Diagnosis and Management of Skin Disorders
Diagnosis and Management of Skin Disorders Essay
Diagnosis and Management of Skin Disorders Essay
Discussion: Diagnosis and Management of Skin Disorders
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 studies of skin disorders.Diagnosis and Management of Skin Disorders Essay
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Case Study 1
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
Case Overview
This case involves an adolescent who presented with a complaint of an itchy and red rash that initially appeared on his lower legs a week ago after returning from a camping trip. Days later, the rash spread to his upper legs, trunk, and groin. He, however, denied fever and other systemic symptoms.
Type of Lesion, Distribution, Color and Ancillary Findings
The most likely diagnosis based on the patient’s presentation is poison ivy. Poison ivy is a form of contact dermatitis that occurs following exposure to the oil of the plant genus Toxicodendron called urushiol. In the USA, it affects approximately 10-40 million citizens annually and commonly occurs with frequent outdoor activities. The risks of poison ivy also increase with specific occupations and activities such as farming, camping, gardening, construction and forestry (Elsohly et al., 2015). Therefore, the fact that the patient had just returned from a camping activity increases the chances of this diagnosis.Diagnosis and Management of Skin Disorders Essay
As in this case, patients may be unaware of exposure to the plant until symptoms such as an itchy rash sets in between one to fourteen days following exposure. The rash usually begins as erythema and gradually develops into papules, vesicles or bullae (Yoo & Carius, 2019). These lesions have a linear configuration and found in exposed areas that may have been in contact with the plant. Therefore, diagnosis is through history taking and physical exam and warrants no laboratory testing. In other instances, a primary healthcare provider may use the leaf spray mass spectrometry to detect poison ivy’s allergenic urushiol directly.
Differential Diagnosis
Poison Ivy: is a type of allergic contact dermatitis that occurs after exposure to urushiol, an oil resin found in the plant’s stems, leaves, and roots. The primary signs and symptoms exhibited by patients include itching, redness, blisters, swelling and DIB in case of inhaled smoke from poison ivy.
Irritant Contact Dermatitis: occurs following exposure of the skin to a toxic material. Patients usually exhibit the following signs and symptoms: itching, cracking of the skin due to dryness, tight skin, blistering, ulceration and open sores (Boone, Jemec & Del Marmol, 2015).
Allergic Contact Dermatitis: occurs following the skin’s exposure to a foreign material/substance. The body releases inflammatory chemicals that result in itch and irritation. Patients usually present with the symptoms of a flaky, dry and scaly skin, oozing blisters, redness, extreme itching, swelling of the face, eyes and groins and sun sensitivity (Rustemeyer et al., 2020). Diagnosis and Management of Skin Disorders Essay
Treatment Plan
Since the patient displays a severe skin reaction with the involvement of a large body surface area, his management includes a systemic corticosteroid to give the patient immediate relief from the symptoms of the severe rash (Yarbrough, 2020). It is also necessary to prescribe topical histamine alongside the corticosteroid to provide relief from the itch as follows:
1% topical Benadryl apply to the affected area thrice daily
Prednisolone 1m/kg/day PO gradually tapering the dose for 10 days.
Non-Pharmacological Therapy
Patient education in case of a similar incidence to wash the exposed area immediately is necessary
The patient should wash all the exposed clothing, equipment and tools using soap and water, a measure that also prevents secondary exposure
To prevent secondary bacterial infections, advise the patient to keep his/her nails clean and short.
Symptomatic relief using colloidal oatmeal and cool compress baths
Always wear protective clothing during outdoor activities or walking in areas likely to have toxic plants.Diagnosis and Management of Skin Disorders Essay
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References
Boone, M. A., Jemec, G. B., & Del Marmol, V. (2015). Differentiating allergic and irritant contact dermatitis by high-definition optical coherence tomography: a pilot study. Archives of dermatological research, 307(1), 11-22.
Elsohly, M. A., Gul, W., Ashfaq, M. K., & Manly, S. P. (2015). U.S. Patent No. 9,029,417. Washington, DC: U.S. Patent and Trademark Office.
Rustemeyer, T., van Hoogstraten, I. M., von Blomberg, B. M. E., & Scheper, R. J. (2020). Mechanisms of allergic contact dermatitis. Kanerva’s Occupational Dermatology, 151-190.
Yoo, M. J., & Carius, B. M. (2019). Mango Dermatitis After Urushiol Sensitization. Clinical practice and cases in emergency medicine, 3(4), 361.
Yarbrough, W. M. (2020). U.S. Patent No. 10,561,626. Washington, DC: U.S. Patent and Trademark Office.Diagnosis and Management of Skin Disorders Essay
Diagnosis and Management of Skin Disorders Essay
