You have a patient that is clearly suffering from contact dermatitis. Select the questions you would ask to distinguish between allergic and irritant dermatitis.
"How long did it take for the rash to develop?"
"How long have you had the rash for?"
"Do you have a family history of allergies?"
"Do you have eczema?"
"Do you work in a profession that requires frequent handwashing?"
You have a male patient in your emergency room with painful redness, swelling, bullae, dry skin, and flaking on his face and eyelids, with particular concentration of symptoms on his cheeks. Which of the following questions would you ask this patient?
"Have you recently tried any new cosmetics, skin care products, or hair care products?"
"Have you recently tried any new colognes?"
"Have you recently tried any new toothpastes or mouth washes?"
"Have you recently tried any new moisturizers?"
A young, female patient is concerned because she has newly formed lesions on her lips and mouth. She thinks she may have gotten herpes from somebody. Some of the bullae on her lips and in her mouth have ruptured and crusted over, and she informs you that they are incredibly itchy.
Select the questions you may ask this young lady.
"Have you recently tried any new toothpastes, mouthwashes, foods, or medications?"
"Have you gone to the dentist recently?"
"Have you tried any new lipsticks, lip glosses, or lip liners lately?"
"Have you engaged in any sexually promiscuous behaviors in the last few months?"
"Have you tried any new skin care products?"
An adolescent female patient is in your office for a routine check up. She is concerned and upset because she woke up with a painful, red, dry, scaly rash on her neck, both of her ear lobes, and left wrist.
Which of the following questions do you ask her?
"Did you go to bed wearing any jewelry?"
"Have you tried any new moisturizers recently?"
"Have you put on a new sunscreen recently?"
"Have you been prescribed any new medications?"
A mother is concerned because her son broke out in these huge, red, itchy welts all over his arms, legs, and torso this morning. Select the questions you would ask this mother.
"Have you tried any new soaps on your son in the last 3 days?"
"Have you put any new brands on sunscreen on your son in the last 3 days?"
"Have you used any new lotions on your son in the last 3 days?"
"Have you tried any new shampoos or conditioners on your son in the last 3 days?"
"Have you purchased for your son any clothing with metal snaps or belt buckles?"
Your neighbor comes over to your house concerned because of her son's allergy test tomorrow. She tells you he's getting a patch test, and she's scared that it will cause him a lot of unnecessary pain. Select an appropriate response you can make to your neighbor.
"It may be slightly painful. All they're going to do is put patches on your son's back to test for reactions."
"It may be slightly painful. They are assessing for patches of allergic reaction by placing allergens on your son's back and then using a needle to get the allergen under the skin.
"It may be slightly painful. They are testing for patches of allergic reaction by injecting small amounts of allergen into the skin on the arm.
"Has your son had any life-threatening allergic reactions? Or does he have large amounts of contact dermatitis? Because if so, your son shouldn't undergo this test."
A person undergoing a patch test can still shower.
Intense burning, itching, and discomfort is not a reason for patch removal, as it is normal for this type of testing.
Your patient breaks out in a full body (torso, arms, legs, neck) that you identify as allergic contact dermatitis. He is complaining about how badly it itches, stating that it reminds him of when he had the chicken pox as a kid.
Select appropriate pharmacologic interventions to enact for this patient
Apply a wet dressing to the area.
Apply a cool compress of Burow solution to blisters 3-4 times a day.
Administer diphenhydramine every 4 hrs, PRN.
Apply topical betamethasone at the beginning and end of the shift.
Administer 0.75 mg of dexamethasone BID
You are father ways to prevent and treat allergic contact dermatitis in his son. Which of the following statements made by the father shows that teaching has been received?
"Signs of allergic contact dermatitis include painful redness, swelling, dryness, scaliness, and cracking of the skin."
"Allergic contact dermatitis will present within 24 hours of exposure.
"If my son gets a reaction, we should make sure he bathes daily and use strong soaps to wash the skin."
"If my son gets a reaction, we shouldn't use any moisturizers, lotions, or lubricants on the skin because they may exasperate the condition."
"I should wash my son's clothing with a mild detergent, rinse twice, and not use fabric softener."
"It is best to not mess with the areas of redness on his skin, no matter how itchy and uncomfortable they are."
