,Patient Information
Name: Emily Chen (per iHuman case documentation)
Age: 25 years
Gender: Female
Height: 5’4” (162.6 cm, approximately 50th percentile for age)
Weight: 130 lb (59 kg, BMI 22.3 kg/m², normal range)
Reason for Encounter: New-onset rash for 1 week, presenting to a
primary care clinic in 2024 for evaluation.
History of Present Illness
Emily Chen, a 25-year-old female, presents to the primary care clinic
with a chief complaint of a new rash that began 1 week ago. She
describes the rash as red, raised, and intensely itchy, primarily located
on her arms, legs, and trunk. The rash started on her forearms and has
spread to her thighs, abdomen, and lower back. She rates the itching as
7/10, worse at night, leading to disrupted sleep and visible scratch
marks. She reports no pain, burning, or oozing from the lesions, and no
fever, chills, or systemic symptoms. The patient denies recent travel,
known exposure to allergens, new foods, or changes in soaps,
detergents, or cosmetics. She started a new medication, amoxicillin, 2
weeks ago for a sinus infection, which resolved, and she completed the
, 10-day course 4 days ago. She notes mild swelling around the rash sites
but no facial swelling, difficulty breathing, or throat tightness.
Associated symptoms include mild fatigue, which she attributes to poor
sleep due to itching, and occasional headaches, which are not new and
are managed with over-the-counter ibuprofen. She denies joint pain,
muscle aches, gastrointestinal symptoms, or urinary changes. Emily
reports a history of seasonal allergies (pollen) but no previous rashes or
skin conditions. She is concerned about the rash’s appearance and
persistence, as well as its impact on her sleep and daily activities as a
graduate student. Medical History
Past Medical History:
Seasonal allergic rhinitis, managed with over-the-counter
cetirizine as needed during spring and fall.
Sinus infection 2 weeks ago, treated with amoxicillin 500 mg
three times daily for 10 days.
No history of eczema, psoriasis, asthma, or autoimmune
diseases.
No history of hospitalizations or surgeries.
Name: Emily Chen (per iHuman case documentation)
Age: 25 years
Gender: Female
Height: 5’4” (162.6 cm, approximately 50th percentile for age)
Weight: 130 lb (59 kg, BMI 22.3 kg/m², normal range)
Reason for Encounter: New-onset rash for 1 week, presenting to a
primary care clinic in 2024 for evaluation.
History of Present Illness
Emily Chen, a 25-year-old female, presents to the primary care clinic
with a chief complaint of a new rash that began 1 week ago. She
describes the rash as red, raised, and intensely itchy, primarily located
on her arms, legs, and trunk. The rash started on her forearms and has
spread to her thighs, abdomen, and lower back. She rates the itching as
7/10, worse at night, leading to disrupted sleep and visible scratch
marks. She reports no pain, burning, or oozing from the lesions, and no
fever, chills, or systemic symptoms. The patient denies recent travel,
known exposure to allergens, new foods, or changes in soaps,
detergents, or cosmetics. She started a new medication, amoxicillin, 2
weeks ago for a sinus infection, which resolved, and she completed the
, 10-day course 4 days ago. She notes mild swelling around the rash sites
but no facial swelling, difficulty breathing, or throat tightness.
Associated symptoms include mild fatigue, which she attributes to poor
sleep due to itching, and occasional headaches, which are not new and
are managed with over-the-counter ibuprofen. She denies joint pain,
muscle aches, gastrointestinal symptoms, or urinary changes. Emily
reports a history of seasonal allergies (pollen) but no previous rashes or
skin conditions. She is concerned about the rash’s appearance and
persistence, as well as its impact on her sleep and daily activities as a
graduate student. Medical History
Past Medical History:
Seasonal allergic rhinitis, managed with over-the-counter
cetirizine as needed during spring and fall.
Sinus infection 2 weeks ago, treated with amoxicillin 500 mg
three times daily for 10 days.
No history of eczema, psoriasis, asthma, or autoimmune
diseases.
No history of hospitalizations or surgeries.
