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Dermatologic Disorders

Write an explanation of the skin disorder in the case study. Include in your explanation the lesion
type, lesion distribution, color, and any ancillary findings. Then, present a differential diagnosis and
explain which is the most likely diagnosis for the patient and why. Finally, explain a treatment and
management plan for the patient’s skin disorder, including appropriate dosages for any recommended


Case Study:

An adolescent presents to your office with a complaint of an itchy, red rash that first appeared on
his lower legs 1 week ago after he returned from a camping trip. The rash has since spread to the
upper legs, trunk, and groin. He denies fever or other systemic symptoms.

The case study is of an adolescent who presented with a localized itchy red rash on the lower
legs seven days following a camping trip. The patient reported the rash then spread from lower
legs to other areas of the upper leg, trunk and groin. No fever or other problems reported. 



The diagnosis for this patient is allergic contact dermatitis following the exposure history during
the camping trip. Taking thorough history is needed to identify any prior episodes of skin
irritations such as atopic dermatitis. Patients who have a history of atopic dermatitis have an
increased risk of dermatitis (Taylor& Amado, 2013). The American Family Physician (2010)
defines allergic contact dermatitis as” delayed hypersensitivity reaction in which a foreign
substance comes into contact with the skin; skin changes occur with re-exposure”. In allergic
contact dermatitis, the distribution of lesions is more localized on the area of intense exposure.
As in this case, the rash begins on the lower legs before spreading to other regions. According to
(American Academy of Dermatology, 2011) a rash can appear within hours or can take up to a
week before appearing following an exposure.


The first step would be to identify and avoid the allergen if possible. Localized lesions respond
well to medium to high potency steroids. For this case, a topical corticosteroid betamethasone
valerate cream 0.1% would be applied twice daily until the lesions clear. This will help to
minimize the redness and the intense of the itching (WebMD, 2015) In addition, Dermnet (2011)
provides for use of Prednisone 20 mg twice a day for seven to ten days followed by prednisone
20 mg in the morning for three days to help in relieving the pruritus. Use of wet compresses may
be repeated severally throughout the day to ease the situation
Differential diagnosis


A patient presenting with an itchy red rash on the legs that seems to spread to other areas with no
fever could be suffering from hives. WebMD (2015) points out that the rashes are itchy and may
appear anywhere on the body. WebMD (2015) stresses that hives are caused by allergic reactions
after an exposure to a trigger, however, they may not spread to other areas other than the
stimulated part.


American Family Physician (2010). Diagnosis and Management of Contact Dermatitis

American Academy of Dermatology. (2011). Contact dermatitis.
James S. Taylor & Antoine Amado (2013). Contact Dermatitis and Related Conditions

WebMD (2005-2015) Skin problems and treatment health center.
WebMD (2005-2015) Drugs and Medications.

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