DIFFERENTIAL DIAGNOSIS FOR SKIN CONDITIONS
Graphic 2
Subjective data
Chief complainant: the patients came for clinical examination and treatment because of the red pimples distributed all over the stomach region.
History of the illness: the red pimples lesion like is located in the stomach region, the lesions are in the chronic stage and few are red-spotted.
The onset of the infection is less than two weeks and its cause can be a skin dead cell that has been trapped in the follicle or the pore which has caused blockage hence infection by a bacterium thus becoming red.
Family history most acne dermatitis is inherited in the family and can cluster in the family hence the patient can have contracted the infection through a family pattern.
Medication and medication allergies
The patient’s condition can be caused by side effects of drugs such as corticosteroids, these drugs can worsen the condition when used after the onset of the disease. (Berry, et al,2020)
The patient used food allergies such as frequent use of dairy products and refined grains which might have caused the body to produce more insulin hormone hence t
triggering the acne. The patient used alcohol which was the main cause of food intolerance.
Objective data.
Physical examination:
Inspection for lesion distribution: The lesion is widely distributed with spotted fever.
General signs: Red inflammatory pimples distributed all in the stomach, the patient presented fever, itching, and burning of the lesion.
Causes of the infection
More Skin death cells
The red pimples develop when the dead skin cells and oil become trapped in the follicle also, it can be a pore that creates a blockage that becomes blackhead and finally become inflamed pimple after the bacteria has invaded. (Saunders,2009) Also, excessive hormones such as androgen.
Assessment
Correct Diagnosis of the infection
Dermoscopy
This diagnosis uses a microscope known as a dermatoscope to illuminate and magnify the lesion or the pimple. The instrument allows more inspection of the lesion to determine if the lesion is a melanoma also, assess if the lesion requires to be removed. The diagnosis is best for graphics because of skin lesions.
Diascopy
The diagnosis determines the blanching of the lesion after being pressed red lesion and using a slide the color change is observed.it is usually used to assess the purpuric lesion, blood that is inside the lesion will blanch because it will dilate the vessel) (Sadick, et al,2019). The instrument determines if the lesion is vascular or nonvascular.
Tzanck Smear
It is used to determine the herpes virus as the graphic lesion can be a sign of the infection, so the lesion is swabbed onto a glass slide to obtain the cells then Giemsa staining is applied onto the slide. Using a microscope presence of multinucleated cells is observed for the herpes virus.
Bacterial and viral culture
For the bacterial culture the lesion is obtained with a sterile swabbed and then cultured in a growth media then gram staining to determine if the infection is gram-positive or negative afterward antibiotic sensitivity test is done.
For viral culture, the lesion is collected using a Dacron swab and cultured for the viral identification as the red lesion can be herpes virus.
Skin scrapping
The lesion is scraped using a scalpel to collect active cells then treated with 20% potassium hydroxide for a few minutes to soften the keratin then followed by dimethyl sulfoxide for diagnosing. This method is useful for the diagnosis of the infection as it can retrieve the dermatophyte spore.
Reference
Berry, K., Lim, J., & Zaenglein, A. L. (2020). Acne Vulgaris: Treatment Made Easy for the Primary Care Physician. Pediatric Annals, 49(3), e109-e115.
Sadick, N., Edison, B. L., John, G., Bohnert, K. L., & Green, B. (2019). An Advanced, Physician-Strength Retinol Peel Improves Signs of Aging and Acne Across a Range of Skin Types Including Melasma and Skin of Color. Journal of drugs in dermatology: JDD, 18(9), 918.
Saunders, Philadelphia (2009) textbook of physical diagnostic, history, and examination 6th edition.