Nu632U11peerresponseKayla

Differential diagnosis: Eczema, Psoriasis

Information: Is this the first time he has had a flair? Have you noticed the flair associated with anything like new soaps, clothes, etc? Has he had any recent illnesses? Have you attempted any treatments? Tell me about your bathing and skin regimen.

Plan and education: This photo does not look inflamed so therefore I am not prescribing topical steroids, in the event there was excoriation or swelling I would then start with prescribing Hydrocortisone 2.5% BID once in the morning and once after bathing while symptoms persist. The goal would be to use the lowest potency topical steroid to control itching and associated irritation (Leung et al., 2020).

Caregiver education: “You should base your treatment plan around prevention. Daily you should bathe your child in lukewarm water for short intervals of 5-10 minutes. Avoid triggers by using soaps and shampoos that are hypoallergenic, dye and fragrance-free. Some children have reactions to certain fabrics or foods. Monitor your child for associated flair-ups and eliminate those triggers if at all possible. Immediately after bathing pat your child’s skin dry and apply emollients to seal in the moisture. Pay attention to your child’s itching as this will aggravate the skin and cause more itching (Chovatiya, 2023).”

Second Picture

Differential diagnosis: Tinea corpus, contact dermatitis

Further information: Does anyone at home have a similar rash, has the school or daycare reported anyone with a rash, has he had a similar rash in the past?, have their been any recent illnesses?, any animals at home?, have you attempted any treatments?, any recent changes in products used at home?

Plan and education: Clotrimazole 1% twice daily x1-4 weeks.

Caregiver education: “When applying the cream be sure to go a little past the red border. Once the rash has resolved you can stop the ointment. If the rash has not begun improving in two weeks there needs to be a new assessment. This is a fungal infection and contagious. Check your family’s skin to make sure it hasn’t passed on to or from someone. If anyone else has a similar rash they need to be treated by their physician. Your child should stay home from daycare or school for 24 hours after you begin treatment. Don’t allow your child to share linens, clothing, or any other personal items (Leung et al., 2020).”

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