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iHuman Clinical Case Study: Adult Patient with Pruritic Rash – Differential Diagnosis and Management

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This iHuman case study focuses on a 36-year-old patient presenting with an intensely itchy, erythematous rash in an outpatient setting. Designed to strengthen clinical reasoning and diagnostic skills, the case guides learners through systematic history taking, focused physical examination, and development of a differential diagnosis—including contact dermatitis, atopic eczema, fungal infection, and scabies. Includes a complete SOAP note, evidence-based treatment plan with topical steroids and antihistamines, patient education strategies, and follow-up recommendations. Ideal for medical, nursing, and physician assistant students preparing for dermatology-related OSCEs, clinical rotations, or board-style assessments.

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Uploaded on
January 5, 2026
Number of pages
8
Written in
2025/2026
Type
Exam (elaborations)
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IHUMAN CASE STUDY WEEK 2: 6531 – ITCHY
RASH IN A 36-YEAR-OLD PATIENT




1|Page

, Patient Profile

• Age: 36 years

• Gender: Adult patient

• Chief Complaint (CC): “I have an itchy rash.”

• Setting: Outpatient / Primary care



History of Present Illness (HPI)

The patient presents with an itchy skin rash that began several days to weeks ago.

Key HPI details:

• Onset: Gradual

• Duration: Persistent

• Location: Commonly affects exposed areas (arms, hands, trunk, neck depending on case
path)

• Character: Pruritic (intensely itchy), erythematous rash

• Severity: Moderate to severe itching

• Timing: Worse at night or after sweating

• Associated symptoms:

o Redness

o Dry or scaly skin

o Possible excoriations from scratching

• Aggravating factors:

o Heat

o New soaps, detergents, lotions

o Environmental exposure

• Relieving factors:

o Avoiding irritants

o Temporary relief with topical creams

Denies:

• Fever

• Chills

• Shortness of breath


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