I need to know what type of rash is indicated in this case study and what evidence you have to support the reasoning. Thank you!
Case Study
AT is a white woman, age 62, complaining of fatigue, arthralgias of both hips and knees and the small joints of both hands, and a red, scaly rash on her upper torso, extremities, and face. She says that sunlight aggravates the rash and that she has had all of these problems for approximately 2 months, but is most disturbed by the itching rash. She says the rash has made her very depressed, and she has trouble sleeping at night and concentrating at work during the day.
PMH
AT has a history of allergies to penicillins, osteoarthritis for 10 years, depression for 4 years, severe gastroesophageal reflux disease and hypertension for 7 years
Medication:
Fluoxetine (Prozac) 20mg QD | Hydralazine 50mg BID |
Naproxen 500mg BID | Diltiazem (Cardizem) CD 120mg QD |
Lansoprazole (Prevacid) 30mg QD | AT is very compliant |
SH: no tobacco or alcohol use
Physical Examination:
GEN: Obese female who appears anxious about her condition
VS: BP 130/70, HR 72, RR 20, T 98.6, Wt 179lb, Ht 5’3”
HEENT: patient has circular, erythematous, scaly plaques on cheeks of face, upper torso, and upper extremities
COR: WNL
CHEST: WNL
ABD: WNL
GU: WNLt
EXT: rash, limited range of motion of both knees and hips; pain upon movement of hands, but no noticeable swelling
NEURO: WNL
Laboratory: WNL
Expert Solution Preview
Introduction:
In this case study, a 62-year-old female patient has presented with multiple symptoms, including fatigue, joint pain, and a red, scaly rash on her upper torso, extremities, and face. The patient has reported that the rash worsens with exposure to sunlight and has been present for approximately two months. The purpose of this answer is to identify the type of rash indicated in this case study and the evidence to support this reasoning.
Answer:
Based on the symptoms presented in this case study, the patient is likely suffering from systemic lupus erythematosus (SLE). SLE is an autoimmune disorder that affects multiple organs and often presents with symptoms that include fatigue, joint pain, and a rash that is photosensitive and can occur on the face, upper torso, and extremities. The circular, erythematous, scaly plaques on the face, upper torso, and upper extremities observed in this patient are common manifestations of the rash associated with SLE. Additionally, the fact that the patient has a history of severe gastroesophageal reflux disease and hypertension, which are conditions that have been linked to SLE, further supports this diagnosis. Further testing, including a review of the patient’s medical history, physical examination, and laboratory tests, may be necessary to establish a definitive diagnosis and determine the appropriate treatment plan.
