Comprehensive i-Human Virtual Patient Case (2026):
Evaluation and Evidence-Comprehensive i-Human
Virtual Patient Case (2026): Evaluation and Evidence-
Based Management of a NewOnset Rash, Integrating
History, Physical Examination, Differential Diagnosis,
T
,Comprehensive i-Human Virtual Patient Case (2026): New-Onset Rash
1. Patient Introduction
• Patient Name: [Patient Name Redacted]
• Age/Sex: 24-year-old female
• Chief Complaint: “I have a rash that just appeared on my arms and trunk.”
• Setting: Outpatient clinic with laboratory capabilities
• Presenting Context: Patient noticed a sudden red rash over the past 3 days. Denies prior
episodes. No known allergies.
2. History of Present Illness (HPI)
• Onset: Acute, 3 days ago
• Location: Arms, trunk, some spreading to legs
• Duration: Persistent since onset
• Character: Red, raised, mildly itchy patches
• Associated Symptoms: Mild pruritus, occasional low-grade fever (100.4°F), fatigue
• Exacerbating/Relieving Factors: No clear triggers; minimal relief with moisturizers
• Recent Exposures: New detergent, recent hiking, possible tick exposure
• Medications: OTC ibuprofen occasionally for headaches; no new medications
• Past Medical History: Healthy; no chronic illnesses
• Family History: No history of eczema, psoriasis, or autoimmune disease
• Social History: Non-smoker, social alcohol use, lives with roommate, works in an office
• Review of Systems (relevant):
o Skin: Rash as above, no blisters or oozing
o Constitutional: Fatigue, low-grade fever
o Musculoskeletal: No joint pain
o Respiratory/ENT: No sore throat, cough
, o GI: No nausea, vomiting, diarrhea
3. Focused Physical Examination
• General: Alert, mildly uncomfortable due to itching, afebrile at exam
• Vital Signs: T 100.2°F, BP 112/70 mmHg, HR 78 bpm, RR 16/min, SpO₂ 98%
• Skin:
o Distribution: Symmetric, trunk and proximal extremities
o Morphology: Erythematous maculopapular patches, some confluent
o Surface: Slightly raised, non-vesicular, non-purulent
o Borders: Well-defined
o Other: No mucosal involvement, no lymphadenopathy
• HEENT: No conjunctival injection, oral mucosa clear
• Cardiac/Respiratory/Abdomen: Normal
• Musculoskeletal: No joint swelling or tenderness
4. Differential Diagnosis Table
Condition Key Features Supporting Features Against Notes
Common in young
Viral Exanthem (e.g., Acute onset, symmetric, mild No prodrome, no
adults; often self-
Parvovirus B19, EBV) fever, maculopapular pharyngitis
limited
Drug Reaction / Acute onset, pruritus, No new meds; no recent Consider OTC or
Allergic Exanthem symmetric antibiotics herbal agents
Pruritus, recent exposure to Widespread, not Could be delayed-type
Contact Dermatitis
new detergent localized to contact area reaction
Usually post-
Acute rash, trunk No scaling, no prior
Psoriasis (guttate type) infectious in young
involvement history
adults
Symmetric rash, No genital lesion, low- Rare but considered if
Secondary Syphilis
trunk/extremities risk sexual history risk factors present
Evaluation and Evidence-Comprehensive i-Human
Virtual Patient Case (2026): Evaluation and Evidence-
Based Management of a NewOnset Rash, Integrating
History, Physical Examination, Differential Diagnosis,
T
,Comprehensive i-Human Virtual Patient Case (2026): New-Onset Rash
1. Patient Introduction
• Patient Name: [Patient Name Redacted]
• Age/Sex: 24-year-old female
• Chief Complaint: “I have a rash that just appeared on my arms and trunk.”
• Setting: Outpatient clinic with laboratory capabilities
• Presenting Context: Patient noticed a sudden red rash over the past 3 days. Denies prior
episodes. No known allergies.
2. History of Present Illness (HPI)
• Onset: Acute, 3 days ago
• Location: Arms, trunk, some spreading to legs
• Duration: Persistent since onset
• Character: Red, raised, mildly itchy patches
• Associated Symptoms: Mild pruritus, occasional low-grade fever (100.4°F), fatigue
• Exacerbating/Relieving Factors: No clear triggers; minimal relief with moisturizers
• Recent Exposures: New detergent, recent hiking, possible tick exposure
• Medications: OTC ibuprofen occasionally for headaches; no new medications
• Past Medical History: Healthy; no chronic illnesses
• Family History: No history of eczema, psoriasis, or autoimmune disease
• Social History: Non-smoker, social alcohol use, lives with roommate, works in an office
• Review of Systems (relevant):
o Skin: Rash as above, no blisters or oozing
o Constitutional: Fatigue, low-grade fever
o Musculoskeletal: No joint pain
o Respiratory/ENT: No sore throat, cough
, o GI: No nausea, vomiting, diarrhea
3. Focused Physical Examination
• General: Alert, mildly uncomfortable due to itching, afebrile at exam
• Vital Signs: T 100.2°F, BP 112/70 mmHg, HR 78 bpm, RR 16/min, SpO₂ 98%
• Skin:
o Distribution: Symmetric, trunk and proximal extremities
o Morphology: Erythematous maculopapular patches, some confluent
o Surface: Slightly raised, non-vesicular, non-purulent
o Borders: Well-defined
o Other: No mucosal involvement, no lymphadenopathy
• HEENT: No conjunctival injection, oral mucosa clear
• Cardiac/Respiratory/Abdomen: Normal
• Musculoskeletal: No joint swelling or tenderness
4. Differential Diagnosis Table
Condition Key Features Supporting Features Against Notes
Common in young
Viral Exanthem (e.g., Acute onset, symmetric, mild No prodrome, no
adults; often self-
Parvovirus B19, EBV) fever, maculopapular pharyngitis
limited
Drug Reaction / Acute onset, pruritus, No new meds; no recent Consider OTC or
Allergic Exanthem symmetric antibiotics herbal agents
Pruritus, recent exposure to Widespread, not Could be delayed-type
Contact Dermatitis
new detergent localized to contact area reaction
Usually post-
Acute rash, trunk No scaling, no prior
Psoriasis (guttate type) infectious in young
involvement history
adults
Symmetric rash, No genital lesion, low- Rare but considered if
Secondary Syphilis
trunk/extremities risk sexual history risk factors present
