Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.
In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.
THE LAB ASSIGNMENT
- Choose one skin condition graphic (identify by number (#4) in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
- Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources.
* attached in file are the images of skins conditions to chose from for this particular assignment. I have chosen image #4. Also the SOAP template for this assignment is also provided as well as the rubric to follow for grading purposes.
Expert Solution Preview
Introduction:
The process of differential diagnosis involves a systematic approach to identify the most likely cause of a patient’s skin condition by eliminating potential conditions based on physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms. In this lab assignment, we will examine a graphic of a skin condition and use the SOAP note format to describe our observations, formulate a differential diagnosis of five possible conditions for the skin graphic, and determine which is the most likely correct diagnosis.
Answer:
For the skin condition graphic #4, the patient presents with a rash on the lower legs. Upon clinical examination, the rash appears as multiple erythematous and pruritic papules with central necrosis and pustules. There is no discharge or exudate present.
Based on these physical characteristics, the differential diagnosis for this skin condition could include the following:
1. Ecthyma
2. Folliculitis
3. Vasculitis
4. Cellulitis
5. Scabies
Out of these five conditions, the most likely correct diagnosis is ecthyma. Ecthyma is a skin infection caused by group A beta-hemolytic Streptococcus or Staphylococcus aureus. It presents as pustules or papules with a central necrotic ulceration, which is consistent with the patient’s physical presentation. Additionally, the patient’s symptoms of erythema and pruritus also suggest ecthyma.
References:
1. George, E., & Tsianakas, A. (2020). Ecthyma. In StatPearls [Internet]. StatPearls Publishing.
2. Sullivan, E. (2019). Skin and Subcutaneous Tissue. In Clinical Guidelines for Advanced Practice Nursing (3rd ed.) (pp. 547-592). Springer Publishing Company.
3. Lebwohl, M., Heymann, W. R., Berth-Jones, J., & Coulson, I. (Eds.). (2020). Treatment of Skin Disease: Comprehensive Therapeutic Strategies. Elsevier.