Complaint of an Itchy Red Rash on her Arms

	Case 2
Chief Complaint (CC)	A 45-year-old female presents with a complaint of an itchy red rash on her arms and legs for about two weeks.
Subjective	She has been going on a daily basis to the local YMCA with children for Summer camp.
VS	(T) 98.3°F; (RR) 18; (HR) 70, regular; (BP) 118/74
General	healthy-appearing female in no acute distress
HEENT	EYES: no injection, no increase in lacrimation or purulent drainage; EARS: normal TM: Normal
Skin	Mild edema with inflammation located on forearms, upper arms, and chest wall, thighs and knees; primary lesions are a macular papular rash with secondary linear excoriations on forearms and legs.
Neck/Throat	No neck swelling or tenderness with palpation; neck is supple; no JVD; thyroid is not enlarged; trachea midline.

 

1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient presenting symptoms?
5. Give rationales for your each differential diagnosis.

	Case 2
Chief Complaint (CC)	A 45-year-old female presents with a complaint of an itchy red rash on her arms and legs for about two weeks.
Subjective	She has been going on a daily basis to the local YMCA with children for Summer camp.
VS	(T) 98.3°F; (RR) 18; (HR) 70, regular; (BP) 118/74
General	healthy-appearing female in no acute distress
HEENT	EYES: no injection, no increase in lacrimation or purulent drainage; EARS: normal TM: Normal
Skin	Mild edema with inflammation located on forearms, upper arms, and chest wall, thighs and knees; primary lesions are a macular papular rash with secondary linear excoriations on forearms and legs.
Neck/Throat	No neck swelling or tenderness with palpation; neck is supple; no JVD; thyroid is not enlarged; trachea midline.

 

1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient presenting symptoms?
5. Give rationales for your each differential diagnosis.

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