Assignment: CC/HOPI: A 13-year-old girl complains about zits on her face and shoulders. She has tried over-the-counter benzoyl peroxide for 2 months to no avail, and has stopped eating chocolate and French fries on her mother’s advice. She states that she tries to wash her face three times a day with soap. She has been invited to an upcoming school dance and wants to look her best. She complains about blackheads, but also lesions that are deep and painful

Assignment: CC/HOPI: A 13-year-old girl complains about zits on her face and shoulders. She has tried over-the-counter benzoyl peroxide for 2 months to no avail, and has stopped eating chocolate and French fries on her mother’s advice. She states that she tries to wash her face three times a day with soap. She has been invited to an upcoming school dance and wants to look her best. She complains about blackheads, but also lesions that are deep and painful

Assignment: CC/HOPI: A 13-year-old girl complains about zits on her face and shoulders. She has tried over-the-counter benzoyl peroxide for 2 months to no avail, and has stopped eating chocolate and French fries on her mother’s advice. She states that she tries to wash her face three times a day with soap. She has been invited to an upcoming school dance and wants to look her best. She complains about blackheads, but also lesions that are deep and painful

PEDIATRIC CASE STUDY

CC/HOPI: A 13-year-old girl complains about “zits’ on her face and shoulders. She has tried over-the-counter benzoyl peroxide for 2 months to no avail, and has stopped eating chocolate and French fries on her mother’s advice. She states that she tries to wash her face three times a day with soap. She has been invited to an upcoming school dance and wants to look her best. She complains about blackheads, but also lesions that are deep and painful.

PMH: non-contributory. No surgical history.

Allergies: None known.

Medications: OTC Benzoyl Peroxide

Immunization status: Up-to-date; has not received Gardasil.

SH: Lives with both parents; denies smoking, drinking or recreational drugs; denies being sexually active.

FH: No known contributory history.

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ROS:

General – No complaints other than skin today.

HEENT – Denies hearing or vision problems; denies nasal drainage or congestion; denies sore throat.

Lungs – Denies shortness of breath; no cough reported

Skin – States that acne seems to worsening over the past 6 months, in spite of OTC management

PE:

VS Wt. 98lbs Ht. 5’1” T 98.6 P 108 R 14

General – 13-year-old female who appears pleasant, in no apparent distress, well developed, well-nourished and with good attention to hygiene and body habitus. Looks older than stated age

HEENT –

• Head: normocephalic

• Eyes: PERRLA.

• Ears: left and right canals without redness or swelling.

• Nose: no drainage noted

• Throat: tonsils +1 bilaterally with no erythema or exudate.

Neck – negative anterior and posterior cervical and occipital lymph nodes.

Cardiac – RRR, normal S1/S2; no murmurs appreciated.

Respiratory – CTAB

Skin – Examination of scalp shows no abnormalities. Hair growth and distribution is normal. Inspection of skin outside of affected area reveals no abnormalities. Palpation of skin shows no abnormalities. Keratotic papules, open and closed comedonesnoted across forehead, lower cheeks, chin, shoulders and back, with mild redness over all.

DIAGNOSIS: Acne vulgaris

The differential diagnosis for acne includes:

?Adenoma sebaceum

?Candidiasis

?Eosinophilic folliculitis

?Erythema toxicum neonatorum

?Keratosis pilaris

?Milia

?Miliaria

?Pityrosporum folliculitis

?Rosacea

?Sebaceous hyperplasia

No chart necessary. I will add differential rule out chart

sources can include uptodate.com, epocrates, lexicomp, the textbook, etc.

The textbook information:

Primary care pediatrics for the nurse practitioner : a practical approach / [edited by] Theresa Kyle.

Description: New York, NY : Springer Publishing Company, LLC, 2021. | Includes bibliographical references and index.

Identifiers: LCCN 2021012452 | ISBN 9780826140944 (paperback) | ISBN 9780826140951 (ebook)

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