Differential Diagnosis for Skin Conditions Essay Example Paper
Differential Diagnosis for Skin Conditions
Shadow Health Comprehensive SOAP: Picture #2
Patient Initials: _M.J______ Age: _28______ Gender: _____F__
SUBJECTIVE DATA:
Chief Complaint (CC): “I have marks in my tummy that are soft to touch.”
History of Present Illness (HPI): M.J. is a 28-year old African American woman who comes to the facility in her third tri-semester for a routine prenatal appointment with a complaints of marks on her abdomen. Because this is her first pregnancy, she is worried that the marks may create problems during her pregnancy. She claims she first saw a couple markings two weeks ago, and they are rapidly growing ever since. She claims the impacts are not uncomfortable, do not interfere with her ability to function, and are soft to the feel. M.J denies any alterations that might have caused the markings, and said she had no previous skin problems Differential Diagnosis for Skin Conditions Essay Example Paper.
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Medications: patient claims she is only taking pregnancy supplements like prenatal vitamins, folic acid, iron, and magnesium
Allergies: Penicillin
Past Medical History (PMH): she denies having any significant medical history except seizures during her childhood but they were resolved.
Past Surgical History (PSH): None
Sexual/Reproductive History: patient is heterosexual. LMP is 16/11/2020.
Personal/Social History: LT is engaged, and this will be her first child. She works as chef in a local restaurant and interacts well with her coworkers, family, and neighbors. She exercises and engages in physical activities with her fiancé. She hasn’t used any alcoholic drink, illegal substances, or smoked cigarettes during pregnancy. Her favorite pastimes include shopping, traveling, and jogging. She has a cat as a pet.
Health Maintenance: She applies sunscreen when on beach and practices precautionary steps including putting on a hat to avoid skin damage. She also puts on a seat belt and avoids calling and texting when driving Differential Diagnosis for Skin Conditions Essay Example Paper.
Immunization History: Immunizations up to date. Influenza Vaccine 2020, Tdap 2018.
Significant Family History: Both parents and siblings are alive and in good health. Paternal grandmother is alive but battling diabetes; paternal grandfather died of stroke; maternal grandmother is in good health; maternal grandfather is schizophrenic.
Review of Systems:
General: patient denies any fatigue, body weakness, fever, loss of appetite, or weight loss.
HEENT: she denies headaches or no eye problem. Denies hearing issues or ear infection. No runny nose or nasal infection. Denies sore throat.
Respiratory: Denies difficulty breathing, coughs, SOB, past TB infections, and dyspnea
Cardiovascular/Peripheral Vascular: Denies chest pain, discomfort, or pressure.
Gastrointestinal:
Genitourinary: Denies urinary incontinence or problems passing urine.
Musculoskeletal: Denies muscle pain, tenderness, or joint pain. Has minor back pains that appear after standing for a prolonged period.
Neurological: no dizziness, headaches, or lightheadedness.
Psychiatric: Denies depression, anxiety and any other mental illness.
Skin/hair/nails: patient has marks on her stomach but no rashes on her body. Hair evenly distributed. No abnormalities of the nails Differential Diagnosis for Skin Conditions Essay Example Paper
OBJECTIVE DATA:
Physical Exam:
Vital signs: Temp 87; BP 127/78; RR 8; P 88; HT 167cm; WT 149lbs
General: The patient appears nervous since she suspects her symptoms are an indication that something could be happening with her pregnancy.
HEENT: PERRLA, normal conjunctivae, mucous membranes moist.
Neck: Supple, no bruits or JVD noted,
Chest/Lungs: Clear to auscultation bilaterally
Heart/Peripheral Vascular: No murmur, rub, or gallop. Regular rate and rhythm. Normal peripheral circulation.
Abdomen: BS X4, round, soft, non-tender.
Musculoskeletal: Normal muscular development and gait with good posture.
Neurological: A/O x4, affect and mood are congruent
Skin: no rashes except the marks in her stomach.
Diagnostic results:
ASSESSMENT:
Striae gravidarum was the appropriate diagnosis after thoroughly inspecting the patient’s abdomen and applying clinical expertise. The marks are stretch marks that develop during pregnancy, particularly in the third trimester; thus, the pregnancy is a major source of the markings in this instance. However, a blood chemistry is advised to give insight and rule out any other medical issues that could cause the marks to emerge.
Primary Diagnosis: Striae Gravidarum
Striae gravidarum, commonly referred to as pregnancy stretch marks, are markings on the abdomen skin caused by the uterus expanding and gaining weight so quickly. Approximately 90 percent of expectant mothers are bothered by this disorder during pregnancy, resulting in an off-color appearance (Farahnik et al., 2017). The Striae gravidarum markings are produced by ripping of the dermis during the fast development of pregnancy, straining of the skin, hormonal impacts, and tension on the tissues. Striae gravidarum symptoms start out as purple or red patches on the abdomen that fade with time, leaving the abdomen bare and smooth to touch. striae gravidarum is not associated with any pain, does not generate any malfunction, and does not impede or affect every day functioning (Kocaöz et al., 2020)Differential Diagnosis for Skin Conditions Essay Example Paper. However it generates psychological anguish since it are regarded a cosmetic annoyance.
Differential Diagnoses
Mid-dermal elastolysis
This is an uncommon skin disease that affects the skin’s flexible tissues and fibers. Subtle wrinkles may be seen in the lower extremities, trunk, and upper arms, which are caused by the breakdown of flexible fibers in the skin (Hoang et al., 2020). The elastase enzyme, which is responsible for elastin degradation, becomes overactive, resulting in this disorder. Pregnancy, autoimmune disorders, ultraviolet rays exposure, preexisting skin diseases are the possible causes of Mid-dermal elastolysis. Sunscreen should be used to avoid sun damage, and topical retinol should be used to improve the physical look of wrinkles.
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Cutis laxa
This is a skin disorder that is typified by loose, drooping, and inelastic skin. This disease causes the skin to hang loosely, producing creases and a drooping look in the afflicted area of the body (Neves et al., 2020). If this disease isn’t treated properly, it may lead to internal health problems including an aortic aneurysm. It may also be serious, affecting other structural tissues and organs, including the lungs, heart, and blood vessels, resulting in complexities and serious health concerns (Neves et al., 2020). Although there is no specific therapy for this disease, experts concentrate on avoiding problems from developing. Surgical surgery is also used to minimize skin creases, although this is just a short-term solution Differential Diagnosis for Skin Conditions Essay Example Paper.
Anetoderma
This is a mild skin disease in which dermal elastic fibers are lost, resulting in drooping and bulging loose and sack-like skin. This disorder is associated with illnesses like Lyme disease or leprosy, anti-phospholipid syndrome, and lupus (Genta et al., 2020).
References
Farahnik, B., Park, K., Kroumpouzos, G., & Murase, J. (2017). Striae gravidarum: Risk factors, prevention, and management. International journal of women’s dermatology, 3(2), 77-85. https://doi.org/10.1016/j.ijwd.2016.11.001
Genta, M. P., Abreu, M. A. M. M. D., & Nai, G. A. (2020). Anetoderma: an alert for antiphospholipid antibody syndrome. Anais brasileiros de dermatologia, 95(1), 123-125. https://doi.org/10.1016/j.abd.2019.04.010
Hoang, N., Jibbe, A., Fraga, G., & Rajpara, A. (2020). Skin wrinkling of the upper arms: a case of mid-dermal elastolysis. Dermatology Online Journal, 26(4). https://doi.org/10.5070/D3264048350
Kocaöz, S., Gördeles Beşer, N., & Kizilirmak, A. (2020). Striae gravidarum in primigravid women: prevalence, risk factors, prevention interventions, and body image. The Journal of Maternal-Fetal & Neonatal Medicine, 33(23), 3922-3928. https://doi.org/10.1080/14767058.2019.1591363
Neves, J. F., Doffinger, R., Barcena-Morales, G., Martins, C., Papapietro, O., Plagnol, V., … & Nejentsev, S. (2018). Novel PLCG2 mutation in a patient with APLAID and cutis laxa. Frontiers in immunology, 9, 2863. https://doi.org/10.3389/fimmu.2018.02863 Differential Diagnosis for Skin Conditions Essay Example Paper
Assignment 1: Lab Assignment: Differential Diagnosis for Skin Conditions Photo Credit: Getty Images/iStockphoto Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause. In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition. To Prepare Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment. Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies? Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected. Consider which of the conditions is most likely to be the correct diagnosis, and why. Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment. Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note. Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment. The Lab Assignment Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources. Using the SOAP (Subjective, Objective, Assessment, and Plan) note format: · Create documentation, following SOAP format, of your assignment to choose one skin condition graphic (identify by number in your Chief Complaint). · Use clinical terminologies to explain the physical characteristics featured in the graphic.– Excellent 30 (30%) – 35 (35%) Good 24 (24%) – 29 (29%) Fair 18 (18%) – 23 (23%) Poor 0 (0%) – 17 (17%) · Formulate a different diagnosis of three to five possible considerations for the skin graphic. · Determine which is most likely to be the correct diagnosis, and explain your reasoning using at least three different references from current evidence-based literature.– Excellent 45 (45%) – 50 (50%) Good 39 (39%) – 44 (44%) Fair 33 (33%) – 38 (38%) Poor 0 (0%) – 32 (32%) Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.– Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3 (3%) – 3 (3%) Poor 0 (0%) – 2 (2%) Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation– Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3 (3%) – 3 (3%) Poor 0 (0%) – 2 (2%) Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.– Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3 (3%) – 3 (3%) Poor 0 (0%) – 2 (2%) Total Points: 100 Name: NURS_6512_Week_4_Assignment_1_Rubric