Endocrine: No endocrine symptoms, no hormonal therapies. Allergic/Immunologic: Endorsed seasonal allergies, no known immune deficiencies, negative HIV test in the last 3 years. OBJECTIVE DATA: Physical Exam: Vital signs: BP 125/76, Right arm, sitting, regular cuff, P 85, RR 18, T 98.7 F orally, SPO2 100%, Wt 180 lb, Ht 5ft 5in, BMI 29.95 (overweight). General: AO x 4. Well groomed, appears depressed, steady gait, comfortable, blunted affect, no smell. HEENT: PERRLA, eye glasses on, oronasopharynx clear Neck: No JVD, carotids no bruit Chest/Lungs: CTA AP & L Heart: No murmur, rub, or gallop, pulses+2 bilaterally and Radial pulse +2 bilaterally Peripheral Vascular: Intact, no claudication Genital/Rectal: intact, no tenderness Musculoskeletal: Muscle development is symmetrical, No weakness, no joint stiffness Neurological: CN II – XII intact, no loss of memory, no syncope Skin: Plaques on the neck and on the lower back, itchy, elevated, scaly, silvery. Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses . Labs are not needed for diagnosing this patient’s skin disease.
DIFFERENTIAL DIAGNOSIS FOR SKIN CONDITIONS 6 ASSESSMENT: Differential Diagnoses Psoriasis: This is a plague or scaling papules known to be well-circumscribed, dry and silvery. In pale skin individuals, psoriasis appears pink to red, while in darker skins, it appears to be brown or purple and are covered in white or silvery flaky scales. It forms due to increased epidermal cell turnover, increased numbers of epidermal stem cells, and due to abnormal differentiation of keratin expression which led to the formation of thickened skin with copious scale (Ball, Dains, Flynn, Solomon, & Stewart, 2015). Psoriasis is an auto immune condition resulting from excess production of skin cell. Eczema: A skin condition also known as dermatitis that appears dry, sometimes cracked, red, and or inflamed depending on the severity (Sutherland, 2018). Eczematous dermatitis when in chronic stage is thick, lichenified, and pruritic plagues; itching may or may not be present (Ball, Dains, Flynn, Solomon, & Stewart, 2015).
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- Fall '18
- Cutaneous conditions, Medical diagnosis, Differential diagnosis