Case Study #2: Itching Health Problem

In the case of a 45-year old female patient who has been experiencing an itchy red rash on her arms and legs, both subjective and objective assessments need to be conducted to assess her conditions. The possible subjective data that should be obtained in her case are monitoring her skin to figure its dryness, figure out the razor bumps, possible insect bites, folliculitis, and hair regrowth (Healthline, 2019). The following data will help the nurse in knowing the possible cause of itch on both hands and legs. On the other hand, the nurses will also opt to collect objective data regarding the case of the patient. The possible objective findings are allergies, expanded blood vessels, prurigo gestationis, etc.

As a result of itching as a major sign of her problem, there are different categories of the diagnostic exam that can be used to examine the cause of itching. One of the diagnostic tests that can be used in her case allergy test. An allergy test is a diagnostic exam that is conducted by an allergy specialist looking forward to examining if the body has reacted to a substance in one’s environment. The possible allergic tests for the 45-year old patient will be elimination or skin tests. Secondly, the clinician can also opt to conduct blood tests. For a patient found with itching problem, the clinician opts to conduct blood tests to figure out if there are mineral and vitamin deficiencies (Cleverland Clinic, n.d.). Specifically, in the case of an itching patient, a clinician will be examining if there is a possibility of iron deficiency that could have played part in causing an itch. Thirdly, there is a need of conducting a skin biopsy. The skin biopsy will be relied upon in identifying the skin conditions that could have played part in causing pruritus. In this case, it will entail examining the sample of the skin via a microscope.

There are three differential diagnoses of itchy skin, namely: dermatitis, lichen planus, and psoriasis (DermNet NZ, 2016). Dermatitis is a health condition that entails having dry skin, swollen, reddened, and itchy skin. This condition is also linked with the affecting the skin or health condition of a patient. Dermatitis is a common disease affecting most people, and therefore a patient could have been a victim of it too. Additionally, this health condition has almost the same symptoms as what a patient was experiencing. The second kind of disease is lichen planus. It is a condition that causes irritation and swelling of the skin. A victim of lichen planus also experiences irritation on the nails, hair, and mucous membranes. The selection of Lichen Planus was made because of having its major symptom as itching and swelling, and therefore, having conducted subjective and objective assessment will help in differentiating the real cause and close related health condition. The third differential diagnosis is psoriasis. It is also the skin disorder that has been leading the skin cells of a person to multiply thus resulting to bump red patches. This skin condition mostly appears on the knees, elbows, scalp, and lower back (DermNet NZ, 2016). The selection of psoriasis as a differential diagnosis is because it has almost the same attributes as her signs and symptoms of itching.

References

Cleveland Clinic. (n.d.). Itchy Skin (Pruritus): Diagnosis and Tests. Retrieved from https://my.clevelandclinic.org/health/diseases/11879-pruritus/diagnosis-and-tests.

DermNet NZ. (2016). The differential diagnosis of itchy skin. Retrieved from https://dermnetnz.org/topics/differential-diagnosis-of-itchy-skin/.

Healthline. (2019). Causes of Itchy Legs and What to Do About It. Retrieved from https://www.healthline.com/health/beauty-skin-care/itchy-legs.

Reply