Diffuse Rash

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of generalized rash

Onset was ‍gradualsudden, started ‍whileafter ‍

Location is on ‍faceneckarmshandslegsfeetchestabdomenback ‍generalized

Described as ‍itchynon-itchy, ‍painfulpainless, ‍blistering, ‍scaling, ‍swollen

Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective





Associated symptoms: *Try using right-click for negatives*

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍cough, ‍non-productiveproductive of ‍clearcolored phlegm

‍runny nose, ‍clearcolored

‍sore throat

‍shortness of breath

‍headache, ‍diffuse, ‍persistentintermittent, ‍pressurethrobbing, ‍mild

‍body ache

‍joint pain

‍fatigue

‍loss of appetite

‍decreased fluid intake

‍nausea

‍vomiting, ‍ episodes ‍per day, ‍, ‍hematemesis

‍diarrhea, ‍ episodes ‍per day, ‍

‍abdominal pain, ‍diffuse, ‍dull, ‍mild



Contributing factors:

‍recent viral infection

‍exposure to irritants or allergens

‍current stress

‍poor hygiene

no history of: ‍atopic dermatitis, ‍hay fever, ‍autoimmune disease

no use of: ‍antibiotics, ‍immunosuppressants





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Eyes: conjunctiva/sclera ‍normal, lids/lashes ‍normal

Throat: ‍normal, ‍erythema, ‍exudate, ‍

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍

Skin: ‍rashlesions on ‍

Musculoskeletal: joints ‍ ‍normal, ‍limited ROM





ASSESSMENT:

‍Viral exanthem ‍likelysuspectedpossible

DDx: drug eruption, viral exanthem, allergic reaction, urticaria, atopic dermatitis, nummular eczema, psoriasis, pityriasis rosea, scabies, contact dermatitis, seborrheic dermatitis, lichen planus, cutaneous T-cell lymphoma, systemic lupus erythematosus, dermatomyositis, sarcoidosis, photodermatitis, vasculitis, erythema multiforme, Kawasaki disease, toxic epidermal necrolysis, Stevens-Johnson syndrome, lichen simplex chronicus, impetigo, disseminated herpes zoster, tinea corporis, tinea versicolor





PLAN:

Investigations:

- Blood work: ‍CBC, ‍creatinine, ‍electrolytes, ‍glucose, ‍TSH, ‍LFTs, ‍ANA, ‍RF

- Patch testing

- Skin biopsy

Treatments:

- ‍Topical Steroids

- ‍Antihistamines

- ‍Antifungal Topical

- ‍Antifungal Oral

- ‍Scabicides

- Avoidance of irritants and allergens

- Education on proper skin care and avoidance of triggers

Further care:

- Referral to dermatologist

- Follow-up in ‍ ‍weeksmonths

- Return if rash worsens, if new symptoms develop, or if condition does not improve after 2 weeks