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NRNP 6512 Week 4 Case Report: Dermatologic Assessment and Care Planning for a 25-Year-Old, Exams of Integrated Case Studies

Massachusetts Institute of Technology (MIT)Integrated Case Studies

NRNP 6512 Week 4 Case Report: Dermatologic Assessment and Care Planning for a 25-Year-Old Male With Acute Skin Eruption"Actual I-HUMAN CASE WEEK #4: A 25-YEAR-OLD MALE WITH SKIN PROBLEM COURSE nrnp 6512 INCLUDING (REFERENCE & CITATION) “Identifying Allergic Contact Dermatitis: Case-Based Diagnostic Reasoning in NRNP 6512” From Exposure to Eruption: Week 4 I-Human Analysis of a Pruritic Rash in a Young Male

Typology: Exams

2024/2025

Available from 06/23/2025

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NRNP 6512 Week 4 Case Report: Dermatologic Assessment
and Care Planning for a 25-Year-Old Male With Acute Skin
Eruption"Actual I-HUMAN CASE WEEK #4: A 25-YEAR-OLD
MALE WITH SKIN PROBLEM COURSE nrnp 6512 INCLUDING
(REFERENCE & CITATION) “Identifying Allergic Contact
Dermatitis: Case-Based Diagnostic Reasoning in NRNP 6512”
From Exposure to Eruption: Week 4 I-Human Analysis of a Pruritic Rash in a Young Male
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Download NRNP 6512 Week 4 Case Report: Dermatologic Assessment and Care Planning for a 25-Year-Old and more Exams Integrated Case Studies in PDF only on Docsity!

NRNP 6512 Week 4 Case Report: Dermatologic Assessment

and Care Planning for a 25-Year-Old Male With Acute Skin

Eruption"Actual I-HUMAN CASE WEEK #4: A 25-YEAR-OLD

MALE WITH SKIN PROBLEM COURSE nrnp 6512 INCLUDING

(REFERENCE & CITATION) “Identifying Allergic Contact

Dermatitis: Case-Based Diagnostic Reasoning in NRNP 6512”

From Exposure to Eruption: Week 4 I-Human Analysis of a Pruritic Rash in a Young Male

Here is a comprehensive guide for I-Human Case Week #4: A 25-Year-Old Male With Skin Problem in the context of Walden University Course 6512 – Advanced Health Assessment and Diagnostic Reasoning. This includes a case summary, clinical reasoning, differential diagnosis, and references.

I-Human Case: A 25-Year-Old Male With Skin Problem

Course: NRNP 6512: Advanced Health Assessment and Diagnostic Reasoning

Week: 4

Case Topic: Dermatologic Condition in a Young Adult Male

Patient: 25 - Year-Old Male

Subjective Data

  • Chief Complaint (CC): “I have this itchy rash on my arms and chest.”
  • History of Present Illness (HPI): o Rash began 3 days ago. o Intensely pruritic. o No fever, fatigue, or systemic symptoms. o Denies recent new products or travel.
  • Past Medical History: None significant.
  • Allergies: NKDA
  • Medications: None
  • Family History: No skin conditions reported.
  • Social History: o Non-smoker o Drinks alcohol socially o Works as a landscaper

Objective Data

  • Vitals: WNL
  • Skin Exam: o Erythematous papules and vesicles on forearms and chest.

o Linear streaks observed. o Some areas of excoriation due to scratching. o No signs of secondary infection.

  • No lymphadenopathy or systemic involvement.

Clinical Reasoning and Assessment

The pattern of linear vesicular lesions with intense itching in a landscaper strongly suggests allergic contact dermatitis , likely due to poison ivy (urushiol-induced reaction). The lesions follow the line of contact, characteristic of plant exposure.

Differential Diagnosis

  1. Allergic Contact Dermatitis (ACD) – Most likely o Common in outdoor workers o Linear lesions, pruritic vesicles o Acute onset, no systemic involvement
  2. Atopic Dermatitis o Typically starts in childhood o Chronic, with flexural involvement o Less likely due to age of onset and distribution
  3. Scabies o Extremely pruritic, often worse at night o Usually involves webs of fingers, genitals o Transmission history often present
  4. Tinea Corporis o Annular lesions with central clearing o More scaly than vesicular o KOH prep would help confirm

Plan

  • Diagnosis: Allergic Contact Dermatitis (ACD) secondary to urushiol exposure Management:
  • Topical corticosteroids (e.g., triamcinolone 0.1% cream BID x 7-10 days)
  • Oral antihistamines for pruritus (e.g., diphenhydramine or cetirizine)
  • Education: o Avoidance of poison ivy/oak/sumac

2. Irritant Contact Dermatitis - Non-allergic; due to repeated chemical or physical irritation (e.g., soaps, detergents, sweat/friction from work clothes) - Erythematous, scaly rash - Burning or stinging > itching - No vesicles typically 3. Scabies - Intensely pruritic rash, especially at night - Burrows in web spaces, genitalia, wrists - Often excoriated papules - May have secondary infection from scratching 4. Tinea Corporis (Ringworm) - Fungal infection of the body - Annular plaques with raised, scaly borders and central clearing - Mild to moderate itching - KOH prep reveals hyphae 5. Atopic Dermatitis (Eczema) - Chronic relapsing dermatitis - Often associated with personal or family history of asthma/allergies - Flexural surfaces (e.g., elbows, knees) commonly affected - Pruritus is hallmark; may ooze or crust 6. Pityriasis Rosea - Acute self-limiting rash, mostly in young adults - Starts with a single "herald patch," followed by widespread smaller lesions on trunk - "Christmas-tree" distribution - Mild pruritus

7. Drug Eruption (Exanthematous or Morbilliform) - Widespread symmetric red maculopapular rash - Usually begins 1–2 weeks after starting a new medication - May have low-grade fever or eosinophilia - Rash resolves with drug withdrawal 8. Psoriasis (Guttate Type or Plaque) - Erythematous plaques with silvery scales - Typically involves elbows, knees, scalp, and lower back - Guttate psoriasis can appear suddenly post-streptococcal infection 9. Folliculitis - Inflammation/infection of hair follicles - Erythematous papules or pustules centered around follicles - May be itchy or tender - Often from shaving or hot tub use 10. Secondary Syphilis - Can present with a generalized symmetric, non-pruritic rash (often on palms/soles too) - Systemic symptoms may include malaise, fever, sore throat - Confirm with RPR/VDRL and FTA-ABS Great! Here's a comparison table of the top differential diagnoses for a 25 - year-old male presenting with a pruritic rash on the upper body , ideal for your Course 6512 I-Human Week 4 case. This table can be included in your SOAP note, PowerPoint, or case report:

Differential Diagnosis Comparison Table

Next Steps:

Let me know which format you'd like this in:

  1. ✅ SOAP Note
  2. ✅ PowerPoint Slide Set (with speaker notes)
  3. ✅ Patient Education Handout (PDF style)
  4. ✅ Clinical Reflection + Learning Objectives Excellent! Since this is for I-Human Week 4, Course 6512 , I'll prepare all formats as you've worked with them in previous cases. Here's a breakdown of what you'll receive:

✅ Deliverables List:

1. SOAP Note

Includes full patient encounter documentation:

  • CC, HPI, PMH, SH/FH, ROS, PE
  • Full assessment
  • Differential diagnoses
  • Diagnostics
  • Final diagnosis
  • Treatment plan & follow-up
  • APA references

2. PowerPoint Slide Set (10–12 slides):

  • Title & Case Overview
  • Subjective & Objective Data
  • Differential Diagnosis (with table)
  • Final Diagnosis
  • Diagnostic Workup
  • Treatment & Management
  • Patient Education
  • Clinical Reflection
  • Learning Objectives
  • References (APA 7th)

3. Patient Education Handout (PDF-ready)

  • What is Allergic Contact Dermatitis?
  • Causes (Poison Ivy, etc.)
  • How to treat it
  • How to avoid future reactions
  • When to seek help
  • Simple layout, bullet points, plain language

4. Clinical Reflection & Learning Objectives

  • What you learned from the case
  • Application to future practice
  • Learning goals related to dermatologic assessment, diagnosis, and management

✅ APA References (Included in All Materials)

  • Bolognia, J. L., Schaffer, J. V., & Cerroni, L. (2022). Dermatology (5th ed.). Elsevier.
  • Habif, T. P. (2021). Clinical Dermatology: A Color Guide to Diagnosis and Therapy (6th ed.). Elsevier.
  • Woo, T. M., & Robinson, M. V. (2020). Pharmacotherapeutics for Advanced Practice Nurse Prescribers (5th ed.). F.A. Davis.
  • Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s Guide to Physical Examination (10th ed.). Elsevier.
  • American Academy of Dermatology Association. (n.d.). Contact dermatitis. https://www.aad.org/public/diseases/rashes/contact-dermatitis SOAP NOTE Patient Name: [Confidential] Age: 25 Gender: Male Date: [Insert Date] Provider: [Your Name], NP Student Course: NRNP 6512 Week 4 Subjective

Diagnosis Onset Distribution Key Features Diagnostics Allergic Contact Dermatitis Acute Exposed areas; linear Vesicles, erythema, pruritus, outdoor exposure Clinical history, patch test Irritant Contact Dermatitis Acute/Chronic Hands, thighs Erythema, dryness, scaling Clinical diagnosis Scabies Weeks Interdigital, waistline, genitals Burrows, nocturnal pruritus Skin scraping Tinea Corporis (Ringworm) Gradual Trunk, arms, thighs Annular lesions, raised borders, central clearing KOH prep Pityriasis Rosea Self-limiting Trunk Herald patch, oval salmon-colored plaques Clinical Drug Eruption 1 - 2 weeks post- drug Symmetrical trunk/limbs Maculopapular, possibly febrile Medication review, eosinophils Final Diagnosis: Allergic Contact Dermatitis (ACD) Plan

  1. Pharmacologic Treatment: o Triamcinolone 0.1% cream topically BID x 7 days o Cetirizine 10 mg PO daily for itching
  2. Non-Pharmacologic: o Avoid known irritants/allergens (e.g., poison ivy) o Wash skin/clothes immediately after outdoor exposure
  3. Diagnostics: o None immediately required unless non-resolving o Consider patch testing if recurrent
  4. Education: o Explain the cause of allergic dermatitis o Importance of skin protection during landscaping o When to return (e.g., worsening, signs of infection)
  5. Follow-up: 1 week; sooner if symptoms worsen Clinical Reflection This case reinforced the importance of environmental exposure history in dermatologic complaints. It emphasized pattern recognition (linear vesicles) and occupational risk (landscaping). I learned to consider scabies and tinea in the differential, but the exposure pattern and acute onset supported ACD.

Learning Objectives

  1. Distinguish common dermatologic conditions in primary care.
  2. Apply clinical reasoning to rashes based on distribution and morphology.
  3. Develop appropriate treatment and patient education for contact dermatitis. References
  • Bolognia, J. L., Schaffer, J. V., & Cerroni, L. (2022). Dermatology (5th ed.). Elsevier.
  • Habif, T. P. (2021). Clinical Dermatology: A Color Guide to Diagnosis and Therapy (6th ed.). Elsevier.
  • Woo, T. M., & Robinson, M. V. (2020). Pharmacotherapeutics for Advanced Practice Nurse Prescribers (5th ed.). F.A. Davis.
  • Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s Guide to Physical Examination (10th ed.). Elsevier.
  • American Academy of Dermatology. (n.d.). Contact dermatitis. https://www.aad.org/public/diseases/rashes/contact-dermatitis