NURS 6512 Wk 4 Differential Diagnosis for Skin Conditions

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.NURS 6512 Wk 4 Differential Diagnosis for Skin Conditions

In this Discussion, 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.

Note: Your Discussion post should be in the SOAP (Subjective, Objective, Assessment, and Plan) note format, rather than the traditional narrative style Discussion posting format. 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.

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To prepare:

  • Review the Skin Conditions document provided in this week’s Learning Resources, and select two conditions to closely examine for this Discussion.NURS 6512 Wk 4 Differential Diagnosis for Skin Conditions
  • Consider the abnormal physical characteristics you observe in the graphics 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.

Post a 1 page paper APA format Your Discussion post should be in the SOAP (Subjective, Objective, Assessment, and Plan) note format,

  1. a description of the two graphics you selected (identify each graphic by number). (see sample skin conditions attached)
  2. Use clinical terminologies to explain the physical characteristics featured in each graphic.
  3. Formulate a differential diagnosis of three to five  possible conditions for each.
  4. Determine which is most likely to be the correct diagnosis, and explain your reasoning.

Differential Diagnosis for Skin Conditions
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 Discussion, 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.

Note: Your Discussion post should be in the SOAP (Subjective, Objective, Assessment, and Plan) note format, rather than the traditional narrative style Discussion posting format. 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.NURS 6512 Wk 4 Differential Diagnosis for Skin Conditions

To prepare:
•Review the Skin Conditions document provided in this week’s Learning Resources, and select two conditions to closely examine for this Discussion.
•Consider the abnormal physical characteristics you observe in the graphics 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.

Post on or before Day 3 a description of the two graphics you selected (identify each graphic by number). Use clinical terminologies to explain the physical characteristics featured in each graphic. Formulate a differential diagnosis of three to five possible conditions for each. Determine which is most likely to be the correct diagnosis, and explain your reasoning.
Resources can not be any older than 5 years and they must be scholarly resources

Facial rashes are a common presentation in primary care and are often very distressing for the affected individual, causing embarrassment and frustration. Approximately 14% of GP consultations are for the management of skin conditions1 and around 8% of all antibiotics prescribed in the UK2 are thought to be for the management of skin conditions. Antibiotics have been an important treatment of choice for acne for around 50 years, but with the continuing global increase in the use of antibiotics, and resistance reported in all major regions of the world, the responsible use of antibiotics is of major concern.3NURS 6512 Wk 4 Differential Diagnosis for Skin Conditions

Making a clear diagnosis before starting treatment can help improve outcomes and management. The Primary Care Dermatology Society (PCDS) has developed a range of guidelines on skin conditions, which aim to help GPs create targeted, rational treatment plans for people with skin conditions.

The following differential diagnosis case studies will explore possible causes of facial rashes, with the aim of making it easier to understand the presentations and complexity.

Allergic contact dermatitis (ACD) is a cutaneous manifestation of delayed-type hypersensitivity (type IV) reactions, usually manifesting as pruritic eczematoid changes of the skin. Barrier defects further enable allergen entry, subsequent processing, and presentation of the allergen to naïve T cells by dendritic cells. This process is defined as “sensitization” and results in the clonal expansion of memory T cells. After repeated exposure to a particular allergen, the second “re-activation” phase of ACD, named “elicitation,” occurs. Depending on the level of sensitization and frequency of repeat elicitations, some patients develop intermittent dermatitis while others develop a persistent dermatitis. The persistent dermatitis may expand from a localized presentation to a generalized dermatitis. In addition, a localized reaction may be diffuse or patchy within the exposed area, making identification challenging.

For diagnosis and definitive treatment ACD must be considered within a broad differential diagnosis, but the differential can be narrowed with careful history taking and clues found on physical examination. Herein, we discuss a differential diagnosis of ACD, clues to making the diagnosis, and finally a treatment algorithm for patients with disease refractory to avoidance measures.NURS 6512 Wk 4 Differential Diagnosis for Skin Conditions

Epidemiology

While ACD is known to affect a large percentage of the population, the exact prevalence in the general population is unknown. Estimations of contact sensitization prevalence have been calculated based on patch-tested populations with and without chronic dermatitis. In 2007, the estimated median prevalence of contact allergy in the general population was calculated at 21.2 %, with a weighted average prevalence of 19.5 % [1]. One group of patients that may not be included in these estimates includes those with acute dermatitis, such as with toxicodendron (poison ivy). These patients less commonly present for dermatologic diagnostic evaluation and are more likely to either self-treat or present to the primary care practitioner. The pediatric population is likely under-diagnosed, as the Food and Drug Administration (FDA) has not yet approved patch testing in kids. Also, in patients with concomitant diagnoses, such as atopic dermatitis, the secondary diagnosis of ACD may remain undiagnosed.

Although differences in presentation and allergens follow exposure patterns, ACD affects a large percentage of the population, young and old, all races, and both genders. Populations at higher risk for ACD include those with occupational exposure, such as hairdressers, veterinarians, and athletes. This risk is heightened in individuals with underlying atopy or other chronic skin barrier defects.NURS 6512 Wk 4 Differential Diagnosis for Skin Conditions