,Patient Information
Name: Emma Carter
Age: 14 years
Gender: Female
Setting: Primary Care Outpatient Clinic with Laboratory
Capabilities
Chief Complaint: Bumps on face
Date of Visit: July 17, 2025
History of Present Illness (HPI):
Emma Carter, a 14-year-old Caucasian female, presents to the primary
care clinic accompanied by her mother with a 6-month history of
"bumps on her face" that have worsened over the past 2 months. She
describes the bumps as red, inflamed lesions with occasional
whiteheads, primarily on her forehead, cheeks, and chin, causing self-
consciousness and mild discomfort (rated 3/10 when inflamed). Emma
reports the lesions are persistent, with new bumps appearing weekly,
and some resolve with scarring. She denies pain, itching, or bleeding
but notes increased oiliness of her skin and exacerbation during
menstruation (last menstrual period 1 week ago, regular 28-day cycles
, since menarche at age 12). She has tried over-the-counter (OTC)
benzoyl peroxide 2.5% wash (used irregularly, ~2-3 times/week) with
minimal improvement. Emma denies fever, systemic symptoms, or
similar lesions elsewhere on the body (e.g., chest, back). She reports no
recent changes in diet, skincare products, or medications, but her
mother notes Emma frequently touches her face and uses heavy
makeup to cover the bumps, potentially worsening the condition.
Emma is distressed about her appearance, stating, “I hate how my face
looks, and kids at school notice.” Her mother is concerned about
scarring and seeks effective treatment. No recent stressors, bullying, or
significant psychosocial issues are reported, though Emma admits to
feeling embarrassed during school photos.Explanation of HPI:
The HPI focuses on characterizing the facial bumps to guide diagnosis.
The 6-month duration, distribution (forehead, cheeks, chin), and
description (red papules, whiteheads, scarring) strongly suggest acne
vulgaris, a common condition in adolescents due to hormonal changes
during puberty (AAD, 2024). Exacerbation during menstruation
indicates hormonal influence, increasing sebum production and
follicular occlusion. Irregular use of benzoyl peroxide and makeup
application are common aggravating factors, while scarring raises
concern for moderate acne severity. The absence of systemic
symptoms (fever, weight loss) or lesions elsewhere reduces suspicion
Name: Emma Carter
Age: 14 years
Gender: Female
Setting: Primary Care Outpatient Clinic with Laboratory
Capabilities
Chief Complaint: Bumps on face
Date of Visit: July 17, 2025
History of Present Illness (HPI):
Emma Carter, a 14-year-old Caucasian female, presents to the primary
care clinic accompanied by her mother with a 6-month history of
"bumps on her face" that have worsened over the past 2 months. She
describes the bumps as red, inflamed lesions with occasional
whiteheads, primarily on her forehead, cheeks, and chin, causing self-
consciousness and mild discomfort (rated 3/10 when inflamed). Emma
reports the lesions are persistent, with new bumps appearing weekly,
and some resolve with scarring. She denies pain, itching, or bleeding
but notes increased oiliness of her skin and exacerbation during
menstruation (last menstrual period 1 week ago, regular 28-day cycles
, since menarche at age 12). She has tried over-the-counter (OTC)
benzoyl peroxide 2.5% wash (used irregularly, ~2-3 times/week) with
minimal improvement. Emma denies fever, systemic symptoms, or
similar lesions elsewhere on the body (e.g., chest, back). She reports no
recent changes in diet, skincare products, or medications, but her
mother notes Emma frequently touches her face and uses heavy
makeup to cover the bumps, potentially worsening the condition.
Emma is distressed about her appearance, stating, “I hate how my face
looks, and kids at school notice.” Her mother is concerned about
scarring and seeks effective treatment. No recent stressors, bullying, or
significant psychosocial issues are reported, though Emma admits to
feeling embarrassed during school photos.Explanation of HPI:
The HPI focuses on characterizing the facial bumps to guide diagnosis.
The 6-month duration, distribution (forehead, cheeks, chin), and
description (red papules, whiteheads, scarring) strongly suggest acne
vulgaris, a common condition in adolescents due to hormonal changes
during puberty (AAD, 2024). Exacerbation during menstruation
indicates hormonal influence, increasing sebum production and
follicular occlusion. Irregular use of benzoyl peroxide and makeup
application are common aggravating factors, while scarring raises
concern for moderate acne severity. The absence of systemic
symptoms (fever, weight loss) or lesions elsewhere reduces suspicion
