Differential Diagnosis of Skin Conditions             

 

Chief complain

            Red patches on the skin which are itchy and burning with no control over scratching them all the time

History of presenting illness

James is a 28-year-old male client who attended the health care facility with itchy red bumps in his skin that does not allow him control over scratching. He explains that the rushes started three weeks ago and he hoped it would go away but it had become bigger and the skin has started peeling off. He also states that the rashes are painful and if scratches for a long time it becomes more painful, itchy and sometimes bleed. He also reports that his joints have also become stiff and he cannot do things comfortably. On physical examination the skin is dry and cracked and there are presence of silvery scales on the bumps. The client has also thickened nails on observation.

Differential diagnosis

Eczema causes itchiness, dryness of the skin, occurs mostly on the face, neck, hands, ankles and even eyelid. It causes small raised bumps which may leak fluid (Agha et al., 2016). It may also affect pigmentation and thus might make the affected part lighter and darker

Psoriasis presents with itchy skin, red bumps which painful. The skin becomes dried and cracked and might bleed at times on scratching. There are also signs of thick, pitted and cracks on the nails (Limaye, 2015). This are the main presentations.

Pityriasis rubra pilaris causes pink, red scaly patches on the skin which are usually itchy and it might cause development of the patches on one side of the body and most often on elbows, knees, hand and feet (Brown & Badri, 2019). The skin may be thickened and the scaly patches may spread to the whole body.

 

Actual diagnosis

The correct diagnosis for the condition is psoriasis due to the fact that, the client reported some form of bleeding from the cracked parts of the skin on scratching. Presence also of the pitted nails suggest psoriasis. There also the presence of the stiff joints which is not present in the above condition as they do not present with it.

 

 

References

Agha, H. M., Asim, S. A., Alam, M. Z., & Wahid, Z. (2016). ECZEMA. The Professional Medical Journal, 23(01), 060-064.

Brown, F., & Badri, T. (2019). Pityriasis rubra pilaris. In StatPearls [Internet]. StatPearls Publishing.

Limaye, K. (2015). Psoriasis: an overview and update. The Nurse Practitioner, 40(3), 23-26.