MS: The patient has no complaints of joint or muscle pain. Psych: The patient has no history of depression or anxiety and denies any suicidal history or ideation. Neuro: The patient has had no syncopal episodes nor episodes of dizziness. The patient has had no memory issues. He does not have a history of falls or seizures. Integument/Heme/Lymph: The patient has 25, 1-2 mm hard papule that are raised off the skin. They are scattered of the chest and abdomen. They are bright red in color.
INTEGUMENTARY 5 Endocrine: The patient does not have any hormone or endocrine issues. Allergic/Immunologic: The patient has no allergy or immunologic issues OBJECTIVE DATA Physical Exam: Vital signs: B/P 126/62, P 67 and regular; T 97.9; RR 18; non-labored; Wt: 190 lbs; Ht: 5'10"; BMI 28 General: Alert and oriented and appears uncomfortable HEENT: PERRLA Neck: Carotids no bruit, jugglar vein distension Chest/Lungs: Bilateral lower lobes diminished Heart/Peripheral Vascular: Patient's heart rate is regular heart rate and no murmur is heard. ABD: Normal and active bowel sounds and no tenderness to palpation Genital/Rectal: Deferred Musculoskeletal: symmetric Muscle strength is 5/5 in all groups Neuro: Cranial Nerves II – XII are intact Skin/Lymph Nodes: 25, 1-2 mm hard papule that are raised off the skin. They are scattered over abdomen and chest. They are bright red. ASSESSMENT: Lab Tests and Results: Diagnostics: DEFERRED Differential Diagnosis (DDx):
INTEGUMENTARY 6 1.) Cherry angioma - The cherry angioma can manifest in one or multiple places on a body. They are mostly found on the arms and upper trunk. The cherry angioma are round or oval and bright red. They are shaped like domes and can be several millimeters around in diameter. They are formed by newly developed capillaries in the papillary dermis. They capillaries have narrow lumens and prominent endothelia cells. Cherry angioma frequency increases with a person's age. Around 75% of adults over 75 were said to have cherry angiomas (Kim, Park, and Ahn, 2009).
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- Summer '15
- Cutaneous conditions, papule