Alicia Smiley Clinical Case Study: Differential Diagnosis of
Pediatric Pruritus
Comprehensive Pediatric Case Study
1. Patient Demographics & Identifying Data
• Initials: A.S.
• Name: Alicia Smiley
• Age: 13 years
• Gender: Female
• Ethnicity: White
• Height: 5'2" (157 cm)
, • Weight: 104 lb (47.3 kg)
• Occupation: Eighth-grade student
• Living Situation: Lives with her parents and older brother
in a suburban home. The family has a pet rabbit. No
smokers in the household.
• Source of Information: Patient and mother; both are
reliable historians.
2. Chief Complaint (CC)
"I have a painful red bump on my left arm that keeps getting
bigger."
3. History of Present Illness (HPI) – OLD CARTS
Onset
The patient noticed a small, tender bump on her left forearm 4
days ago after what she believed was an insect bite while
gardening.
Location
The lesion is located on the left forearm.
Duration
, The lesion has gradually enlarged over the past four days and
has become increasingly painful.
Characteristics
The patient describes the lesion as red, swollen, warm, and
throbbing. She reports a small amount of yellow drainage this
morning.
Aggravating Factors
• Touching the affected area
• Moving the arm
• Wearing long sleeves that rub against the lesion
Relieving Factors
• Warm compresses
• Rest
• Keeping the arm elevated
Treatment
Mother applied an over-the-counter antibiotic ointment and
warm compresses twice daily. The patient took acetaminophen
for pain with partial relief.
Severity
• Pain: 7/10
Pediatric Pruritus
Comprehensive Pediatric Case Study
1. Patient Demographics & Identifying Data
• Initials: A.S.
• Name: Alicia Smiley
• Age: 13 years
• Gender: Female
• Ethnicity: White
• Height: 5'2" (157 cm)
, • Weight: 104 lb (47.3 kg)
• Occupation: Eighth-grade student
• Living Situation: Lives with her parents and older brother
in a suburban home. The family has a pet rabbit. No
smokers in the household.
• Source of Information: Patient and mother; both are
reliable historians.
2. Chief Complaint (CC)
"I have a painful red bump on my left arm that keeps getting
bigger."
3. History of Present Illness (HPI) – OLD CARTS
Onset
The patient noticed a small, tender bump on her left forearm 4
days ago after what she believed was an insect bite while
gardening.
Location
The lesion is located on the left forearm.
Duration
, The lesion has gradually enlarged over the past four days and
has become increasingly painful.
Characteristics
The patient describes the lesion as red, swollen, warm, and
throbbing. She reports a small amount of yellow drainage this
morning.
Aggravating Factors
• Touching the affected area
• Moving the arm
• Wearing long sleeves that rub against the lesion
Relieving Factors
• Warm compresses
• Rest
• Keeping the arm elevated
Treatment
Mother applied an over-the-counter antibiotic ointment and
warm compresses twice daily. The patient took acetaminophen
for pain with partial relief.
Severity
• Pain: 7/10
