Pediatric DB wk 7: Actinic Keratosis Essay.

Posted: November 5th, 2022

Pediatric DB wk 7: Actinic Keratosis Essay.

CASE STUDY 1 An adolescent presents to your office with a complaint of an itchy, red rash that first appeared on his lower legs 1 week ago after he returned from a camping trip. The rash has since spread to the upper legs, trunk, and groin. He denies fever or other systemic symptoms. Review the DermNet NZ and Dermnet Skin Disease Atlas websites in this week’s Learning Resources. Select one of the four case studies of skin disorders. Analyze the skin disorder in the case you selected including lesion type, lesion distribution, color, and any ancillary findings. Consider 3 differential diagnoses for the skin disorder in the case study you selected. Determine the most likely diagnosis for the patient. Pediatric DB wk 7: Actinic Keratosis Essay.Think about a treatment and management plan for this disorder. Consider appropriate dosages for any recommended treatments. Post an explanation of the skin disorder in the case study you selected. Include in your explanation the lesion type, lesion distribution, color, and any ancillary findings. Then, present 3 differential diagnoses and explain which is the most likely diagnosis for the patient and why. Finally, explain a treatment and management plan for the patient’s skin disorder, including appropriate dosages for any recommended treatments .http://www.dermnetnz.org /http://www.dermnet.com/ ALL RESOURCES HAVE TO BE NO OLDER THAN 5 YEARS AND PEER REVIEWED JOURNAL

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Pediatric DB wk 7: Actinic Keratosis

A Brief Description of Actinic Keratosis

Actinic keratosis (AK) is among the primary causes of dermatologic consultation in most healthcare facilities. AK also referred to solar keratosis can be described as a rough, scaly patch that appears on the skin. In most cases, this condition occurs on the face, ears, lips, back of hands, scalp, forearms, and the neck. Actinic keratosis (AK) is common among fair-skinned individuals (Del Rosso et al, 2014). The size of the rough, scaly skin patch increases gradually. However, it does not result in any other symptoms apart from a small spot or patch that appears on the skin. It takes at least two years for a lesion to develop. A few cases of actinic keratosis lesions become skin cancer if they are not treated on time. AK develops following years of being exposed to the sun. Therefore, the risk of this condition can be reduced by minimizing exposure to the sun thus preventing the skin from ultraviolet (UV) rays. Additionally, this condition can be prevented by wearing clothing, which covers legs and arms. Also, a person should reapply sunscreen after every hour while outdoors to reduce the risk of this condition. AK is common among older adults aged 40 years and above (Mane et al, 2018). However, these symptoms might appear in younger people depending on the climatic conditions of the region. This is the case among individuals living in Florida and California. Actinic keratosis (AK) is usually characterized by grade I and II type lesions (Puviani & Milani, 2018). Grade III lesions are rare and their treatment is generally difficult. The lesion of actinic keratosis (AK) is usually distributed on the face, trunk, and scalp among other extremities. The color of AKs is usually presented as macules or plaques, which turn to color brown later.Pediatric DB wk 7: Actinic Keratosis Essay.

Differential Diagnoses for Actinic Keratosis

Actinic Keratosis requires differential diagnosis due to its clinical features, which are relatively nonspecific. In particular, several features of AK are similar to those of malignant and benign skin conditions such as seborrheic keratosis, atopic dermatitis, discoid lupus erythematosus, and squamous cell carcinoma (SCC).

The first diagnosis involves differentiating the symptoms of AK from those of Squamous cell carcinoma of the scalp. The features of Squamous cell carcinoma of the scalp are similar to those of Actinic Keratosis. It is relatively challenging for healthcare practitioners to differentiate between AK and SCC especially during the last stages of these conditions. In this stage, features of AK such as the increase of erythema, ulceration, thickening, and change in diameter occur. These changes might indicate that the condition is progressing to invasive SCC. The second diagnosis involves differentiating the symptoms of Actinic Keratosis (AK) from those of atopic dermatitis. Cases of Atopic dermatitis among adults are very rare. In most cases, this condition affects people who are below 5 years. The patient experiences an abrupt eczematous, which is characterized by sudden itchiness. Additionally, the patient experiences scaling plaques, ill-defined erythematous, and patches.Pediatric DB wk 7: Actinic Keratosis Essay. Also, chronic lesions are pruritic, they become leathery, dry, and develop a dull red color. In most cases, atopic dermatitis lesions are found in the hands, ankles, feet, wrists, neck, face, and the upper chest. The last diagnosis involves differentiating the symptoms of Actinic Keratosis from those of seborrheic keratosis. In most cases, the lesions of seborrheic keratosis are yellow, tan, grey-brown or black. Just like in the case of AK, the sizes of lesions of seborrheic keratosis lesions vary greatly. Some are a few millimeters while others centimeters wide (Berlin, 2014). They can occur in any part of the body although they commonly appear on the chest, face, back, and, the neck. Although the three differential diagnosis is recommendable, the most likely diagnosis for the patient involves differentiating the symptoms of AK from those of Squamous cell carcinoma. This diagnosis is recommendable since both conditions have similar symptoms. Therefore, clinicians are likely to administer patients with AK medications that are supposed to be used for Squamous cell carcinoma. Nonetheless, despite focusing on clinical presentation, clinicians should consider biopsy either to exclude underlying malignancies or verify the diagnosis.Pediatric DB wk 7: Actinic Keratosis Essay.

Treatment and Management of Actinic Keratosis

Various therapies can be used in the treatment and management of Actinic Keratosis. First, destructive therapies, including surgery, dermabrasion, cryotherapy, and photodynamic therapy [PDT]) are used to treat patients with Actinic Keratosis (AK). The photosensitizing agent is in particular used in the case of PDT (Chetty, Choi & Mitchell, 2015). It is usually used with exposing the skin to a designated light source subsequently. Topical medications, including topical fluorouracil, ingenol mebutate, imiquimod, diclofenac are also used in the treatment of AK. This type of medication is used to treat both subclinical and clinically evident AKs cases (Del Rosso et al, 2014). Furthermore, field ablation treatments such as chemical peels and laser resurfacing are used to manage the condition. Finally, PS cream and RC gel are used to treat AK. They are applied twice a day for 2 consecutive days weekly. They are applied to the AK lesion using a finger-tip. Generally, treatments that are directed to the lesion like cryotherapy and surgical procedures are primarily used to treat isolated lesions

Pediatric DB wk Poison IVY

A Brief Description of Poison IVY

Poison IVY, which is also known as contact dermatitis is among the major causes of dermatologic consultation in most healthcare facilities in North America. Contact dermatitis can be described as a major inflammatory skin condition in which patients present pruritic skin and erythematous lesions after contact with substances that trigger an allergic reaction (Fonacier et al, 2015). Contact dermatitis occurs in two forms: Allergic and irritant. A skin irritation triggered by non–immune-modulated substances is the primary cause of irritant dermatitis. On the other hand, allergic contact dermatitis is a type of hypersensitivity reaction, which is delayed upon coming into contact with a foreign substance. Re-exposure to the foreign substance leads to a drastic change to the skin.Pediatric DB wk 7: Actinic Keratosis Essay.

Poison IVY, which is also called Toxicodendron radicans, is among the cashew crops that are grown in North America that produces oily resin known as urushiol. Approximately, 85% of the total population in America have an allergic reaction to poison ivy (Fonacier et al, 2015). These individuals develop a rash upon coming into contact with the plant. The other 15% of the population do not have an allergic reaction to this plant. Nonetheless, people are advised to keep off from the shrub since repeated exposure raises the chances of allergic reactions. An individual can react to poison IVY after coming into contact with the plant, upon touching objects that have been contaminated with this plant as well as inhaling the smoke that is produced when poison ivy is burned. Nonetheless, breathing smoke from a burning poison IVY is the most dangerous contamination. In most cases, the rash appears within 1 to 3 days after a person has been exposed to the plant. The time frame depends on the sensitivity of an individual to the shrub (Fonacier & Sher, 2014). The rash appears within a short time frame if a person is sensitive to poison ivy and vice versa. Poison Ivy rash is characterized by an intense itching, red skin, red bumps that are known as papules, blisters that form in lines and ooze, swelling, and crusting skin. The poison IVY rash is not contagious. In addition, it does not spread to other parts of the body. Appearing to other parts of the body is due to further contact with contaminated objects or delayed reaction. Contact dermatitis is characterized by entirely lacking linear lesions that are distributed to various parts of the skin.Pediatric DB wk 7: Actinic Keratosis Essay.

Differential Diagnoses for Poison IVY

Poison IVY requires differential diagnosis due to its clinical features, which are relatively nonspecific. In particular, several features of poison IVY resembles those of atopic dermatitis,

The first diagnosis involves differentiating poison IVY from atopic dermatitis since both conditions have similar clinical presentations. However, some features of Atopic dermatitis make it different from poison IVY. In most cases, Atopic dermatitis affects people who are below 5 years. The patient experiences an abrupt eczematous, which is characterized by sudden itchiness. Additionally, the patient experiences scaling plaques, ill-defined erythematous, and patches. Also, chronic lesions are pruritic, they become leathery, dry, and develop a dull red colour. In most cases, atopic dermatitis lesions are found in the hands, ankles, feet, wrists, neck, face, and the upper chest. Finally, Atopic dermatitis tends to spread widely than contact dermatitis and flexor surfaces are involved in its distribution (Thomsen, 2014).Pediatric DB wk 7: Actinic Keratosis Essay.

Secondly, contact dermatitis would be differentiated from Dyshidrotic eczema. Just like contact dermatitis, poison IVY is characterized by itching and redness (Agarwal et al, 2014). However, this condition is different from contact dermatitis since it mainly appears on the feet and hands. Additionally, Dyshidrotic eczema is characterized by deep-seated and clear vesicles resembling. The last diagnosis involves differentiating contact dermatitis from inverse psoriasis. Just like in contact dermatitis, patients with present itchiness. However, the two conditions differ from each other. Unlike in contact dermatitis, inverse psoriasis is characterized by well-demarcated erythema, which occurs in the intertriginous area. The most likely diagnosis for the patient is contact dermatitis. Contact dermatitis is characterized by itchiness and redness, which were the major clinical presentation of the patient.Pediatric DB wk 7: Actinic Keratosis Essay.

Treatment and Management of Contact Dermatitis

Various therapies can be used in the treatment and management of contact dermatitis. First, the management of contact dermatitis involves avoiding the causative substance. Additionally, the patient can soothe the symptoms using cool compresses in the case of acute contact dermatitis. Also, acute cases contact dermatitis can be soothed using colloidal oatmeal baths and calamine lotion. High or mild-potency topical steroids including clobetasol 0.05% and triamcinolone 0.1% are used to treat lesions of mild acute allergic contact dermatitis lesions (Goldenberg et al, 2015). Additionally, lower-potency steroids, including desonide ointment are used to treat contact dermatitis in regions with thinner skin such as eyelids and anogenital area.Pediatric DB wk 7: Actinic Keratosis Essay.

Allergic contact dermatitis affects an extensive region of the skin (over 20 percent). Systemic steroid therapy is usually used in this type of contact dermatitis. It gives relief to the patient within between 12 and 24 hours. Furthermore, the prednisone 5 mg for five days can be recommended to the patient. The dose can be reduced if the symptoms of the condition are minimized after the first therapy. The severity and period of contact will determine how the dosage will be reduced.

Pediatric DB wk 7: Actinic Keratosis Essay.