i-Human Week 4 Case Study Notes: 13-
Year-Old Female with Itchy Skin
Introduction
This document provides a comprehensive set of
notes for the Week 4 i-Human case study of a 13-
year-old female presenting with itchy skin. It covers
all critical domains of clinical reasoning including
the History of Present Illness (HPI), Physical
Examination findings, Differential Diagnosis,
Diagnostics, and Management Plan. The structured
approach detailed below aims to guide students in
thorough assessment and management of pediatric
patients with dermatological complaints.
History of Present Illness (HPI)
The HPI is key to understanding the underlying
causes and context of the itchy skin complaint. When
gathering history, focus on the following elements:
Chief complaint: Document the patient's
primary concern is itchy skin (pruritus).
Onset: Determine when the itch started (acute
versus chronic).
Duration and course: Ask how long symptoms
have persisted and whether they are continuous,
intermittent, or worsening over time.
, Characteristics: Inquire about the itch severity,
distribution (localized or generalized), and if
there are visible skin changes.
Associated symptoms: Include presence of
rash, redness, swelling, pain, or systemic signs
like fever or fatigue.
Aggravating or relieving factors: Identify
triggers such as soaps, detergents, environmental
exposure, heat, sweating, or stress; also note if
any treatments or home remedies relieve
symptoms.
Previous episodes and treatments: Check for
past occurrences, prior diagnoses, and
medication use.
Personal and family history: Look for history
of atopy including eczema, asthma, allergic
rhinitis, or psoriasis in the patient or family
members.
Social and environmental factors: Exposure to
pets, new detergents, recent travel, or school-
related issues.
Review of systems: Perform a brief ROS to
identify systemic complaints that could indicate
underlying systemic disease (e.g., liver or
kidney disease).
Physical Examination
The physical exam should be focused but thorough,
encompassing skin assessment and systemic
Year-Old Female with Itchy Skin
Introduction
This document provides a comprehensive set of
notes for the Week 4 i-Human case study of a 13-
year-old female presenting with itchy skin. It covers
all critical domains of clinical reasoning including
the History of Present Illness (HPI), Physical
Examination findings, Differential Diagnosis,
Diagnostics, and Management Plan. The structured
approach detailed below aims to guide students in
thorough assessment and management of pediatric
patients with dermatological complaints.
History of Present Illness (HPI)
The HPI is key to understanding the underlying
causes and context of the itchy skin complaint. When
gathering history, focus on the following elements:
Chief complaint: Document the patient's
primary concern is itchy skin (pruritus).
Onset: Determine when the itch started (acute
versus chronic).
Duration and course: Ask how long symptoms
have persisted and whether they are continuous,
intermittent, or worsening over time.
, Characteristics: Inquire about the itch severity,
distribution (localized or generalized), and if
there are visible skin changes.
Associated symptoms: Include presence of
rash, redness, swelling, pain, or systemic signs
like fever or fatigue.
Aggravating or relieving factors: Identify
triggers such as soaps, detergents, environmental
exposure, heat, sweating, or stress; also note if
any treatments or home remedies relieve
symptoms.
Previous episodes and treatments: Check for
past occurrences, prior diagnoses, and
medication use.
Personal and family history: Look for history
of atopy including eczema, asthma, allergic
rhinitis, or psoriasis in the patient or family
members.
Social and environmental factors: Exposure to
pets, new detergents, recent travel, or school-
related issues.
Review of systems: Perform a brief ROS to
identify systemic complaints that could indicate
underlying systemic disease (e.g., liver or
kidney disease).
Physical Examination
The physical exam should be focused but thorough,
encompassing skin assessment and systemic
