Case Study on Differential Diagnosis of Generalized Skin Rashes

This case study presents a differential diagnosis of a generalized skin rash, initially appearing as irritated contact dermatitis. The analysis explores atopic dermatitis and Tinea corporis as possible diagnoses, but ultimately concludes with nummular dermatitis (discoid eczema) based on the patient's symptoms, including red, well-defined, non-itchy, and dry lesions. The study details the etiology of nummular dermatitis, typically a hypersensitivity reaction or bacterial infection, and suggests treatment options such as moisturizers, topical corticosteroids, and antihistamines if infection occurs. The case emphasizes the importance of careful assessment in diagnosing skin rashes to avoid complications from misdiagnosis.

Running head: DIFFERENTIAL DIAGNOSIS OF RASHES
Differential diagnosis of rashes
Names of the student:
Name of the university:
Author note:

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Table of Contents
Introduction: 2
Differential diagnosis: 2
Treatment and etiology: 3
Conclusion: 4
References: 5

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Introduction:
There are many health care adversities that lead to adverse consequences just due to the fact
that the early signs of them go unnoticed by the patient and their family members as well. Rashes
can be considered as one of the most commonly neglected and generalized symptoms, and along
with that, diagnosis of the rash symptoms are also is very complicated (Baron, Cohen & Archer,
2012). This assignment will attempt to describe the differential diagnosis of a generalized skin
rash and will arrive at the final diagnosis based on descriptive, symptomatic and etiological
analysis.
Differential diagnosis:
Rash can be very simply defined as any abnormality of the human skin, it is mostly localized
and can even be spread throughout the body, depending on the severity and the kind of the
infection. One of the major reasons behind the rashes being so difficult to accurately diagnose
can be the confusing and similar manifestation of the early symptoms. In the differential
diagnostic analysis assignment, the patient presented with a generalized skin rash which seemed
a irritated contact dermatitis in the first glance (Pugliarello et al., 2011). However in order for the
diagnosis to be effective and accurate, comprehensive assessment is required. The differential
diagnosis of the disease mainly points out at atopic dermatitis, although the other possibility in
this case that needs to be mentioned is the Tinea corporis.
The signs and symptoms of atopic dermatitis in the very early stages begin with red and itchy
blotches on the skin. Now it has to be mentioned that the physical appearance of Tinea corporis
is also very same with red blotchy patches on the skin (Budihardja, Freund & Mayser, 2010).
However there are significant differences in the shape and location of the process by which

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differential diagnosis can be performed between Eczema and Tinea corporis. In case of the
differential diagnosis the difference between both of the rashes need to be understood very
clearly. First and foremost it has to be mentioned that Tinea corporis is a fungal infection that is
caused by dermatophytosis. Additionally, in this case the skin lesion that appears on the body has
a irregular margin that gives the last appearance of a raised ring surrounded by red skin. On the
other hand in case of Eczema it is an allergic reaction that develops on the epidermis due to
contact with an irritating agent.
In this case the patient appeared in a series of red blotches round shaped lesions on her neck
with scaly and blotchy outer imagine which was moral is well defined. Hence, up to this point,
diagnosis of both Tinea corporis and discoid eczema are valid (Deleuran & Vestergaard, 2014).
Here, discoid Eczema was popularly known as nummular dermatitis is an oval shaped insulation
that is generally caused by contact with irritant but can also have a bacterial origin due to an
infection with Staphylococcus aureus.
Elaborating more on the symptoms, the legends that the patient was exhibiting where red in
color and where completely well defined and the edges are blistered or trusted in terms of
surface. Now the main difference between nummular dermatitis and Tinea corporis is the fact
that the former is mostly non itchy and dry in appearance whereas Tinea corporis is very itchy
and usually in moist skin (Kawachi et al., 2010). In this case the patient did not face any serious
itching and the lesions were also dry scaly. Hence the final diagnosis is nummular dermatitis.
Treatment and etiology:
Nummular dermatitis is a fairly common occurrence, mostly seen in the middle age. It
generally develops by a hypersensitivity reaction to a contact allergen but can soon be infected

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secondarily by bacteria as well. The pathology of the disease is characterized by papules or
papulovesicles that develop into coin sized oval patches. The histological transitions in the
lesions generally depend on the severity and tenacity of the lesions. The treatment for nummular
dermatitis is basically keeping the skin optimally moisturized, skin soothing lotions and creams
can help with the scaling of the skin. However, as the condition of the patient had flared up,
administration of topical corticosteroid will be needed. Topical steroids will calm the spread and
will heal the abraded skin. Emollients can also be applied in case of further complications. If the
lesions become infected the patient might need antihistamine (Berke, Singh & Guralnick, 2012).
Conclusion:
On a concluding note, it can be mentioned that rashes might seem very insignificant and
hence it is by far the most ignored health concern among all age groups. However, lack of proper
care can lead to many complications and as diagnosis is difficult for the skin rashes at most
times, the condition can worsen very quickly. Although, by the virtue of differential diagnostic
procedure and comprehensive assessment, easy and quick diagnosis has become an easy pursuit.

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References:
Baron, S. E., Cohen, S. N., & Archer, C. B. (2012). Guidance on the diagnosis and clinical
management of atopic eczema. Clinical and experimental dermatology, 37(s1), 7-12.
Berke, R., Singh, A., & Guralnick, M. (2012). Atopic dermatitis: an overview. Am Fam
Physician, 86(1), 35-42.
Budihardja, D., Freund, V., & Mayser, P. (2010). Widespread erosive tinea corporis by
Arthroderma benhamiae in a renal transplant recipient: case report. Mycoses, 53(6), 530-
532.
Deleuran, M., & Vestergaard, C. (2014). Clinical heterogeneity and differential diagnosis of
atopic dermatitis. British Journal of Dermatology, 170(s1), 2-6.
Kawachi, Y., Ikegami, M., Takase, T., & Otsuka, F. (2010). Chronically recurrent and
disseminated tinea faciei/corporis—autoinoculation from asymptomatic tinea capitis
carriage. Pediatric dermatology, 27(5), 527-528.
Pugliarello, S., Cozzi, A., Gisondi, P., & Girolomoni, G. (2011). Phenotypes of atopic
dermatitis. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 9(1), 12-20.