Psoriasis
Psoriasis is a disease characterized by red itchy patches on such places of one’s body as elbows, knees, back, face, head, feet, and palms (MedlinePlus, 2017b). Patches of thick red skin can appear in other areas of the body as well. According to Lowes, Suárez-Fariñas, and Krueger (2014), psoriasis can develop because of many factors, including various traumas and injuries, medications, and infections. Psoriasis usually develops in adults between the ages of fifteen and thirty-five, while the patient is sixty-seven. However, this particular disease can become visible earlier or later depending on various circumstances. Redness and itchiness of the skin around the knees and neck can be a symptom of psoriasis.
Contact Dermatitis
This type of dermatitis can occur as an allergic reaction to a certain material touching the skin. The main symptoms of contact dermatitis are red and itchy patches that appear in different areas of the body. Contact dermatitis is topical because the rashes develop on the regions of the skin that come into contact with a toxic substance (American Academy of Dermatology, 2017). Contact dermatitis can occur in individuals of any age because anyone can be exposed to allergens. The development of this disease may be followed by other allergic reactions, such as difficulty breathing, swelling, irritation, and distress (American Academy of Dermatology, 2017). According to Johansen et al. (2015), patch testing should help distinguish, whether a patient has allergic or irritant contact dermatitis, and find the incitant of the allergy.
Eczema
Eczema is a chronic skin disease, causes of which are undetermined (MedlinePlus, 2017a). The symptoms include skin reddening, inflammation, and itchiness. Eczema appears in various areas of the body, including the face, hands, feet, and inside the elbows and knees. Some people with eczema also develop asthma and hay fever (Silverberg & Hanifin, 2013). The causes of eczema may include stress and exposure to various allergens and irritants. According to MedlinePlus (2017a), genetic factors can also influence a person’s chance to have eczema. This skin disease can occur in infants and children in the form of atopic dermatitis. However, adults can have or develop eczema as well.
Final Diagnosis
The patient denies regular contact with house cleaning chemicals and claims that she does not have any apparent allergies. However, she takes acetaminophen daily because of osteoarthritis. This medication can cause mild irritation and itchiness of the skin. If this drug is an allergen, then the patient may have psoriasis that was triggered by the medication. It is unlikely to be topical contact dermatitis because the allergen is taken internally and not applied externally. The patient may have a late development of psoriasis or eczema due to the longevity of the symptoms. She can also have a medical intolerance to acetaminophen. The placement of red patches near the knees and scalp is typical for psoriasis. Some cases of psoriasis also include the development of psoriatic arthritis.
Plan/Therapeutics
A patch test and an allergic test should be conducted to determine the possible cause of skin irritation. If acetaminophen is the reason for the allergic reaction, it should be substituted for another medication. If the cause remains unclear, the patient can consider some external methods of treatment. Psoriasis can be managed with the use of topical lotions and other directly applied medications as well as skin moisturizers and soothing creams. The medications will relieve the symptoms, while creams and moisturizers will help manage dryness and itchiness.
Evaluation of Patient Encounter (Self Assessment)
During the encounter, the patient adequately answered the questions, and concisely presented the required information. She was provided with information on possible diagnoses. The medical professional presented some ways to treat the discussed problems and consulted the patient on further actions (LaVela & Gallan, 2014).
References
American Academy of Dermatology. (2017). Contact dermatitis. Web.
Johansen, J. D., Aalto‐Korte, K., Agner, T., Andersen, K. E., Bircher, A., Bruze, M.,… & Uter, W. (2015). European Society of Contact Dermatitis guideline for diagnostic patch testing – recommendations on best practice. Contact dermatitis, 73(4), 195-221. Web.
LaVela, S. L., & Gallan, A. (2014). Evaluation and measurement of patient experience. Patient Experience Journal, 1(1), 28-36. Web.
Lowes, M. A., Suárez-Fariñas, M., & Krueger, J. G. (2014). Immunology of psoriasis. Annual review of immunology, 32, 227-255. Web.
MedlinePlus. (2017a). Eczema. Web.
MedlinePlus. (2017b). Psoriasis. Web.
Silverberg, J. I., & Hanifin, J. M. (2013). Adult eczema prevalence and associations with asthma and other health and demographic factors: A US population–based study. Journal of allergy and clinical immunology, 132(5), 1132-1138. Web.