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i-Human Case Week 4 & 8: 13-Year-Old Female - Reason for Encounter: Itchy Skin (Pruritis) | H&P + Dx Comprehensive Case Study 2026

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This comprehensive study guide covers the i-Human virtual case for a 13-year-old female with chronic pruritus. It includes a full HPI, physical exam findings, differential diagnosis rationales, and an evidence-based treatment plan for Atopic Dermatitis. Perfect for nursing students mastering clinical reasoning and SOAP note documentation.

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i-Human Case Week 4 & 8: 13-Year-Old Female - Reason for Encounter: Itchy Skin (Pruritis) | H&P
+ Dx Comprehensive Case Study 2026

,i-Human Case Week 4 & 8: 13-Year-Old Female - Reason for Encounter: Itchy Skin (Pruritis) | H&P
+ Dx Comprehensive Case Study 2026


i-Human Case Study
13-Year-Old Female – Chief Complaint: Itchy Skin
(Pruritus)


1. Identifying Information
• Name: [Patient Initials]
• Age: 13 years
• Sex: Female
• Source: Patient + parent (reliable)




2. Chief Complaint (CC)
“My skin has been really itchy for the past few weeks.”




3. History of Present Illness (HPI)
13-year-old female presents with generalized itching for ~2–4 weeks.

Use OLDCARTS framework:

• Onset: Gradual
• Location: Initially arms → now generalized (arms, legs, trunk)
• Duration: Persistent, worse at night
• Character: Intense itching, sometimes burning after scratching
• Aggravating factors: Heat, sweating, nighttime
• Relieving factors: Temporary relief with scratching or cool showers
• Timing: Worse at night
• Severity: 7/10

Associated Symptoms:

• Rash (yes/no depending on case variation)
• Dry skin
• Excoriations from scratching
• Possible sleep disturbance

Pertinent Negatives:

,i-Human Case Week 4 & 8: 13-Year-Old Female - Reason for Encounter: Itchy Skin (Pruritis) | H&P
+ Dx Comprehensive Case Study 2026

• No fever
• No weight loss
• No jaundice
• No recent illness
• No new medications (or specify if present)




4. Past Medical History (PMH)
• Possible history of:
o Atopic dermatitis (eczema)
o Allergies (seasonal, food)
• No chronic systemic illness




5. Medications
• OTC creams or antihistamines (if used)
• No new medications (important for drug reaction)




6. Allergies
• NKDA or specify (e.g., soaps, detergents, foods)




7. Family History
• Atopy (eczema, asthma, allergic rhinitis)
• Skin conditions




8. Social History
• Lives with family
• School-going
• Hygiene habits
• Possible exposure:
o New soaps/detergents
o Pets
o Close contacts with similar symptoms (important for scabies)

, i-Human Case Week 4 & 8: 13-Year-Old Female - Reason for Encounter: Itchy Skin (Pruritis) | H&P
+ Dx Comprehensive Case Study 2026




9. Review of Systems (ROS)
Positive:

• Skin: itching, dryness, rash

Negative:

• Constitutional: no fever, fatigue
• GI: no abdominal pain
• Hepatic: no jaundice
• Endocrine: no heat/cold intolerance




10. Physical Examination
Vitals

• Normal

General

• Alert, mildly uncomfortable due to itching

Skin

Findings depend on diagnosis but may include:

• Dry, scaly skin
• Erythematous patches
• Excoriations
• Possible:
o Flexural involvement → eczema
o Burrows/web spaces → scabies
o Urticarial wheals → allergy

Other Systems

• Normal (important to rule out systemic disease)




Differential Diagnosis

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