By Mary Jo Goolsby, Laurie Grubbs
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The diagnosis is typically evident based on the appearance of the lesion and history. However, skin scraping will reveal the hyphae. Copyright © 2006 F. A. Davis. 30 Advanced Assessment and Differential Diagnosis by Body Regions and Systems PITYRIASIS ROSEA (PLATE 21) Pityriasis rosea is believed to be caused by a virus. It is most common in the spring and autumn. Signs and Symptoms. The patient is usually asymptomatic, although some complain of a prodromal period of malaise preceding the emergence of the rash.
Lymphadenopathy is absent. Without treatment, the lesions can become chronic, with prolonged drainage, and/or scarring. Diagnostic Studies. None are usually indicated, but CBC and blood chemistries and blood glucose may be ordered to assess contributing factors. URTICARIA (PLATE 28) Urticaria, also commonly called “hives,” involves a histamine-mediated response that can be either acute or chronic. A wide range of situations are known to be associated with hives, including a variety of infections, foods, and medications.
MELANOMA (PLATE 18) Malignant melanomas are responsible for most skin cancer–related deaths each year. Most arise in sites without prior hyperpigmentation, but some do arise from previously pigmented sites. The risk is increased among fair-skinned persons with extensive sun exposure, persons with a family history of melanoma, and persons who have had previous changes in moles. Signs and Symptoms. Usually patients present with a history of a changing mole or other area of hyperpigmentation. 5 cm in diameter, has notched or irregular edges, irregular pigmentation, and asymmetry of shape.
Advanced Assessment-Interpreting Findings and Formulating Different Diagnosis by Mary Jo Goolsby, Laurie Grubbs