iHuman Kaylee Hales Dermatology Case Study Primary Care 1 (regis college), Exams of Nursing

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iHuman Kaylee Hales

Dermatology Case Study

Primary Care 1 (regis college)

Kaylee Hales, 25 years old otherwise healthy female, presented with two days of intensely pruritic erythematous popular rash on the inner thighs and left inner forearm. Physical examination shows a 6 cm set of linear circumscribes, erythematous blisters on the left inner forearm, and a 10x12 cm scattered contiguous erythematous popular rash with surrounding superficial excoriation on the inner thighs. Vitals and the remaining physical examination are unremarkable. Recent exposures include hiking through the woods, hot tub use, new lotion use, and ingesting scallops for the first time in her life. PMH: no past medical history Vital signs: 116/62, 70, 98.3, 95% room air, 20. Four different diagnoses: Contact Dermatitis (CD) Contact dermatitis is a skin inflammation caused by direct contact with an allergen or irritant. CD categorize into two subcategories allergy and irritant dermatitis. CD shares the same cardinal symptoms as pruritic, erythematous rash, vesicular and linear, rough, redden patches, weepy lesions with numerous tiny vesicles on an erythematous base that is pruritic or a burning or sting sensation (Dunphy et al., 2019). Based on the patient's activity history, the patient went hiking a couple of days ago; she wore shorts and tank tops and had possible exposure to toxic plants on her extremities and upper arms. Poison ivy (Toxicodendron) dermatitis (TD) results from contact with poison ivy, oak, or sumac. It is a common form of allergic contact dermatitis (ACD) that affects millions of people in the United States annually (Kim, & slowly, 2019). Toxicodendron dermatitis can cause discomfort, marked itching, and blisters formation (Butt et al., 2019). The patient's rash appears pruritic, blister, and erythematous popular rash on her thighs and inner arms. Based on these symptoms, contact dermatitis is the primary diagnose. Pruritus Pruritus is the sensation of itch accompanied by the urge to scratch (Dunphy et al., 2019). Pruritus presents with rash or no rash. No rash pruritus is caused by internal diseases such as renal, liver, the delusion of parasitosis, hyperparathyroidism, Hodgkin's lymphoma, and polycythemia vera. Pruritus with a rash caused by external skin disease, insect bites, fungal infestation, topical products, scabies, dry skin, or drug reaction. Besides pruritis, the patient has other symptoms, such as vesicles on an erythematous base and a rash spreading from her thighs

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• Apply cucumber slices on the rash Diagnostic lab Contact dermatitis diagnosis is based on irritant exposure history and the rash appearance days after the exposure. No labs require currently. Consult/referral Dermatologist or Allergist if symptoms do not improve in 2 weeks Patient Education
• Educate the patient on the diagnosis of contact dermatitis, treatment regimen, and prognosis.
• Apply betamethasone cream as directed.
• Do not use clobetasol cream if a rash appears on the face.
• If a facial rash occurs, return to the office.
• Identify trigger: poison ivy leaf (leaf of three)
• Good hand washing
• Discard exposed clothing
• Trim the fingernails to prevent scratching and infection.
• Avoid future exposure by wearing protective clothing (long pants, long sleeve t-shirt), socks, and closed-toe shoes when hiking or gardening.
• If blisters open, do not remove the overlying skin, as the skin can protect the raw wound underneath and prevent infection.
• Carefully pat the skin dry after washing using a soft cloth without rubbing.
• Machine wash clothes after being outside Follow up Follow up in one week

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iHuman Kaylee Hales

Dermatology Case Study

Primary Care 1 (regis college)