Facial Lesions

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍rashrednessitchingdry skin on the face

Onset was ‍gradualsudden, started ‍whileafter ‍



Symptoms include:

‍redness

‍swelling

‍itching

‍blistering

‍cracking

‍peeling

‍scaling

‍dryness

‍pain

‍burning



Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective



Contributing factors:

‍exposure to irritants or allergens

‍current stress

‍poor hygiene

no history of: ‍atopic dermatitis, ‍perioral dermatitis, ‍rosacea, ‍seborrheic dermatitis, ‍acne, ‍hay fever, ‍autoimmune disease





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

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

Skin: ‍rashlesions on ‍

Eyes: conjunctiva/sclera ‍normal, lids/lashes ‍normal

Ears: tympanic membranes ‍normal ‍, auditory canal ‍ on ‍rightleft, hearing ‍intact

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍





ASSESSMENT:

‍Allergic contact dermatitis ‍likelysuspectedpossible

DDx: allergic contact dermatitis, irritant contact dermatitis, rosacea, seborrheic dermatitis, atopic dermatitis, periorificial dermatitis, impetigo, cellulitis, herpes simplex, herpes zoster, acne vulgaris, psoriasis, drug eruption, lupus erythematosus, dermatomyositis, tinea faciei, photodermatitis, cutaneous lymphoma, sarcoidosis, insect bites





PLAN:

Treatments:

- ‍Topical steroids

- ‍Topical calcineurin Inhibitors

- ‍Topical antibiotics

- ‍Stieva-A

- ‍Oral antibiotics

- ‍Emollients

- Education on proper skin care

- Avoidance of irritants (e.g. soaps, detergents, makeup)

- Avoidance of triggers (e.g. stress, pressure, heat, sun exposure, alcohol, spicy foods)

Further care:

- Referral to dermatologist

- Follow-up in ‍ ‍weeksmonths

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