Petechiae is red to purple lesions appearing on the mucous membranes and skin. Lesions can be macular and palpable (American Academy of dermatology, n.d.). Petechiae is small lesions measuring less than 0.5 cm (Ball et al., 2015). Glomeruloid hemangiomas are rare vascular tumors usually appearing on the trunk and proximal limbs. They are papules and are red to blue in color. They vary in size from a few millimeters to a few centimeters. It occurs mostly in patients with a rare muti-systemic disease called polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome (POEMS). This lesion affects all ages, and will rupture and bleed ( Gupta, Kandhari, Ramesh, & Singh, 2013). The most likely diagnosis is cherry angiomas due to the size compared with petechiae and glomeruloid hemangiomas. Glomeruloid hemangiomas are also common in the rare disease POEMS. References American Academy of Dermatology. (n.d.). Petechiae, purpura, and vasculitis. Retrieved from Ball, J. W., Dains, J, E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Siedel’s guide to physical examination. (8 th ed.). St. Louis, MO: Elsevier Mosby.
Brown, C. W. (2016). Cherry hemangiomas. Medscape. Retrieved from Gupta, J., Kandhari, R., Ramesh, V., & Singh, A. (2013). Glomeruloid Hemangioma in Normal Individuals. Indian Journal of Dermatology , 58 (2), 160. - 5154.108088 Ingram, J. R., Belgi, G., Cook, L. J., Hughes, B. R., Karim, A., & Finlay, A. Y. (2013). Segmental cherry angiomas associated with extragenital lichen sclerosus: a report of two cases. Clinical & Experimental Dermatology , 38 (4), 386-389. doi:10.1111/j.1365- 2230.2012.04479.x United States Department of Health and Human Services, National Institutes of Health. (2017). Cherry angiomas. Retrieved from Patient Initials: AG Age: 35 Gender: F CASEY STUDY: #5 SUBJECTIVE DATA: Chief Complaint (CC) : “I have these dry red patches on my elbows and they have white scales at times.” History of Present Illness (HPI): AG is a pleasant Caucasian female who presents to the clinic today with complaints of dry patches of skin on the bilateral elbows that are red in color with white patches. She reports them being present for three months. She states, “the patches itch and cause me burning pain at times.” “The only thing that helps relieve the itching is to bath in oatmeal.” The severity of the symptoms are progressively getting worse which brings the patient to the clinic today. Medications: 1.) Multivitamin 1 tab po daily 2.) Senna 8.6 mg 1 tab po at bedtime Allergies: No known drug allergies, no known food allergies, no known environmental allergies. Past Medical History (PMH):
1.) Constipation Past Surgical History (PSH): Tonsillectomy in 1999 Sexual/Reproductive History: Heterosexual. Has had same partner x 2 years G0PA0 Menarche age 13 , cycles every 28 days, flow 3-5 days, LMP 12/5/17. Last pap smear 01/2016 Personal/Social History: Denies smoking or alcohol use. States she does little exercise.
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