Question

A 17-year-old male presents with a complaint of a red, itchy rash over his torso and back x 1 week, which is keeping him up at night. He denies sick exposures or recent visit to wooded areas. He denies other symptoms, significant history or allergies.

• Describe three (3) questions, in order of importance that you would like to ask this patient and give a brief explanation of why?
• From the information provided, list your differential diagnoses in the order of “most likely” to “possible but unlikely”.

Answer 1

1) Is your rash is so uncomfortable or painful?

Is the rash interferes with daily activity or your sleep?

These may occur if the infection is severe as if it is life threatening like anaphylaxis.

Are you exposed to a new detergent to wash your clothes or tried a new food variety in this week?

It is because the allergies to food, medication and chemicals are potentially serious source of rash.

2)The patient is more likely to have contact dermatitis. Some of other possible conditions are eczema, psoriasis which may flare up for a time, then resolves.

The patient might be possible but unlikely to have allergic purpura or anaphylactic reaction.