his lower legs 1 week ago after he returned from a camping trip. The rash has since spread to the upper legs, trunk, and groin. He denies fever or other systemic symptoms.

The case study is of an adolescent who presented with a localized itchy red rash on the lower legs seven days following a camping trip. The patient reported the rash then spread from lower legs to other areas of the upper leg, trunk and groin. No fever or other problems reported.

The diagnosis for this patient is allergic contact dermatitis following the exposure history during the camping trip. Taking thorough history is needed to identify any prior episodes of skin irritations such as atopic dermatitis. Patients who have a history of atopic dermatitis have an increased risk of dermatitis (Taylor& Amado, 2013). The American Family Physician (2010) defines allergic contact dermatitis as” delayed hypersensitivity reaction in which a foreign substance comes into contact with the skin; skin changes occur with re-exposure”. In allergic contact dermatitis, the distribution of lesions is more localized on the area of intense exposure. As in this case, the rash begins on the lower legs before spreading to other regions. According to (American Academy of Dermatology, 2011) a rash can appear within hours or can take up to a week before appearing following an exposure.

Treatment

The first step would be to identify and avoid the allergen if possible. Localized lesions respond well to medium to high potency steroids. For this case, a topical corticosteroid betamethasone valerate cream 0.1% would be applied twice daily until the lesions clear.  This will help to minimize the redness and the intense of the itching (WebMD, 2015) In addition, Dermnet (2011) provides for use of Prednisone 20 mg twice a day for seven to ten days followed by prednisone 20 mg in the morning for three days to help in relieving the pruritus. Use of wet compresses may be repeated severally throughout the day to ease the situation

Differential diagnosis

A patient presenting with an itchy red rash on the legs that seems to spread to other areas with no fever could be suffering from hives. WebMD (2015) points out that the rashes are itchy and may appear anywhere on the body. WebMD (2015) stresses that hives are caused by allergic reactions after an exposure to a trigger, however, they may not spread to other areas other than the stimulated part.

References

American Family Physician (2010). Diagnosis and Management of Contact Dermatitis
From http://www.aafp.org/afp/2010/0801/p249.html
American Academy of Dermatology. (2011). Contact dermatitis. Retrieved from: https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/a—d/contact-dermatitis
James S. Taylor & Antoine Amado (2013). Contact Dermatitis and Related Conditions
from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/contact-dermatitis-and-related-conditions/

WebMD (2005-2015) Skin problems and treatment health center. Retrieved from http://www.webmd.com/skin-problems-and-treatments/guide/hives-urticaria-angioedema?page=2

WebMD (2005-2015) Drugs and Medications. Retrieved from http://www.webmd.com/drugs/2/drug-4897-722/betamethasone-valerate-topical/betamethasonevalerate-topical/details

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