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Scabies
Chief Complaint
The patient's chief complaint is a rash and scathes that appear as tunnels. There are small, grey-white linear lesions with a minute black speck at the closed end. The rash is persistently itchy.
Precipitating/Alleviating Factors/Past Medical History
There are no obvious precipitating factors. The patient is young and otherwise healthy. The patient has a normal diet, and reports no surgeries, history of illness, medications (except OTC Tylenol) or allergies. The patient works in an oil field, however, and in the course of that work may have been exposed to hazardous chemicals, which are common in that industry. The patient's family does not have any medical history that appears related to the rash. The patient is sexually active with one partner. The patient's financial and living situation is stable. It is not known if the partner has a similar rash, but this would be important information because scabies is often sexually transmitted (Monsel & Chosidow, 2012).
Associated Symptoms
The rash is persistently itchy. Otherwise there are no associated symptoms reported.
Quality of Reported Symptoms
The itchiness is an impediment to comfort at this point. The patient is otherwise able to live as normal.
Temporal Factors
The patient has not indicated date of...
Rash is currently active. The rash is persistent.
Location
It is not known whether the rash is generalized or localized. It is not known if the rash radiates or not.
Sequelae
The nature of the rash is unknown at present. Aside from the itching, there are no active complications. Persistent itching, however, can result in scratching that further damages the skin. Thus, there is risk of secondary infection if the rash persists further.
Severity of Symptoms
The patient is reporting a rash, but has not indicated the severity of the itching, or of the rash itself.
Assessment
The patient believes that he may have scabies. There are no details provided as to why he feels this way. The symptoms of the rash do not align with scabies, in terms of the appearance of the rash. Scabies is typically a sexually-transmitted disease, and the patient's family situation does not align with sexual transmission of scabies, unless there is something the patient is not admitting to. However, given that the rash is not manifesting like a scabies rash, it is unlikely that the patient has scabies.
Potential Differential Diagnoses
Scabies is an option, because the patient is presenting with an itchy rash. More information would be required to obtain a scabies diagnosis, as there are a few…
References
Monsel, G. & Chosidow, O. (2012). Management of scabies. Skin Therapy Letter. Retrieved July 15, 2016 from http://www.skintherapyletter.com/2012/17.3/1.html
Papa, C. (2016) Clinical methods: The history, physical and laboratory examinations: Skin. Butterworth Publishers. Retrieved July 15, 2016 from http://www.ncbi.nlm.nih.gov/books/NBK208/
PCDS (2016). Skin lesion. Primary Care Dermatology Society. Retrieved July 15, 2016 from http://www.pcds.org.uk/p/skin-lesion-appearance-brown-black-blue
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