Carol Year Female Explained for Students (Easy Guide)

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Original Question

Carol a 5-year-old female presents to the clinic accompanied by her mother. The parent is worried because the child has been scratching her arms, legs, and face over the past month. She states that the pruritus is worse at night and prevents the child from sleeping. Her mother reports applying topical steroids with no relief. The mother states the child is otherwise healthy and not on any medication. Medical Hx: History of iron deficiency anemia. (current Hemoglobin is 9.8 g/dL) Medication: OTC steroid cream Allergy: Egg, fish and peanut, and seasonal allergy Family history Mother history of atopy, allergy to cats Father history of atopy and allergy to cats. Brother: Impetigo Sister has asthma. Physical Examination Physical examination reveals multiple scratch marks on the entire body with excoriation and inflammation on the bilateral forearms and lower extremities, around the face, hands, knees, neck, elbows, and ankles, and chest and back. Some areas of the affected skin appear dry, reddened area that weeps clear fluid when scratched. Questions List 3 differential diagnosis • What is the primary diagnosis? • What are the factors exacerbating her pruritus? • What would be your treatment plan?

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